An observational study published in the Journal of the American Heart Association suggests that drinking 12 oz of sugary drinks more than once per day is linked to lower levels of high-density lipoprotein cholesterol (HDL) and higher levels of triglycerides in middle-aged and older adults, both of which have been shown to increase risk of cardiovascular disease.

Researchers hypothesized that dyslipidemia—an unhealthy imbalance of cholesterol and triglyceride levels in the blood—could be one pathway by which sugary drinks may increase cardiovascular disease risk. To determine that, the researchers studied observational medical data of up to 5,924 participants from the Offspring and Generation 3 cohorts of the Framingham Heart Study, who were followed for an average of 12.5 years between 1991 and 2014.

For this study, the beverages were defined as 12 oz of sugary drinks, such as sodas, fruit-flavored drinks, sports drinks, presweetened coffees and teas; 12 oz of low-calorie sweetened beverages, including naturally and artificially sweetened “diet” sodas or other flavored beverages; or 8 oz of 100% fruit juices, including orange, apple, grapefruit, and other juices derived from whole fruits with no added sugars. Study participants were classified into five groups according to how often they drank the different beverage types, ranging from low intake (<1 serving per month) to high intake (>1 serving per day).

Researchers analyzed how the different drink types and their consumption levels correlated with changes in cholesterol and triglyceride levels over approximately four-year periods. They found that drinking sugar-sweetened beverages (more than 12 oz per day) was associated with a 53% higher incidence of high triglycerides and a 98% higher incidence of low HDL cholesterol (the “good” cholesterol) compared to those who drank less than one serving per month. Drinking low-calorie sweetened beverages did not appear to be associated with increased dyslipidemia risk among the people who regularly drank low-calorie sweetened beverages. Regularly drinking up to 12 oz of 100% fruit juice per day was not associated with adverse changes in cholesterol or dyslipidemia, though the researchers noted that further research is needed to warrant this finding.

“For some time, we have known sugary drinks can have a negative effect on Americans’ health status, yet the assumption for many is that they only contribute to weight gain,” said Eduardo Sanchez, chief medical officer for prevention and chief of the Center for Health Metrics and Evaluation at the American Heart Association, in a press release. “This research reinforces our understanding of the potential negative impact sugary drinks have on blood cholesterol, which increases heart disease risk. It is yet one more reason for all of us to cut back on sodas and other sugar-sweetened beverages.”

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