Systematic Reviews and Meta-Analyses (SRMAs) are considered the highest quality in evidence-based guideline and policy development.
Nutrition-related SRMAs tend to focus on either clinical trials assessing disease risk factors, or observational studies (e.g. prospective cohort studies) assessing disease outcomes(e.g. incidence).
Below is a list of scientific references on sugars and various health topics, focusing on SRMAs from the last 10 years.
Additional resources:
A summary of SRMAs of clinical trials on fructose-containing sugars and chronic disease risk factors in the context of energy balance.
A walkthrough of the knowledge and skills needed to read and critically assess SRMAs, including a hands-on exercise and downloadable worksheet.
A full list of the latest research publications on sugars and carbohydrates. To receive monthly emails on emerging sugars-related research, please complete the sign-up form, or contact flora.wang@sugar.ca
For more information, visit Sugars and Health – Cognition.
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| Title |
Citation |
Study Type |
| Fructose-containing food sources and blood pressure: A systematic review and meta-analysis of controlled feeding trials |
Lui Q et al. PLoS One. 2023 Aug;18(8):e0264802. |
SRMA of Clinical Trials |
| Sugar intake and risk of hypertension: a systematic review and dose-response meta-analysis of cohort and cross-sectional studies |
Zhao Y et al. Crit Rev Food Sci Nutr. 2023 May 23:1-12. |
SRMA of Cohort Studies |
| Dietary sugar consumption and health: umbrella review |
Huang Y et al. BMJ. 2023 Apr 5;381. |
Umbrella Review of SRMAs |
| The Relationship Between Major Food Sources of Fructose and Cardiovascular Outcomes: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. |
Sun T et al. Adv Nutr. 2023 Mar;14(2):256-269. |
SRMA of Cohort Studies |
| Added Sugar, Sugar-Sweetened Beverages, and Artificially Sweetened Beverages and Risk of Cardiovascular Disease: Findings from the Women's Health Initiative and a Network Meta-Analysis of Prospective Studies. |
Yang B et al. Nutrients. 2022 Oct 11;14(20):4226. |
SRMA of Cohort Studies |
| Association of added sugar intake with all-cause and cardiovascular disease mortality: a systematic review of cohort studies. |
Song S, et al. Nutr Res Pract. 2022 May. |
Systematic Review of Cohort Studies |
| Sweetened beverage consumption and risk of cardiovascular mortality: A systematic review and meta-analysis |
Bhagavathula, AS. et al. Diabetes Metab Syndr. 2022 Mar 15. |
SRMA of Cohort Studies |
| High versus low-added sugar consumption for the primary prevention of cardiovascular disease |
Bergwall S et al. Cochrane Database Syst Rev. 2022 Jan 5. |
SRMA of Clinical Trials |
| [Consumption of sugar-sweetened beverages and artificially sweetened beverages and risk of cardiovascular disease: a meta-analysis] |
Jiang YW et al. 2021 Sep 6;55(9):1159-1167. |
Meta-Analysis of Cohort Studies |
| Effect of fructose instead of glucose or sucrose on cardiometabolic markers: a systematic review and meta-analysis of isoenergetic intervention trials. |
Fattore E et al. Nutr Rev. 2021 Jan 9;79(2):209-226. |
SRMA of Clinical Trials |
| 100% Fruit juice intake and cardiovascular risk: a systematic review and meta-analysis of prospective and randomised controlled studies. |
D'Elia L et al; SINU Working Group. Eur J Nutr. 2020 Nov 4. |
SRMA of Cohort Studies and Clinical Trials |
| Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose-response meta-analysis. |
Farhangi MA et al. Transl Med. 2020 Sep 5;18(1):344. |
SRMA of Observational Studies |
| Intake of Sugar-Sweetened and Low-Calorie Sweetened Beverages and Risk of Cardiovascular Disease: A Meta-Analysis and Systematic Review. |
Yin J et al. Adv Nutr. 2020 Jul 22:nmaa084. |
SRMA of Cohort Studies |
| Carbohydrate quality, glycemic index, glycemic load and cardiometabolic risks in the US, Europe and Asia: A dose-response meta-analysis. |
Hardy DS et al. Nutr Metab Cardiovasc Dis. 2020 Jun 9;30(6):853-871. |
SRMA of Observational Studies |
| Important Food Sources of Fructose-Containing Sugars and Incident Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies |
Liu Q, et al. J Am Heart Assoc 2019. PMID 31826724 |
SRMA of Cohort Studies |
| Relation of Total Sugars, Sucrose, Fructose, and Added Sugars with the Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. |
Khan TA, et al. Mayo Clin Proc 2019. PMID 31806098 |
SRMA of Cohort Studies |
| Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes. |
Khan TA and Sievenpiper JL. Eur J Nutr. 2016;55:25-43. |
SRMA of Cohort Studies |
| Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta-Analysis of Controlled Feeding Trials |
Chiavaroli L, et al. J Am Heart Assoc. 2015 Sep 10;4(9):e001700. |
SRMA of Clinical Trials |
| Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids |
Te Morenga LA et al. AJCN. 2014;100(1):65-79. |
SRMA of Clinical Trials |
| Effect of fructose on postprandial triglycerides: a systematic review and meta-analysis of controlled feeding trials |
Wang D, et al. Atherosclerosis. 2014 Jan;232(1):125-33. |
SRMA of Clinical Trials |
| Effect of fructose on blood pressure: a systematic review and meta-analysis of controlled feeding trials |
Ha V, et al. Hypertension. 2012 Apr;59(4):787-95. |
SRMA of Clinical Trials |
For more information, visit Sugars and Health - Cardiovsacular Disease.
