无糖汽水并不是含糖汽水的安全替代品：人工甜味饮料与较高的死亡率相关，尤其是循环系统疾病导致的死亡。
原始表述
ومن يتصوَّر أن الحل هو التحوُّل إلى "الدايت" يصدمه أهم رقم في الملف كله ... والقاعدة في نظام الطيبات بسيطة: لا الصودا السكرية، ولا الدايت.
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
无糖汽水并不是含糖汽水的安全替代品：人工甜味饮料与较高的死亡率相关，尤其是循环系统疾病导致的死亡。
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
Artificial sweeteners; (Elawady: carbonation).
- 所声称的健康影响
Mortality, stroke, diabetes.
- 涉及人群
Adults
- Elawady 设定的地域限制
none found
来源版本存在差异
- 来源状态
- 视频转录文本（本人原话）
- 归属
- Elawady (machine transcript)
- 视频
- الجن . آلام العمود الفقري . الحقيقه والسراب (打开来源)
- 发布日期
- 2025年11月26日
- 时间戳
- 无（转录文本不含时间信息）
- 归属的不确定性
- Machine/CC transcript; wording may contain transcription errors.
科学评估
可能正确 – 有一些证据支持该说法，但不足以得出明确判断。
证据确定性: 低 – 进一步研究很可能大幅改变该评估。
1. 说法是什么？
Diet soda is not a healthy substitute; it is associated with death and disease.
2. 哪些内容可证实是正确的？
WHO 2023 (I-SOD-08): NSS do not confer long-term benefit for body fat and 'may' have undesirable effects (T2D, CVD, mortality). Mullee 2019 (A-SOD-17): HR 1.26 total and 1.52 circulatory mortality for >=2 glasses/day of ASB. Imamura 2015: ASB associated with T2D, likely biased.
3. 哪些内容是错误或夸大的？
Associations are probably partly explained by reverse causation and confounding (WHO, Imamura, Malik 2019 note this). Within the archive's own bibliography, ASB were not associated with coronary heart disease (A-SOD-14, A-SOD-15), with gout (A-SOD-06) or with fatty liver (A-SOD-12). Malik 2019 (A-SOD-05) found ASB associations only in the highest category and only in women, which disappeared after adjustment for intermediate conditions (HR 1.00, 0.94-1.06) and in most sensitivity analyses; the authors attribute them largely to reverse causation, and replacing one daily serving of SSB with ASB was associated with 4% lower total mortality (HR 0.96, 0.94-0.98) and 5% lower CVD mortality (HR 0.95, 0.90-0.99). Imamura 2015 (A-SOD-08) concerns type 2 diabetes, not mortality; its ASB estimate is low certainty and non-significant after publication-bias calibration (RR 1.22, 0.98-1.52). Elawady himself said his objection to sodas is the carbonated water, not the sugar or sweetener (see C-SOD-14), which differs from the archive's reasoning.
4. 哪些内容仍不明确？
True long-term effects of NSS.
5. 哪些研究支持该说法？
6. 哪些研究与该说法相矛盾？
A-SOD-14, A-SOD-15 (no CHD association), A-SOD-05 (ASB association limited to very high intake in women and explained by reverse causation; substitution of ASB for SSB associated with lower mortality).
7. 对德国和欧洲而言情况如何？
Sweeteners are authorised in the EU with ADIs; WHO's recommendation is conditional.
8. 关于埃及的已知情况是什么？
No Egypt-specific data.
9. 合理的实际结论是什么？
水比含糖汽水和无糖汽水都更可取。对于习惯喝含糖汽水的人，一项大型队列研究发现，改喝无糖汽水与略低的死亡率相关（A-SOD-05），但这是观察性研究，长期益处尚未得到证实。
评估详情
- 证据确定性的依据
WHO (2023) conditionally recommends against using non-sugar sweeteners for weight control because long-term benefit was not shown and observational data suggest possible harms, but notes likely confounding. Cohort associations for ASB are inconsistent (positive in EPIC, NHS; null for CHD in HPFS and NHS-CHD analyses).
- 来源质量
- 地区可推广性
High; EPIC includes Germany.
- 个体例外情况
People with diabetes: WHO's NSS recommendation explicitly excludes individuals with pre-existing diabetes.
