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Am J Public Health. 2013 Nov;103(11):2071-7. doi: 10.2105/AJPH.2012.300974. Epub 2013 Mar 14.

Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries.

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Sanjay Basu is with the Department of Medicine, Prevention Research Center and Centers for Health Policy, Primary Care and Outcomes Research, Stanford University, Stanford, CA. Martin McKee is with the Department of Public Health and Policy and the European Center for Health of Societies in Transition at the London School of Hygiene and Tropical Medicine, London, UK. Gauden Galea is with the Division of Noncommunicable Diseases and Health Promotion, World Health Organization, Geneva, Switzerland. David Stuckler is with the Department of Sociology, Cambridge University, Cambridge, UK.



We estimated the relationship between soft drink consumption and obesity and diabetes worldwide.


We used multivariate linear regression to estimate the association between soft drink consumption and overweight, obesity, and diabetes prevalence in 75 countries, controlling for other foods (cereals, meats, fruits and vegetables, oils, and total calories), income, urbanization, and aging. Data were obtained from the Euromonitor Global Market Information Database, the World Health Organization, and the International Diabetes Federation. Bottled water consumption, which increased with per-capita income in parallel to soft drink consumption, served as a natural control group.


Soft drink consumption increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons in 2010. A 1% rise in soft drink consumption was associated with an additional 4.8 overweight adults per 100 (adjusted B; 95% confidence interval [CI] = 3.1, 6.5), 2.3 obese adults per 100 (95% CI = 1.1, 3.5), and 0.3 adults with diabetes per 100 (95% CI = 0.1, 0.8). These findings remained robust in low- and middle-income countries.


Soft drink consumption is significantly linked to overweight, obesity, and diabetes worldwide, including in low- and middle-income countries.

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