| Title |
Citation |
Study Type |
| Intakes of Added Sugars, with a Focus on Beverages and the Associations with Nutrient Adequacy in US Adults (NHANES 2003-2018). |
Ricciuto L et al. Nutrients. 2023 Sep 9;15(18):3916. |
Cross-Sectional |
| Free sugar intake from snacks and beverages in Canadian preschool- and toddler-aged children: a cross-sectional study. |
Yu J et al; Guelph Family Health Study. BMC Nutr. 2023 Mar 8;9(1):44. |
Cross-Sectional |
| Trends in Loss-Adjusted Availability of Added Sugars and Energy Contribution from Macronutrients and Major Food Groups in Canada and the United States |
Wang YF et al. J Am Nutr Assoc. 2022 Jun 23;1-10. |
Availability Data |
| Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: Cross-sectional 1 analyses of the Canadian Community Health Survey 2015 Public Use Microdata File. |
Chiavaroli L, et al. Applied Physiology, Nutrition, and Metabolism. 2022 Jan. |
Cross-Sectional |
| Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001–2018. |
Ricciuto L, et al. J Nutr. 2022 Feb 8;152(2):568-578. |
Cross-Sectional |
| Effects of Unsweetened Preloads and Preloads Sweetened with Caloric or Low-/No-Calorie Sweeteners on Subsequent Energy Intakes: A Systematic Review and Meta-Analysis of Controlled Human Intervention Studies. |
Lee HY et al. Adv Nutr. 2021 Jul 30;12(4):1481-1499. |
SRMA of Clinical Trials |
| A Systematic Review of the Recent Consumption Levels of Sugar-Sweetened Beverages in Children and Adolescents From the World Health Organization Regions With High Dietary-Related Burden of Disease. |
Ooi JY et al. Asia Pac J Public Health. 2021 May 20:10105395211014642 |
SRMA of Observational Studies |
| World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review. |
Della Corte K et al. Nutr Rev. 2021 Feb 11;79(3):274-288. |
Systematic Review of Cohort Studies |
| Canadian Adults with Moderate Intakes of Total Sugars have Greater Intakes of Fibre and Key Micronutrients: Results from the Canadian Community Health Survey - Nutrition 2015 Public Use Microdata File. |
Wang YF, et al. Nutrients. 2020 Apr 17;12(4):E1124. |
Cross-Sectional |
| Change in total sugars consumption among Canadian children and adults. |
Langlois K, Garriguet D. Statistics Canada Health Reports. January 2019. |
Cross-Sectional |
| Sugar-fat seesaw: A systematic review of the evidence. |
Sadler et al. Crit Rev Food Sci Nutr. 2015;55:338-356. |
Systematic Review of Observational Studies |
| A review of sugar consumption from nationally representative dietary surveys across the world. |
Newens KJ & Walton J. Journal of Human Nutrition and Dietetics. E-published 10 Oct 15. |
Review of Dietary Surveys |
| Worldwide trends in dietary sugars intake |
Wittekind A & Walton J. Nutrition Research Reviews 2014;27(2):330-345. |
Review of Dietary Surveys |
| Consumption of added sugars is decreasing in the United States. |
Welsh JA, et al. Am J Clin Nutr. 2011;94:726-734. |
Cross-Sectional |
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| Title |
Citation |
Study Type |
| Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis. |
Li B et al. Front Nutr. 2023 Mar 15;10:1019534. |
SRMA of Prospective Studies |
| Dose-dependent effect of carbohydrate restriction for type 2 diabetes management: a systematic review and dose-response meta-analysis of randomized controlled trials. |
Jayedi A, et al. Am J Clin Nutr. 2022 May 10. |
SRMA of Clinical Trials |
| Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose-response meta-analysis of prospective cohort studies |
Hosseini F et al. Sci Rep. 2022 Feb 15;12(1):2491. |
SRMA of Cohort Studies |
| Alterations in sweet taste function in adults with diabetes mellitus: a systematic review and potential implications |
Tan SY et al. Crit Rev Food Sci Nutr. 2021 Dec 14:1-13. |
Systematic Review of Observational Studies |
| Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials. |
Chiavaroli L, et al. BMJ. 2021 Aug 4;374:n1651. |
SRMA of Clinical Trials |
| International tables of glycemic index and glycemic load values 2021: a systematic review. |
Atkinson FS et al. J.Am J Clin Nutr. 2021 Jul 13:nqab233. |
Systematic Review |
| Dietary glycemic index, glycemic load, and chronic disease: an umbrella review of meta-analyses of prospective cohort studies. |
