含糖软饮料会增加冠心病、心血管死亡和过早死亡的风险（例如每天两份或以上：女性冠心病增加35%；心血管死亡率增加31%，总死亡率增加21%）。
原始表述
متابعة 88 ألف ممرضة لمدة 24 عاماً ... أظهرت أن شرب علبتين أو أكثر يومياً يرفع خطر أمراض القلب التاجية لدى النساء بنسبة 35%. والأخطر دراسة Circulation عام 2019 على أكثر من 118 ألف بالغ تابعتهم 34 عاماً: علبتان يومياً ترفعان الوفاة بأمراض القلب 31% والوفاة الكلية 21%.
按来源为原话. 译文由本项目提供；以阿拉伯语原文为准。
译文
含糖软饮料会增加冠心病、心血管死亡和过早死亡的风险（例如每天两份或以上：女性冠心病增加35%；心血管死亡率增加31%，总死亡率增加21%）。
出处
- 来源状态
- 档案网站编辑
- 归属
- Archive editors (study selection and narrative are the archive's, not necessarily Elawady's)
- 出处
- https://eltayebat.com/rule/soda/
- 归属的不确定性
- The archive homepage states that the forbidden-food section is supported by research 'independently of Dr. Diaa's words'. No evidence was found that Elawady himself cited these studies.
- 所声称的机制
Weight gain, dyslipidaemia, inflammation, blood pressure.
- 所声称的健康影响
Coronary heart disease, stroke, cardiovascular and total mortality.
- 涉及人群
Adults
- Elawady 设定的地域限制
none found
科学评估
基本正确 – 核心内容正确，但有局限或细微不准确之处。
证据确定性: 中 – 进一步研究仍可能影响该评估。
1. 说法是什么？
Sugary sodas raise heart disease, stroke and premature death.
2. 哪些内容可证实是正确的？
The figures are reported correctly: Fung 2009 (A-SOD-15) RR 1.35 (1.07-1.69) for >=2 servings/day; Malik 2019 (A-SOD-05) HR 1.21 total and 1.31 CVD mortality; de Koning 2012 (A-SOD-14) RR 1.20 for CHD; Chen 2010 (A-SOD-18): 1 serving/day less was associated with 1.8 mmHg lower systolic BP; Yang 2014 (A-SOD-16): higher added-sugar intake associated with CVD mortality. A dose-response meta-analysis (Zhang 2021, I-SOD-120) confirms higher all-cause and CVD mortality (HR 1.08 per daily serving).
3. 哪些内容是错误或夸大的？
Causal language ('raises') is somewhat stronger than the observational evidence allows. The highlighted single-cohort figures (+31%, +35%) are larger than the pooled estimate (about +8% per daily serving, roughly +17% at two servings). The European EPIC estimate is smaller: in EPIC (A-SOD-17), SSB were associated with all-cause mortality (HR 1.08, 1.01-1.16) and digestive-disease deaths, but not with circulatory-disease deaths (>=2 glasses/day HR 1.11, 0.95-1.30); the circulatory signal in EPIC came from artificially sweetened drinks. The AHA statement (A-SOD-11) concerns children and cardiovascular risk factors, not heart disease or death in adults.
4. 哪些内容仍不明确？
How much of the association is causal and independent of overall diet and lifestyle.
5. 哪些研究支持该说法？
I-SOD-120 (dose-response meta-analysis, NutriGrade high), A-SOD-05, A-SOD-14, A-SOD-15, A-SOD-16, A-SOD-18, A-SOD-23, I-SUG-02; EFSA 2022 (I-SUG-03) rates the certainty of a positive causal relationship between SSB intake and CVD as high (>75-100% probability), with the caveat that attribution to the sugar fraction is more questionable for CVD; A-SOD-11 (indirect: children, risk factors); A-SOD-17 (all-cause mortality only).
6. 哪些研究与该说法相矛盾？
No contradicting cohort evidence found; limitations are confounding and self-reported intake.