- 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
过度解读 – 确有真实的发现，但该说法从中引申出的结论超出了数据所能支持的范围（例如把关联当作因果、把动物数据套用到人身上、把小效应说成大效应）。
研究问题: Is diet soda an unsafe alternative to sugary soda, i.e. are artificially sweetened beverages linked to higher (especially circulatory) mortality?
研究问题详解 (PECO)
- 人群
- Adults
- 干预或暴露
- Artificially sweetened beverages
- 对照
- Low intake; SSB; water
- 地域范围
- universal
- 结局指标
- All-cause and circulatory mortality
- Body weight (RCTs)
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: J-shaped ASB association with CVD mortality (HR 1.15 at 2/day, 1.25 at 2.5/day).
- 实际结果
- CVD mortality HR 1.15 (1.08-1.23) at 2/day.
- 方法学质量
- high
- 相关性
- direct
- 局限
- Reverse causation.
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: ASB >=2 glasses/day associated with circulatory death HR 1.52.
- 实际结果
- HR 1.52 (1.30-1.78).
- 方法学质量
- high
- 相关性
- direct
- 局限
- Observational.
Diet drinks linked to several diseases in observational data
Umbrella review: ASB-all-cause mortality association highly suggestive; CVD mortality weak.
- 实际结果
- Credibility classes.
- 方法学质量
- moderate
- 相关性
- direct
- 局限
- Observational.
哪些证据不支持该说法？
Swapping sugary for diet drinks helped weight in trials
McGlynn ND et al.. JAMA Netw Open 2022 · PMID 35285920 · DOI 10.1001/jamanetworkopen.2022.2092 Meta分析已核查摘要新增Network meta-analysis of 17 RCTs: replacing SSB with low/no-calorie drinks reduced weight by about 1 kg without harm.
- 实际结果
- -1.06 kg (-1.71 to -0.41).
- 方法学质量
- high
- 相关性
- direct for intermediate outcomes
- 局限
- Short; industry links of authors.
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: ASB not associated with higher mortality after adjustment (HR ~0.96-0.98).
- 实际结果
- Pooled ASB categories ~0.96-0.98.
- 方法学质量
- high
- 相关性
- direct
- 局限
- US health professionals.
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？
Diet soda is not a proven health benefit and is associated with higher mortality in several cohorts, but RCTs show short-term benefits when it replaces sugary soda, and the cohort associations are likely partly due to reverse causation; water is preferred.
为什么有些研究权重更大
RCTs for intermediate outcomes vs cohorts for mortality; neither is decisive.
因果关系是否已确立？ 尚未确立 Reverse causation and confounding by indication.
仍存在的不确定性
Long-term causal effects.
合理的结论
Partly true; 'not safe' is overstated.
为什么研究结果看起来互相矛盾？
Cohort harm signals vs RCT benefits: different outcomes (mortality vs weight), durations and populations (diet drinks chosen by people with risk factors).
这是否取决于国家？
- 一般生物学效应
- Universal.
- 法律规则
- Sweeteners authorised in EU with ADIs; WHO 2023 conditional recommendation.
足以改变结论的地区差异没有可靠数据支持。
统计复核
- Difference CI symmetry – -1.06 kg symmetric; z -3.2 已重新计算
- ASB dose-response CIs – Log-symmetric at 1.5, 2, 2.5 servings/day 已重新计算
总体证据的确定性（GRADE，简化版）
- 主要结局
- Mortality with ASB
- 起始等级
- 低（观察性研究）
- 降级理由
- risk of bias (reverse causation)
- inconsistency
- 结果
- 低
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: Use of non-sugar sweeteners: WHO guideline (2023), publication page (I-SOD-08) (2023) · 原始文献
Guidance on NSS use to reduce unhealthy weight gain and NCD risk; not based on toxicological safety assessment and not intended to replace JECFA acceptable daily intakes; accompanying news release: recommends against NSS for weight control (conditional). - 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 | (TITLE:"non-sugar sweeteners" OR TITLE:"artificially sweetened beverages" OR TITLE:"artificial sweeteners") AND (mortality OR cardiovascular OR stroke OR dementia) AND (meta-analysis) AND PUB_YEAR:[2019 TO 2026] | 双向 | 63 | |
| PubMed | 2026年10月26日 | McGlynn ND[au] AND sweetened beverages AND JAMA Netw Open[ta] | 反对性证据 | 1 | |
| 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
Long-term RCTs.