Jayedi A et al. Crit Rev Food Sci Nutr. 2020 Dec 1:1-10. |
Umbrella Review of Meta-Analyses of Cohort Studies |
| Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. |
Tsilas SC et al. CMAJ. 2017;189:E711-20. |
SRMA of Cohort Studies |
| Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes |
Khan TA, Sievenpiper JL. Eur J Nutr. 2016 Nov 30. |
Results from SRMAs |
| Consumption of sugar-sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. |
Imamura F, et al. Br J Sports Med 2016;50:496–504. |
SRMA of Cohort Studies |
| Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective cohort studies |
Greenwood DC, et al. Diabetes Care. 2013 Dec;36(12):4166-71. |
SRMA of Cohort Studies |
| Effect of Fructose on Glycemic Control in Diabetes: A systematic review and meta-analysis of controlled feeding trials |
Cozma A, et al. Diabetes Care. 2012 Jul;35(7):1611-20. |
SRMA of Clinical Trials |
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| Study Topic |
Title |
Citation |
Type of Study |
| Inflammation |
Effect of Important Food Sources of Fructose-Containing Sugars on Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Controlled Feeding Trials |
Qi X, et al. Nutrients. 2022; 14(19):3986. |
SRMA of Clinical Trials |
| Effect of Dietary Sugar Intake on Biomarkers of Subclinical Inflammation: A Systematic Review and Meta-Analysis of Intervention Studies |
Corte Della KW et al. Nutrients. 2018;10(5):606. |
SRMA of Clinical Trials |
| Metabolic Syndrome |
Sugar-sweetened beverages consumption increases the risk of metabolic syndrome and its components in adults: Consistent and robust evidence from an umbrella review. |
Tran QD et al. Clin Nutr ESPEN. 2023 Oct. |
Umbrella Review of SRMAs |
| Association between Sugar-Sweetened Beverage Consumption and the Risk of the Metabolic Syndrome: A Systematic Review and Meta-Analysis. |
Muñoz-Cabrejas A. Nutrients. 2023 Jan 13;15(2):430. |
SRMA of Observational Studies |
| Metabolism |
Impact of isocaloric exchanges of carbohydrate for fat on postprandial glucose, insulin, triglycerides, and free fatty acid responses - a systematic review and meta-analysis |
Kdekian A, et al. Eur J Clin Nutr 2020. PMID 31767988 |
SRMA of Clinical Trials |
| Effect of fructose and its epimers on postprandial carbohydrate metabolism: A systematic review and meta-analysis. |
Braunstein CR et al. Clin Nutr. 2020 Mar 10. S0261-5614(20)30104-7. |
SRMA of Clinical Trials |
| Mortality |
The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies |
Wang Y et al. Nutrients. 2022 Feb 12;14(4):777. |
SRMA of Cohort Studies |
| Association of soft drink and 100% fruit juice consumption with all-cause mortality, cardiovascular diseases mortality, and cancer mortality: A systematic review and dose-response meta-analysis of prospective cohort studies. |
Pan B, Ge L et al. Crit Rev Food Sci Nutr. 2021 Jun 13:1-12. |
SRMA of Cohort Studies |
| Association between intake of sweetened beverages with all-cause and cause-specific mortality: a systematic review and meta-analysis. |
Li H et al. J Public Health (Oxf). 2021 Apr 9:fdab069. |
SRMA of Cohort Studies |
| Association of Consumption of Sugar-Sweetened Beverages or Artificially Sweetened Beverages with Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. |
Zhang YB et al. Adv Nutr. 2021 Mar 31;12(2):374-383. |
SRMA of Cohort Studies |
| The relationship between major food sources of fructose and cardiovascular disease, cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of cohort studies |
Kazemi A et al. Crit Rev Food Sci Nutr. 2021 Nov 30:1-14. |
SRMA of Cohort Studies |
| Uric Acid |
Different Food Sources of Fructose-Containing Sugars and Fasting Blood Uric Acid Levels: A Systematic Review and Meta-Analysis of Controlled Feeding Trials |
Ayoub-Charette S et al. J Nutr. 2021 Jun 4:nxab144. |
SRMA of Clinical Trials |
| Consumption of sugar-sweetened beverages and serum uric acid concentrations: a systematic review and meta-analysis |
Ebrahimpour-Koujan S et al. J Hum Nutr Diet. 2020 Jul 19. |
SRMA of Observational Studies |
| The effects of fructose intake on serum uric acid vary among controlled dietary trials |
Wang D, et al. J Nutr. 2012 May;142(5):916-23. |
SRMA of Clinical Trials |
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