7. 对德国和欧洲而言情况如何？
The WHO guideline (2015) on free sugars and EFSA's 2022 opinion (intake of added and free sugars 'as low as possible') apply in Germany and the EU; the European EPIC cohort (A-SOD-17) found associations in 10 European countries including Germany.
8. 关于埃及的已知情况是什么？
Sugar-sweetened soft drinks are widely sold in Egypt. No Egypt-specific study was reviewed for this claim; the physiological mechanisms and cohort findings are not known to differ by country, but absolute risks depend on local consumption and disease rates.
9. 合理的实际结论是什么？
限制含糖饮料是心血管疾病预防中合理的一部分；但它不能取代对已有危险因素的治疗。
评估详情
- 证据确定性的依据
Prospective cohorts show consistent, dose-related associations; a dose-response meta-analysis of about 0.9-1 million participants (I-SOD-120) found 8% higher all-cause and cardiovascular mortality per daily serving and rated this evidence high (NutriGrade); EFSA 2022 (I-SUG-03) judged a causal SSB-CVD relationship highly likely; RCTs show effects of SSB on the mediating risk factors (weight, blood pressure). GRADE starts low for observational data and is upgraded for dose-response; residual confounding remains and there are no RCTs with hard endpoints.
- 来源质量
Numbers cited by the archive match the abstracts. Causal verbs ('raises') overstate observational evidence.
- 地区可推广性
High; EPIC (10 European countries) found a weaker but positive association for sugar-sweetened soft drinks (HR 1.08 for >=2 glasses/day).
- 个体例外情况
Absolute risk differences are modest; e.g., cohort HRs of 1.2-1.35 for daily drinkers.
- 说法的地域范围
- 普遍性（生物学/医学）
- 最近审核
- 2026年10月26日 初步
科学证据详解
有充分科学证据支持 – 该说法与一致的高质量证据相符。
研究问题: Do sugar-sweetened soft drinks increase the risk of coronary heart disease, cardiovascular death and total mortality, and are the archive's figures accurate?
研究问题详解 (PECO)
- 人群
- Adults
- 干预或暴露
- SSB
- 对照
- Low or no intake
- 地域范围
- universal; magnitude varies (smaller in EPIC)
- 结局指标
- CHD
- CVD mortality
- All-cause mortality
研究结果按作者报告呈现。我们的评估见下文。
哪些证据支持该说法？
Sugary and diet drinks linked to higher death rates
Dose-response meta-analysis (~0.9-1 million participants): each daily SSB serving associated with 8% higher all-cause and CVD mortality; NutriGrade high.
- 实际结果
- HR 1.08 (1.04-1.12) for both.
- 方法学质量
- high
- 相关性
- direct
- 局限
- Observational.
Sugary and diet drinks and death in 118,000 US adults
Malik VS et al.. Circulation 2019 · PMID 30882235 · DOI 10.1161/CIRCULATIONAHA.118.037401 队列研究全文，含结构化偏倚风险评估Malik 2019 (NHS/HPFS): >=2 SSB/day CVD mortality HR 1.31 (1.15-1.50).
- 实际结果
- HR 1.31.
- 方法学质量
- high
- 相关性
- direct
- 局限
- US health professionals.
EFSA: how much sugar is safe?
EFSA 2022: high certainty of causal SSB-CVD relationship.
- 实际结果
- Causal certainty high (>75-100%).
- 方法学质量
- high
- 相关性
- direct
- 局限
- Sugar-fraction attribution less certain.
哪些证据不支持该说法？
Soft drinks and death in 10 European countries
Mullee A et al.. JAMA Intern Med 2019 · PMID 31479109 · DOI 10.1001/jamainternmed.2019.2478 队列研究全文，含结构化偏倚风险评估EPIC (10 European countries): SSB not significantly associated with circulatory deaths.
