You may want to replace that sweetened beverage with water.

A study published Monday in the American Heart Association journal Circulation found an association between people who consume sugary drinks and an increased risk of death.

The observational study found adults who consumed more than two sweetened drinks a day had their risk of death increase by 21 percent over adults who drank less than one sweetened drink a month. For women, their risk increased by 25 percent, while the risk for men was up 12 percent.

The study also found sugary drinks were associated with a 31 percent increased risk of death from cardiovascular disease for both men and women.

Vasanti Malik, lead author of the study and a research scientist in the Department of Nutrition in the Harvard T.H. Chan School of Public Health, said in an interview with USA TODAY it's not clear what's driving the differences in overall risk of death between men and women who consume sweetened drinks.

"It could simply be the physiological or metabolic differences between men and women," said Malik. "It could also be something methodological, where women tend to underreport energy intake a little bit more than men."

The study examined data from two larger health studies, controlling for other dietary factors as well as physical activity and body mass index to determine the impact of sugary drinks.

Researchers also found substituting one sweetened beverage a day with a drink that's artificially sweetened was associated with a slightly lower risk of death.

"Drinking water in place of sugary drinks is a healthy choice that could contribute to longevity,” said Malik in a statement. "Diet soda may be used to help frequent consumers of sugary drinks cut back their consumption, but water is the best and healthiest choice."

In a statement, the American Beverage Association said soft drinks and other beverages with sugar are safe to consume as part of a balanced diet. "The sugar used in our beverages is the same as sugar used in other food products," the ABA said. "We don’t think anyone should overconsume sugar, that’s why we’re working to reduce the sugar people consume from beverages across the country."

Story continues

The ABA said the industry is introduced smaller portion sizes and rolled out more brands with low sugar or no sugar content.

Last month, a study published in the journal Stroke found women age 50 and older who consume more than one artificially sweetened drink a day have a higher risk of stroke, heart attack or early death.

Follow Brett Molina on Twitter: @brettmolina23

This article originally appeared on USA TODAY: Sugary drinks linked to increased risk of death, study suggests