核查深度如何？
11 项相关研究：4 项核查了全文（其中 3 项进行了结构化偏倚风险评估），7 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
通俗解释
一些大型研究发现，大量喝无糖汽水的人死亡更多，但另一些研究没有发现其与心脏病的关联。本来就超重或患病的人常常选择无糖饮料，这可能会造成误导性的关联。在一项大型美国研究中，用无糖饮料代替含糖饮料的人死亡风险略低。世界卫生组织（WHO）建议不要依靠甜味剂来控制体重，因为尚未显示出长期益处。白开水是最好的替代品。
与该说法相关的研究
支持该说法的研究 (4)
-
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).
-
WHO on non-sugar sweeteners
World Health Organization. WHO news release 2023指南 / 立场声明独立交叉核查已核查全文★ 关键研究WHO advises not to use sweeteners for weight control, because no long-term benefit was shown; possible harms may be confounded.
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？
Should NSS be used for weight control/NCD risk reduction?
- 研究是如何开展的？
International guideline (news release read in full).
- 研究了多少人、动物或样本？
Not applicable; All people except those with pre-existing diabetes
- 实际发现了什么？
Recommends against NSS to control weight or reduce NCD risk; NSS confer no long-term benefit for body fat; potential undesirable effects (T2D, CVD, mortality) from long-term use; recommendation conditional because observed links might be confounded by baseline characteristics and complicated patterns of NSS use.
- 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？
Water or unsweetened drinks are preferable.
- 该研究有哪些局限？
Conditional; observational evidence for harms
- 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？
Applies globally.
- 从该研究中明确不能得出什么结论？
That sweeteners cause disease.
-
Diet drinks linked to several diseases in observational data
Diaz C et al.. Adv Nutr 2023 · PMID 37187453 · DOI 10.1016/j.advnut.2023.05.010系统综述独立交叉核查已核查摘要★ 关键研究Across many studies, regular diet-drink consumers had more obesity, diabetes, hypertension, heart disease and deaths; stroke and heart-death links were weak.
ASB-all-cause mortality association highly suggestive; CVD mortality weak.
该研究是否支持这一具体说法？ 部分支持 · 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？
Grade the credibility of links between diet drinks and health.
- 研究是如何开展的？
Umbrella review of meta-analyses.
- 研究了多少人、动物或样本？
55 underlying studies.
- 实际发现了什么？
Several associations highly suggestive; stroke and cardiovascular mortality weak.
- 观察到的效应有多大？
Credibility classes, not single effect sizes.
- 研究结果对日常生活意味着什么？
Diet drinks are not proven healthy; causation unclear.
- 该研究有哪些局限？
Observational; reverse causation likely.
- 它对 Elawady 的具体说法说明了什么？
Partly supports 'diet soda is not a safe alternative'; does not support strong stroke effects.
- 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 show that sweeteners cause these diseases.
-
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.
ASB J-shaped association with CVD mortality at >=1.5 servings/day.
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 (4)
-
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.
ASB not associated with CHD or biomarkers.
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.
Artificially sweetened beverages not associated with CHD.
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.
-
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.
ASB association limited to highest category and to women (NHS); authors call for confirmation.
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
-
Swapping sugary for diet drinks helped weight in trials
McGlynn ND et al.. JAMA Netw Open 2022 · PMID 35285920 · DOI 10.1001/jamanetworkopen.2022.2092Meta分析独立交叉核查已核查摘要★ 关键研究In 17 randomised trials, replacing sugary drinks with low- or no-calorie drinks lowered weight by about 1 kg, similar in direction to water.
RCTs show small benefit when diet drinks replace sugary drinks.
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？
Compare diet drinks, sugary drinks and water as substitutes.
- 研究是如何开展的？
Network meta-analysis of randomised trials.
- 研究了多少人、动物或样本？
1733 adults with overweight or obesity.
- 实际发现了什么？
Diet drinks instead of sugary drinks: about 1 kg less weight and less liver fat.
- 观察到的效应有多大？
-1.06 kg (-1.71 to -0.41).
- 研究结果对日常生活意味着什么？
For heavy soda drinkers, diet drinks can be a step down; water remains first choice.
- 该研究有哪些局限？
Short trials; several authors with industry links.
- 它对 Elawady 的具体说法说明了什么？
Weakens the claim that diet soda is clearly harmful.
- 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 show long-term safety.