- 实际结果
- SSB >=2/day circulatory HR 1.11 (0.95-1.30).
- 方法学质量
- high
- 相关性
- direct
- 局限
- Mixed; ASB associated.
总体证据说明了什么？
基于上述研究的编辑评估——其本身并非研究结果。
哪种观点有更好的证据支持？
SSB are consistently associated with more CHD and earlier death; pooled effect sizes are smaller than the single-cohort figures the archive quotes.
为什么有些研究权重更大
Dose-response meta-analysis and EFSA's causal assessment outweigh the null circulatory result in EPIC.
因果关系是否已确立？ 很可能 Dose-response; mediation through weight, blood pressure and diabetes shown in RCTs on risk factors.
仍存在的不确定性
Magnitude; residual confounding.
合理的结论
Well supported in direction; magnitude modest.
为什么研究结果看起来互相矛盾？
EPIC found no significant SSB-circulatory death association while US cohorts did; lower SSB intakes in Europe, different adjustment and beverage definitions may explain it.
这是否取决于国家？
- 一般生物学效应
- Universal.
- 实际监测数据
- Modelled MENA SSB-attributable CVD incidence was the highest of all regions (815 per million adults, I-SOD-127).
足以改变结论的地区差异没有可靠数据支持。
统计复核
- Log-symmetry; extrapolation to 2 servings – HR 1.08 symmetric; ~1.17 at 2/day vs archive's 1.31-1.35 已重新计算
总体证据的确定性（GRADE，简化版）
- 主要结局
- CVD mortality with SSB
- 起始等级
- 低（观察性研究）
- 降级理由
- risk of bias (residual confounding)
- 升级理由
- dose-response
- 结果
- 中
由单名审查者参照 GRADE 方法进行的简化评估；并非正式的 GRADE 专家组评估。GRADE 评价的是针对某一结局的整体证据，而非单项研究。
已核查的临床指南和官方声明
- WHO: Guideline: sugars intake for adults and children (2015), publication page and news release (I-SUG-05) (2015) · 原始文献
Reduce free sugars to <10% of energy (strong); further reduction to <5% (~25 g) conditional. Free sugars include sugars added by manufacturer, cook or consumer and sugars naturally present in honey, syrups, fruit juices and concentrates (news release https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children, fetched 2026-10-26). - ADA: 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2026 (Diabetes Care 2026;49 Suppl 1:S89-S131; I-INTC-03) (2026) · 原始文献
Rec. 5.14: minimise sugar-sweetened beverages, sweets, refined grains, processed and ultra-processed foods. Rec. 5.21: encourage water over other beverages (A). Rec. 5.22: nonnutritive sweeteners can replace sugar-sweetened products if consumed in moderation and for the short term (B). Rec. 5.25: replace sugar-sweetened beverages (including any juices) with water or low/no-calorie beverages and minimise foods with added sugar (B).
检索策略
本次审查的文献检索记录（检索式采用原数据库语法）。
| 数据库 | 日期 | 检索式 | 检索目标 | 命中数 | 纳入数 |
|---|---|---|---|---|---|
| Europe PMC | 2026年10月26日 | ("sugar-sweetened beverages") AND ("cardiovascular disease" OR "coronary heart disease") AND ("meta-analysis") AND ("prospective cohort") AND PUB_YEAR:[2020 TO 2026] | 双向 | 927 | |
| PubMed | 2026年10月26日 | (sugar-sweetened beverages[ti]) AND (cardiovascular[ti] OR coronary[ti] OR mortality[ti]) AND meta-analysis[pt] | 双向 | 4 |
待解决的问题
Causal effect size.
