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The sweet tooth gnawing on the heart

Comment by Nicolle Kränkel, EACPR Exercise, Basic and Translational Research Section

1) The relationship between sweetened beverage consumption and risk of heart failure in men
Rahman I, Wolk A, Larsson SC
Heart 2015; DOI:10.1136/heartjnl-2015-307542.

2) Preventing heart failure: sweetened beverages and healthy lifestyles
Martínez-González MA, Ruiz-Canela M.
Heart2015; DOI:10.1136/heartjnl-2015-308426.


Although an imbalance between nutrient intake (i.e. diet) and usage (i.e. physical activity) is generally understood to confer a large portion of acquired cardio-metabolic risk, few prospective studies have until now provided solid evidence between heart failure (HF) and one particular, widely-consumed part of diet: sweetened beverages.

The recent study by Rahman et al. [1] has prospectively investigated the impact of sweetened beverage consumption on HF incidents in a population-based cohort of 42.400 Swedish men between 45 and 79 years of age.  Besides this high number of participants, the study also provides a long follow-time of <10 years.

Rahman et al. report a 23% higher risk of developing HF in men who consumed two or more sweetened beverages per day as compared to participants not consuming sweetened beverages. The study asks for further investigation: of mechanisms, of interactions with other lifestyle parameters, such as fried meat consumption or sedentary time, and also with the age of the study participants. This is of interest as sweetened beverages are consumed more frequently by young people, while the study by Rahman et al. investigates men over 45 years of age.

In their editorial for the article by Rahman et al., Martinez-Gonzalez and Ruiz-Canela worry about the long-term impact of sweetened beverages on the younger population, too [2]. They also wonder whether increased consumption of sweetened beverages might be an indicator for an overall poor dietary pattern.

The editorial also provides an overview on other studies examining the association between a healthy lifestyle score and the risk of heart failure [2]. One of them, the Women´s Health Initiative, observed that better adherence to dietary recommendations improved survival of female patients admissioned for heart failure [3].

The message therefore becomes very clear: habitual consumption of sweetened beverages increases the risk for developing heart failure. It is now the responsibility of healthcare professionals, but also decision makers across society, to get this message through to the general population.


The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology


1    Rahman I, Wolk A, Larsson S. The relationship between sweetened beverage consumption and risk of heart failure in men. Heart. 2015;101(24):1961-5.
doi: 10.1136/heartjnl-2015-307542
2    Martínez-González MA, Ruiz-Canela M. Preventing heart failure: sweetened beverages and healthy lifestyles. Heart. 2015;101(24):1935-7.
doi: 10.1136/heartjnl-2015-308426
3    Agha G, Loucks EB, Tinker LF, Waring ME, Michaud DS, Foraker RE, Li W, Martin LW, Greenland P, Manson JE, Eaton CB. Healthy lifestyle and decreasing risk of heart failure in women: the Women's Health Initiative observational study. J Am Coll Cardiol. 2014;64(17):1777-85.
doi: 10.1016/j.jacc.2014.07.981

Notes to editor

Nicolle Kränkel, Charité – Universitätsmedizin Berlin, Berlin Germany