该组中没有被标记为关键研究的研究。
结果不一或不明确的研究 (3)
-
Sugary drinks, diet drinks, juice and diabetes
Imamura F et al.. BMJ 2015 · PMID 26199070 · DOI 10.1136/bmj.h3576Meta分析被 Tayebat 档案网站引用全文，含结构化偏倚风险评估Each daily sugary drink was linked with 13-18% more diabetes; diet drinks and juice also showed (possibly biased) links.
ASB association likely biased (publication bias, residual confounding).
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？
Are SSB, ASB and fruit juice associated with T2D independently of adiposity?
- 研究是如何开展的？
Systematic review and random-effects meta-analysis of prospective cohorts; PAF estimation (US, UK).
- 研究了多少人、动物或样本？
17 cohorts; 38,253 cases; 10,126,754 person-years; Adults without diabetes
- 实际发现了什么？
Per serving/day: SSB +18% (9-28%; I2 89%) and +13% (6-21%) after adiposity adjustment; ASB +25% and +8% (publication bias and residual confounding indicated); fruit juice +5% (-1 to 11%) and +7% (1-14%). PAF: 8.7% USA, 3.6% UK.
- 观察到的效应有多大？
+18% per serving (+13% adiposity-adjusted)
- 研究结果对日常生活意味着什么？
Neither diet drinks nor juice are proven healthier alternatives to sugary drinks.
- 该研究有哪些局限？
High heterogeneity; observational studies; protocol not registered; ASB and juice results likely biased
- 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 (UK PAF estimated).
- 从该研究中明确不能得出什么结论？
Causation; that diet drinks or juice cause diabetes; diet-drink effects on mortality
-
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.
-
Diet drinks: short-term substitute, not a long-term goal
Choi JH et al.. Diabetes Metab J 2026 · PMID 41531289 · DOI 10.4093/dmj.2025.0848指南 / 立场声明独立交叉核查已核查摘要Korean experts found that swapping sugary drinks for diet drinks lowered weight slightly in trials, but long-term observational links to disease mean water is the better goal.
Short-term substitution beneficial; long-term use not recommended.
该研究是否支持这一具体说法？ 部分支持 · 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？
Give evidence-based advice on sugary and diet drinks.
- 研究是如何开展的？
Meta-analysis of trials plus review of cohort reviews.
- 研究了多少人、动物或样本？
14 trials and 20 reviews.
- 实际发现了什么？
Swapping lowered weight by 0.73 kg; long-term cohort links for both drink types.
- 观察到的效应有多大？
-0.73 kg body weight.
- 研究结果对日常生活意味着什么？
Diet drinks can help people cut sugary drinks, but water is best.
- 该研究有哪些局限？
Consensus; abstract reviewed.
- 它对 Elawady 的具体说法说明了什么？
Partly supports 'diet soda is not a safe alternative'.
- 研究结果是否适用于德国和欧洲？
Applicable in principle.
- 从该研究中明确不能得出什么结论？
Cannot settle whether sweeteners cause disease.
该组中没有被标记为关键研究的研究。
地区背景
德国 / 欧盟
Sweeteners are authorised in the EU with ADIs; WHO's recommendation is conditional.
埃及
No Egypt-specific data.
在我的国家适用什么？
一般科学评估
可能正确 无糖汽水的健康益处未经证实；有关其真正危害的证据也不确定。
以下食品安全领域与该说法相关：
- 添加剂与加工
- 监管、进口、召回、标签
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
- 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
- WHO advises not to use non-sugar sweeteners for weight control in newly released guideline (Use of non-sugar sweeteners: WHO guideline, 2023) — news release. World Health Organization. WHO news release 2023
- Artificially Sweetened Beverages and Health Outcomes: An Umbrella Review.. Diaz C et al.. Adv Nutr 2023 · PMID 37187453 · DOI 10.1016/j.advnut.2023.05.010
- 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
- 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
- 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
- Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis.. McGlynn ND et al.. JAMA Netw Open 2022 · PMID 35285920 · DOI 10.1001/jamanetworkopen.2022.2092
- Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction.. Imamura F et al.. BMJ 2015 · PMID 26199070 · DOI 10.1136/bmj.h3576
- 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
- Health Effects of Sugar-Sweetened and Artificially Sweetened Beverages: Umbrella Review and Evidence-Based Consensus Statement of the Korean Diabetes Association and the Korean Nutrition Society.. Choi JH et al.. Diabetes Metab J 2026 · PMID 41531289 · DOI 10.4093/dmj.2025.0848