核查深度如何？
11 项相关研究：6 项核查了全文（其中 6 项进行了结构化偏倚风险评估），5 项基于摘要核查，0 项仅核查了文献信息。 尚未进行由两名独立审查者完成的正式评估，也尚未进行独立的人类专家审核。
最近一次科学审核: 2026年10月26日
评定结论的变更历史
- 2026年10月25日 · 第 1 阶段 · 初始评估: 基本正确 (低)
- 2026年10月26日 · 第 4 阶段（系统证据审查） · 评定结论已更改: 基本正确 (低) → 基本正确 (中)
Certainty raised to moderate: a dose-response meta-analysis rated the SSB-mortality evidence high (NutriGrade), EFSA judged the SSB-CVD causal relationship highly likely, and RCTs show effects on the mediating risk factors; GRADE upgrade for dose-response from a low start.
新来源: I-SOD-120
通俗解释
在许多大型长期研究中，每天喝含糖饮料的人心脏病更多，死亡也更早。该档案网站对这些数字的引用是正确的，不过跨研究的汇总结果显示增幅较小（每天每喝一份饮料，死亡风险约高8%）。由于这些研究是观察人们的行为，而不是随机分配饮料，其他生活习惯可能解释了这种关联的一部分。尽管如此，这些发现是一致的，随饮用量增加而增强，并且与含糖饮料对体重和血压的已知影响相符。
与该说法相关的研究
支持该说法的研究 (10)
-
Sugary and diet drinks and death in 118,000 US adults
Malik VS et al.. Circulation 2019 · PMID 30882235 · DOI 10.1161/CIRCULATIONAHA.118.037401队列研究被 Tayebat 档案网站引用全文，含结构化偏倚风险评估★ 关键研究Two or more sugary drinks a day: 21% higher death risk; diet drinks linked only at the highest intake and only in women.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Are SSB and ASB associated with total and cause-specific mortality?
- 研究是如何开展的？
Two prospective cohorts (HPFS 1986-2014; NHS 1980-2014); repeated FFQs; Cox models.
- 研究了多少人、动物或样本？
118,363 (37,716 men; 80,647 women); 36,436 deaths; Health professionals and nurses free of chronic disease at baseline
- 实际发现了什么？
SSB >=2/d vs <1/mo: total mortality HR 1.21 (1.13-1.28); CVD mortality 1.31 (1.15-1.50); cancer mortality 1.16 (1.04-1.29). ASB: only highest category, total 1.04 (1.02-1.12), CVD 1.13 (1.02-1.25); association in NHS but not HPFS (P interaction 0.01); not with cancer mortality.
- 观察到的效应有多大？
HR 1.21 total, 1.31 CVD (SSB)
- 研究结果对日常生活意味着什么？
Regular sugary drinks are linked with earlier death.
- 该研究有哪些局限？
Health professionals (limited generalisability); Observational design; residual confounding possible; Self-reported dietary intake
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
That diet drinks are as harmful as sugary ones; causality
-
Added sugar and children's heart health
Vos MB et al.. Circulation 2017 · PMID 27550974 · DOI 10.1161/CIR.0000000000000439指南 / 立场声明被 Tayebat 档案网站引用全文，含结构化偏倚风险评估The AHA recommends no more than about 6 teaspoons of added sugar a day for children and none under age 2.
该研究是否支持这一具体说法？ 是 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
What are the cardiovascular effects of added sugars in children?
- 研究是如何开展的？
Scientific statement reviewing and grading evidence.
- 研究了多少人、动物或样本？
Not applicable; Children
- 实际发现了什么？
Strong evidence supports association of added sugars with increased CVD risk in children via energy intake, adiposity and dyslipidaemia; recommended <=25 g/day (~6 teaspoons) and avoidance under age 2.
- 观察到的效应有多大？
<=25 g/day recommended
- 研究结果对日常生活意味着什么？
Applies to all added sugars, including honey and sweets.
- 该研究有哪些局限？
Narrative expert review, not a systematic review; children and risk factors only; the 25 g/day limit is based on low-level evidence (Level C, expert extrapolation); evidence for insulin resistance and fatty liver is inconclusive.
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
Moderate (US guidance; WHO similar).
