Cancer
Sugar-sweetened soda consumption and mortality risk in Mexican: A target trial emulation Ana Rodríguez* Ana Rodríguez Nancy López Liliana Gómez Marion Brochier Martín Lajous Dalia Stern
Numerous studies have shown that higher consumption of sugar-sweetened beverages (SSBs) is associated with increased disease risk and mortality. However, a more critical public health question is whether reducing SSB consumption can lower disease risk. While a randomized trial would be ideal to answer this question, it may be infeasible. This study uses the target trial framework to estimate the effect of reducing sugar-sweetened soda consumption on mortality risks.
Methodology: Using observational data from 115,527 women in the Mexican Teacher Cohort. Eligibility criteria included Mexican women aged >25 y who were current consumers of sugar-sweetened soda. Mortality data were obtained through probabilistic linkage with national death records. We estimated the observational analog of the intention-to-treat effect. To adjust for confounding, we used the parametric g-formula to estimate the effect of reducing sugar-sweetened soda to one serving/month versus no intervention on the risk of all-cause and cause-specific mortality over 13 years. Bootstrap resampling (500 iterations) was used to calculate confidence intervals.
Results: A total of 87,529 women met the eligibility criteria. During 13 years of follow-up, 1,480 deaths occurred, including 563 from cancer, 234 from CVD, and 91 from liver diseases. The median consumption of sugar-sweetened soda was 3 servings/week (IQR:0.5-4.0). The 13-year RD (95% confidence interval) for all-cause mortality with reduced soda consumption versus no intervention was -0.06%(-0.23%,0.13%) and the corresponding RR was 0.97 (95% CI:0.90,1.06). The RD for cancer mortality was -0.07%(-0.17%, 0.03%), and a RR of 0.92(0.80, 1.04).The RD for liver disease mortality was -0.03%(-0.06%,0.00%) and an RR of 0.79(0.56,1.03). For CVD mortality, the RD was 0.04%(-0.04%,0.16%) with a corresponding RR of 1.10(0.89,1.37).
Conclusion: In the Mexican context, reducing sugar-sweetened soda consumption may reduce the risk of cancer and liver disease mortality.