The rise in CSD consumption preceded the rise in cases of ACE by 20 years. A 40 percent increase for each five-year increase in date of birth “ a birth cohort effect “ was previously reported. Using linear regression to compare trends between CSD and ACE rates, the researchers found a highly significant correlation between the two (r=0.99, 95% CI 0.96-1.0).

Researchers found published data for a strong biological basis to explain the increased dose and duration of esophageal exposure to acid: CSD drinking causes gastric distension that triggers reflux. Consumption of 350 milliliters of CSD per day (approximately one can of soda) corresponds to 53.5 minutes of pH less than four and 53 gallons per year translates to 32,100 more minutes of acid exposure per year. Excess CSD consumption started in childhood and American teenagers drank two cans of CSD per day on average, which can explain the birth cohort effect.

White children drank significantly more CSD than black children. In general, identical time trends were seen worldwide, as countries with per capita CSD below 10 gallons (including Eastern Europe, Japan, China, Taiwan, Korea and India, among others) had little increase in the incidence of ACE.

Countries with per capita CSD of more than 20 gallons have seen a rising trend of ACE cases. The surprisingly strong correlation demonstrates the impact of diet patterns on health trends, said Mohandas Mallath, M.D., lead author on the study. This study re-emphasizes a general life style dictum that if little is good, a lot isn ™t better. ™ As the rates may continue to rise for another 20 years, we believe that more epidemiological studies are urgently required to establish the true association.

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