- 从该研究中明确不能得出什么结论？
It cannot show how much added sugar is safe, nor that added sugar causes heart attacks or strokes in children; it concerns risk factors such as weight and blood lipids.
-
Sweetened drinks and heart disease in men
de Koning L et al.. Circulation 2012 · PMID 22412070 · DOI 10.1161/CIRCULATIONAHA.111.067017队列研究被 Tayebat 档案网站引用已核查摘要Men with highest sugary-drink intake had 20% more heart disease; diet drinks showed no link.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Are SSB and ASB associated with CHD and biomarkers?
- 研究是如何开展的？
Prospective cohort (HPFS) 22 years.
- 研究了多少人、动物或样本？
42,883; 3,683 CHD cases; Male health professionals
- 实际发现了什么？
Top vs bottom SSB quartile RR 1.20 (1.09-1.33); ASB RR 1.02 (0.93-1.12); SSB associated with higher TG, CRP, IL-6, TNF receptors and lower HDL, Lp(a), leptin.
- 观察到的效应有多大？
RR 1.20 (SSB); 1.02 (ASB)
- 研究结果对日常生活意味着什么？
Sugary, not diet, drinks linked to heart disease.
- 该研究有哪些局限？
Observational design; residual confounding possible; Self-reported dietary intake
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
Causation.
-
Sugary drinks and heart disease in women
Fung TT et al.. Am J Clin Nutr 2009 · PMID 19211821 · DOI 10.3945/ajcn.2008.27140队列研究被 Tayebat 档案网站引用已核查摘要Two or more sugary drinks a day: 35% higher heart disease risk; diet drinks not linked.
该研究是否支持这一具体说法？ 是 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Is SSB consumption associated with CHD in women?
- 研究是如何开展的？
Prospective cohort (NHS) 1980-2004.
- 研究了多少人、动物或样本？
88,520; 3,105 CHD cases; Women aged 34-59 without CHD, stroke, diabetes
- 实际发现了什么？
RRs 1.0, 0.96, 1.04, 1.23 (1.06-1.43) for 1/d and 1.35 (1.07-1.69) for >=2/d (P trend <0.001); attenuated but significant after BMI, energy and diabetes adjustment; ASB not associated.
- 观察到的效应有多大？
RR 1.35 (1.07-1.69)
- 研究结果对日常生活意味着什么？
Sugary drinks linked to heart disease.
- 该研究有哪些局限？
Observational design; residual confounding possible; Self-reported dietary intake
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
Causation.
-
Added sugar and heart deaths in the US
Yang Q et al.. JAMA Intern Med 2014 · PMID 24493081 · DOI 10.1001/jamainternmed.2013.13563队列研究被 Tayebat 档案网站引用全文，含结构化偏倚风险评估People getting 25% or more of calories from added sugar had nearly three times the CVD death risk of those under 10%.
该研究是否支持这一具体说法？ 是 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Is % energy from added sugar associated with CVD mortality?
- 研究是如何开展的？
NHANES trend analysis and NHANES III linked mortality cohort.
- 研究了多少人、动物或样本？
31,147 (trends); 11,733 (cohort); 831 CVD deaths; US adults (nationally representative)
- 实际发现了什么？
Fully adjusted HRs across quintiles 1.00, 1.07, 1.18, 1.38, 2.03 (1.26-3.27); 10-24.9% vs <10%: HR 1.30 (1.09-1.55); >=25%: 2.75 (1.40-5.42). Most adults (71.4%) consumed >=10% from added sugar.
- 观察到的效应有多大？
Highest vs lowest fifth of added-sugar intake: HR 2.03 (1.26-3.27); >=25% vs <10% of calories: HR 2.75 (1.40-5.42); about 1 extra CVD death per 22 people over 15 years in the highest fifth.
- 研究结果对日常生活意味着什么？
Total added sugar matters, from any source.
