Soft drinks linked to asthma in meta-analysis

  • Al-Zalabani AH & al.
  • BMJ Open
  • 14 Oct 2019

  • International Clinical Digest
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Takeaway

  • A meta-analysis of mostly cross-sectional studies finds that high (vs low) soft drink consumption is associated with asthma in both adults and children.

Why this matters

  • This meta-analysis supports the theory that fructose in soft drinks activates inflammatory pathways, which in turn may be tied to asthma development.

Study design

  • Meta-analysis of 19 studies (n=468,836, including >50,000 asthma cases) after search of Medline, Scopus, ISI Web of Science, and the Cochrane Library.
  • 16 of 19 studies were cross-sectional cohorts.
  • 10 of 19 studies were of children aged
  • Funding: None.

Key results

  • High soft drink intake (vs low) was associated with 37% increased risk for asthma in adults (OR, 1.37; 95% CI, 1.23-1.52) and 14% increased risk in children (OR, 1.14; 95% CI, 1.06-1.21).
  • Subgroup analysis of childhood studies found the association holds for sugar-sweetened drinks (OR, 1.26; 95% CI, 1.07-1.48), but not for carbonated beverages (OR, 1.05; 95% CI, 0.94-1.16).
  • High soft drink intake (vs low) was associated with wheeze in children (OR, 1.09; 95% CI, 1.05-1.13).
  • High soft drink intake by pregnant women had marginally significant association with onset of asthma in children (OR, 1.11; 95% CI, 1.00-1.23).

Limitations

  • Most studies were cross-sectional.
  • High heterogeneity across studies.