People Consuming More Sugary Drinks Gain More Visceral Fat Over Time

Drinking larger amounts of sugar-sweetened beverages is associated with greater gains in visceral adipose tissue over time, a longitudinal study shows. No such relationships were seen for diet soda, however.

The main implications are for public health policy, according to study author Caroline Fox, MD, MPH, who was at the National Heart, Lung, and Blood Institute when the research was conducted and is now vice president and head of genetics and pharmacogenomics at Merck.People Consuming More Sugary Drinks Gain More Visceral Fat Over Time

The findings, published online this week in Circulation, “are in line with messages about consumers reducing their intake and having a modest intake of sugar-sweetened beverages in their diet,” she told TCTMD.

Sugar-sweetened beverages are the largest contributor to added sugar intake in the US diet, and they have been associated with adverse changes in abdominal adipose tissue in prior studies. Those studies had cross-sectional designs, however, and the potential link between consuming sugary drinks and longitudinal changes in abdominal fat remained an open question.

To explore the issue, Fox and colleagues turned to the Framingham Heart Study’s Third generation cohort. Their study included 1,003 people (mean age 45.3; 45.0% women) who had the quantity and quality of fat tissue assessed using CT at 2 exams about 6 years apart.

Sugar-sweetened beverage and diet soda intake were assessed at baseline using a food frequency questionnaire and the participants were divided into 4 groups based on consumption: nonconsumers (< 1 serving/month), occasional (1 serving/month to < 1 serving/week), frequent (1 serving/week to < 1 serving/day), and daily (≥ 1 serving/day).

There were no relationships between consumption of sugar-sweetened beverages or diet soda and changes in body weight or subcutaneous adipose tissue volume or quality.

However, increased sugar-sweetened beverage intake at baseline was tied to a greater change in visceral adipose tissue volume after multivariate adjustment (P < .001 for trend). Volume increased by 658, 649, 707, and 852 cm3 across consumption categories from nonconsumers to daily drinkers.

Imbibing more sugary drinks was also related to a greater decline in visceral adipose tissue attenuation, indicating lower quality (P = .007), but that association became nonsignificant after further adjustment for change in fat volume.

The findings are important because the accumulation of visceral adipose tissue has adverse metabolic and cardiovascular consequences, Vasanti Malik, ScD, of the Harvard T.H. Chan School of Public Health (Boston, MA), told TCTMD.

The study provides support to existing and future policies to reduce sugar-sweetened beverage intake, she said, noting that fiscal measures, like taxation, appear to have the greatest impact.

But regardless of approach, “it’s also really important for there to be educational campaigns that go along with them,” she said. “The public should know why these efforts are being made to reduce intake.”

Malik added that “it’s important to recognize that sugar-sweetened beverages aren’t the only obesity risk factor out there, but measures to reduce intake can easily be adopted, which can have an important impact on obesity risk down the road.”


Ma J, McKeown NM, Hwang S-J, et al. Sugar-sweetened beverage consumption is associated with change of visceral adipose tissue over 6 years of follow-up. Circulation. 2016;Epub ahead of print.

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Todd Neale is the Associate News Editor for TCTMD and a Senior Medical Journalist. He got his start in journalism at …

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  • The study was supported by the National Heart, Lung, and Blood Institute.
  • Fox and Malik report no relevant conflicts of interest.