- 该研究有哪些局限？
Observational; diet measured once by 24-hour recall at baseline; possible residual confounding; no association seen in non-Hispanic black participants; total mortality not significantly raised.
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
Moderate.
- 从该研究中明确不能得出什么结论？
Causation.
-
Cutting sugary drinks and blood pressure
Chen L et al.. Circulation 2010 · PMID 20497980 · DOI 10.1161/CIRCULATIONAHA.109.911164队列研究被 Tayebat 档案网站引用已核查摘要One sugary drink less per day was linked with about 1.8 mmHg lower systolic BP.
该研究是否支持这一具体说法？ 是 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Are changes in SSB intake associated with BP changes?
- 研究是如何开展的？
Prospective analysis within an 18-month behavioural intervention trial (PREMIER).
- 研究了多少人、动物或样本？
810; Adults with elevated BP (mean 134.9/84.8)
- 实际发现了什么？
1 serving/day reduction associated with -1.8 mmHg SBP (1.2-2.4) and -1.1 mmHg DBP (0.7-1.4); significant after weight-change adjustment; no association for diet beverages or caffeine.
- 观察到的效应有多大？
-1.8 mmHg SBP per serving reduced
- 研究结果对日常生活意味着什么？
Fewer sugary drinks may slightly lower BP.
- 该研究有哪些局限？
Observational analysis within trial; Self-reported intake
- 它对 Elawady 的具体说法说明了什么？
Supports C-SOD-03.
- 研究结果是否适用于德国和欧洲？
Moderate.
- 从该研究中明确不能得出什么结论？
Causation.
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Sweetened drinks dose-response
Qin P et al.. Eur J Epidemiol 2020 · PMID 32529512 · DOI 10.1007/s10654-020-00655-yMeta分析被 Tayebat 档案网站引用已核查摘要Each extra 250 mL/day of sugary drinks was linked with 12-19% higher risks of obesity and diabetes; diet drinks showed similar links.
该研究是否支持这一具体说法？ 是 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Dose-response of SSB/ASB with obesity, T2D, hypertension, mortality.
- 研究是如何开展的？
Dose-response meta-analysis of prospective cohorts.
- 研究了多少人、动物或样本？
39 articles; Adults
- 实际发现了什么？
Per 250 mL/day SSB vs ASB: obesity RR 1.12 vs 1.21; T2D 1.19 vs 1.15; hypertension 1.10 vs 1.08; all-cause mortality 1.04 vs 1.06 (with I2 up to 92.6%).
- 观察到的效应有多大？
T2D RR 1.19 per 250 mL/d (SSB)
- 研究结果对日常生活意味着什么？
More sweetened drinks, more risk in observational data.
- 该研究有哪些局限？
High heterogeneity; Cohorts only; Reverse causation for ASB
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
Causation, especially for diet drinks.
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Sugar and health: umbrella review
Huang Y et al.. BMJ 2023 · PMID 37019448 · DOI 10.1136/bmj-2022-071609系统综述独立交叉核查全文，含结构化偏倚风险评估★ 关键研究Across 73 meta-analyses, high sugar intake was linked to 45 adverse outcomes; authors advise under 25 g/day of added sugar.
该研究是否支持这一具体说法？ 否 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Quality and validity of evidence on sugar and health outcomes.
- 研究是如何开展的？
Umbrella review of 73 meta-analyses.
- 研究了多少人、动物或样本？
73 meta-analyses; 83 outcomes; Humans free of acute/chronic disease
- 实际发现了什么？
Significant harmful associations with 45 outcomes; moderate-quality: SSB and body weight, added sugars and ectopic fat; low-quality: +4% gout per SSB serving/week, +17% CHD and +4% all-cause mortality per 250 mL/day SSB; recommends free/added sugars <25 g/day and SSB <1 serving/week.
- 观察到的效应有多大？
CHD +17% per 250 mL/d SSB
- 研究结果对日常生活意味着什么？
High sugar intake is more harmful than beneficial.
