From a health perspective, sugar-sweetened beverages don’t help the body. The very thing that makes sugary sodas, sports drinks and lemonade taste so sweet can lead to obesity, diabetes, heart disease and other metabolic abnormalities.

In a study published in the American Heart Association journal Circulation, researchers provide the strongest evidence yet that sugared drinks can lead to the accumulation of unhealthy visceral fat over time.

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Visceral fat differs from the kind of fat that most of us are familiar with that builds up just underneath the skin. Visceral fat emerges deep within organs; it’s embedded in the liver, pancreas and intestines. Unlike other types of fat, it tends to be more metabolically active, meaning it releases compounds that can disrupt the body’s ability to efficiently break down sugar from food and use it for energy, as well as boost production of cholesterol in the liver.

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Previous studies have connected sugar-sweetened drinks with higher levels of visceral fat, but those only included one-time measurements of fat levels where researchers linked how much people’s self-reports of drinking sugary beverages to their visceral fat volume. In the current study, Caroline Fox—who at the time of the study was at the National Heart, Lung and Blood Institute—and her colleagues tracked changes in visceral fat concentrations in a group of about 1,000 people over six years. They found that people who drank the most sugared beverages had the highest increases in visceral fat over that time. Drinking at least one sugar-sweetened drink a day was linked to a 27% greater increase in visceral fat volume, compared to people who didn’t drink any of these sweetened beverages.

The scientists also showed that the visceral fat was biologically more likely to cause health problems. The people who drank sweet things also regularly also showed lower quality fat, which has been linked to greater metabolic abnormalities and problems such as insulin resistance, a contributor to diabetes.

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Fox (now at Merck) and her colleagues did not ask the people in the study about how much 100% fruit juice they drank; the latest Dietary Guidelines for Americans considers equivalent servings of 100% fruit juice as fruit, despite the fact that nutritionists say that fruit contains additional benefits in the form of nutrients and fiber that juice alone can’t provide. The researchers also did not follow the people to record their rates of diabetes or heart disease to see if their increases in visceral fat could lead to more health problems. But, Fox says, there is a growing body of data connecting visceral fat levels to these chronic health problems, so “this provides an additional piece of evidence suggesting that sugar-sweetened beverages may be associated with a harmful metabolic parameter. This is consistent with other studies and public health messages that people be mindful of how many sugar-sweetened beverages they drink.”

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