Thai woman who reported consuming at least one sugar-sweetened beverage per day were twice as likely to develop type 2 diabetes over 8 years vs. those who reported rarely consuming sugary drinks, according to study findings published in Nutrition & Diabetes.
Keren Papier, a PhD student at the National Center for Epidemiology and Population Health at the Australian National University in Canberra, analyzed data from 39,175 Thai adults without diabetes at baseline in 2005 participating in the Thai Cohort Study, a prospective study of students enrolled at Sukothai Thammithirat Open University designed to examine the health-risk transition in Thailand. Participants completed questionnaires on sociodemographic, health and lifestyle factors, including sugary drink consumption, and health outcomes; follow-up questionnaires were completed in 2009 and 2013. Researchers used logistic regression analysis to assess associations between sugar-sweetened beverage intake and type 2 diabetes incidence over 8 years, as well as counterfactual mediation analysis to explore the potential mediation of the sugar-sweetened beverage intake and type 2 diabetes-risk relationship.
Over the course of follow-up, 695 participants reported a new diagnosis of diabetes.
Researchers found that, among women, consuming a sugar-sweetened beverage at least once daily at baseline was associated with type 2 diabetes incidence in 2013 when compared with women who reported rarely consuming sweetened drinks at baseline (OR = 2.4; 95% CI, 1.5-3.9). There was no observed link between sugar-sweetened beverage intake in men and type 2 diabetes risk. Results for men and women persisted after adjusting for age and BMI.
“We estimated that 1% of [type 2 diabetes] in men and 5% [of type 2 diabetes] in women could be attributed to daily [sugar-sweetened beverage] consumption,” the researchers wrote. “Assuming a causal [sugar-sweetened beverage intake–type 2 diabetes] association, 1,500 [type 2 diabetes] cases in men and 2,700 in women per year may have been prevented in the national Thai population if daily [sugar-sweetened beverage] consumption was avoided.”
Obesity in 2009 was found to mediate 23% of the total association between sugar-sweetened beverage intake in 2005 and type 2 diabetes risk in 2013, according to researchers, with a natural indirect effect of 1.15 (95% CI, 1.02-1.31).
The researchers noted that the questionnaires did not differentiate between sugar-sweetened and artificially sweetened beverages, and there was no information available on non-carbonated, sweetened beverages, such as juices. In addition, there was insufficient food frequency information to estimate the contribution of sugar-sweetened beverages to total energy intake, they wrote.
“The findings from this cohort suggest that at this point of the Thai health-risk transition [sugar-sweetened beverage] intake is increasing the risk of [type 2 diabetes] in women,” the researchers wrote. “As [sugar-sweetened beverages] have no nutritional value and do not protect
against disease, they are an ideal target for public health efforts aimed at preventing increasing national [type 2 diabetes] incidence ... targeting [sugar-sweetened beverages] could serve as one focal point to prevent a national rise in the incidence of [type 2 diabetes].” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.