- 该研究有哪些局限？
Most evidence is observational and of low certainty, and concerns sugary drinks rather than sugar in foods; sucrose intake was even linked to slightly lower diabetes risk in some cohorts; recommendations go beyond the strength of the evidence.
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
It cannot show that sugar in any form or small amount is harmful, nor precise effect sizes; it does not cover honey, fruit or sugars eaten in solid foods well.
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EFSA: how much sugar is safe?
EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074风险评估独立交叉核查全文，含结构化偏倚风险评估★ 关键研究EFSA found no safe intake level and advises keeping added and free sugars as low as possible.
该研究是否支持这一具体说法？ 否 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Can a UL or safe level for dietary sugars be set?
- 研究是如何开展的？
Regulatory scientific opinion with systematic reviews.
- 研究了多少人、动物或样本？
Not applicable; General population
- 实际发现了什么？
Sugars are a well-established hazard for caries; RCTs on surrogate endpoints show causal positive relationship of added/free sugars with obesity and dyslipidaemia (moderate certainty), NAFLD and T2D (low), hypertension (very low); no safe level identified; intake of added and free sugars should be as low as possible in a nutritionally adequate diet.
- 观察到的效应有多大？
Not applicable
- 研究结果对日常生活意味着什么？
Applies to sugar, honey and syrups alike.
- 该研究有哪些局限？
Trials looked at markers (weight, liver fat, blood fats) rather than diseases; cohort studies mostly compared sugar with other calories at equal total energy; few data below 10% of energy.
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
Directly applicable in EU/Germany.
- 从该研究中明确不能得出什么结论？
It cannot name a safe daily amount of sugar; it does not show that sugar is harmful when it does not add extra calories, except for tooth decay.
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Sugary and diet drinks linked to higher death rates
Zhang YB et al.. Adv Nutr 2021 · PMID 33786594 · DOI 10.1093/advances/nmaa110Meta分析独立交叉核查已核查摘要★ 关键研究Pooled cohorts: each daily sugary drink was linked to 8% higher overall and cardiovascular mortality; diet drinks were linked at 1.5 or more per day.
SSB per serving: CVD mortality HR 1.08 (1.04-1.12).
该研究是否支持这一具体说法？ 是 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Pool cohort studies on sweetened drinks and death.
- 研究是如何开展的？
Dose-response meta-analysis.
- 研究了多少人、动物或样本？
About 0.9-1 million participants.
- 实际发现了什么？
Sugary drinks linked to more deaths; diet drinks at higher doses too.
- 观察到的效应有多大？
SSB HR 1.08 per serving.
- 研究结果对日常生活意味着什么？
Fewer sugary drinks is consistent with longer life; diet drinks are not clearly protective.
- 该研究有哪些局限？
Observational; reverse causation for diet drinks.
- 它对 Elawady 的具体说法说明了什么？
Supports the direction of both claims.
- 研究结果是否适用于德国和欧洲？
Applicable.
- 从该研究中明确不能得出什么结论？
Cannot prove causation.
该组中没有被标记为关键研究的研究。
与该说法相矛盾或限制该说法的研究 (0)
该组中没有研究。
结果不一或不明确的研究 (1)
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Soft drinks and death in 10 European countries
Mullee A et al.. JAMA Intern Med 2019 · PMID 31479109 · DOI 10.1001/jamainternmed.2019.2478队列研究被 Tayebat 档案网站引用全文，含结构化偏倚风险评估★ 关键研究Two or more soft drinks a day were linked with higher death rates; for diet drinks the link was even stronger, which may partly reflect who chooses diet drinks.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Are total, SSB and ASB soft drinks associated with total and cause-specific mortality?
- 研究是如何开展的？
Population-based prospective cohort (EPIC), 10 European countries.
