Soft drink consumption has been associated not only with weight gain and obesity but also with excess mortality in U.S. studies. In this prospective cohort study from 10 European countries, ≈450,000 participants (mean age, 51) completed questionnaires on dietary and clinical risk factors, including consumption of sugar-sweetened and artificially sweetened soft drinks. Participants with known heart disease, cancer, or diabetes were excluded. Mean follow-up was 16 years.
These results have potential public health implications. The fact that excess all-cause mortality was associated with both sugar-sweetened and artificially sweetened soft drinks, regardless of BMI, deserves closer examination for possible mechanisms that might not involve weight gain. However, this observational study does not prove that the association is causal, and other unmeasured dietary and lifestyle factors might have influenced the results.