- 研究了多少人、动物或样本？
451,743; 41,693 deaths; Adults without cancer, heart disease, stroke or diabetes
- 实际发现了什么？
>=2 glasses/day vs <1/month: total soft drinks HR 1.17 (1.11-1.22); SSB 1.08 (1.01-1.16); ASB 1.26 (1.16-1.35); ASB and circulatory deaths 1.52 (1.30-1.78); SSB >=1/day and digestive deaths 1.59 (1.24-2.05).
- 观察到的效应有多大？
HR 1.17 total; 1.08 SSB; 1.26 ASB
- 研究结果对日常生活意味着什么？
Soft drinks are linked with earlier death in Europe.
- 该研究有哪些局限？
Observational; drink intake asked only once at baseline; residual confounding; diet-drink results may reflect people at risk switching to diet drinks; sugar-sweetened drinks were not linked to heart or circulatory deaths in this cohort.
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
High (includes Germany).
- 从该研究中明确不能得出什么结论？
It cannot prove that soft drinks cause death, nor that sugary soft drinks raise cardiovascular death in Europeans (that association was not significant here).
该组中没有被标记为关键研究的研究。
地区背景
德国 / 欧盟
The WHO guideline (2015) on free sugars and EFSA's 2022 opinion (intake of added and free sugars 'as low as possible') apply in Germany and the EU; the European EPIC cohort (A-SOD-17) found associations in 10 European countries including Germany.
埃及
Sugar-sweetened soft drinks are widely sold in Egypt. No Egypt-specific study was reviewed for this claim; the physiological mechanisms and cohort findings are not known to differ by country, but absolute risks depend on local consumption and disease rates.
在我的国家适用什么？
一般科学评估
基本正确 含糖饮料与更多的心脏病和更早的死亡之间存在一致的关联，证据确定性为中；该档案网站引用的单项研究数字大于汇总估计值。
以下食品安全领域与该说法相关：
- 添加剂与加工
蜂蜜、糖、甜食
选择一个国家，查看针对该国已核查的信息。
局限：法律规则描述的是允许什么，而不是每一种食品实际含有什么。检测数据来自样本，只有结合其方法细节才有意义。
参考文献
- Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults.. Malik VS et al.. Circulation 2019 · PMID 30882235 · DOI 10.1161/CIRCULATIONAHA.118.037401
- Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association.. Vos MB et al.. Circulation 2017 · PMID 27550974 · DOI 10.1161/CIR.0000000000000439
- Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men.. de Koning L et al.. Circulation 2012 · PMID 22412070 · DOI 10.1161/CIRCULATIONAHA.111.067017
- Sweetened beverage consumption and risk of coronary heart disease in women.. Fung TT et al.. Am J Clin Nutr 2009 · PMID 19211821 · DOI 10.3945/ajcn.2008.27140
- Added sugar intake and cardiovascular diseases mortality among US adults.. Yang Q et al.. JAMA Intern Med 2014 · PMID 24493081 · DOI 10.1001/jamainternmed.2013.13563
- Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure: a prospective study among United States adults.. Chen L et al.. Circulation 2010 · PMID 20497980 · DOI 10.1161/CIRCULATIONAHA.109.911164
- Sugar and artificially sweetened beverages and risk of obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies.. Qin P et al.. Eur J Epidemiol 2020 · PMID 32529512 · DOI 10.1007/s10654-020-00655-y
- Dietary sugar consumption and health: umbrella review.. Huang Y et al.. BMJ 2023 · PMID 37019448 · DOI 10.1136/bmj-2022-071609
- Tolerable upper intake level for dietary sugars.. EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074
- Association of Consumption of Sugar-Sweetened Beverages or Artificially Sweetened Beverages with Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.. Zhang YB et al.. Adv Nutr 2021 · PMID 33786594 · DOI 10.1093/advances/nmaa110
- Association Between Soft Drink Consumption and Mortality in 10 European Countries.. Mullee A et al.. JAMA Intern Med 2019 · PMID 31479109 · DOI 10.1001/jamainternmed.2019.2478