July 22, 2015
2 min read

Sugary drinks linked to type 2 diabetes, independent of adiposity

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Type 2 diabetes is positively associated with regular consumption of sugar-sweetened beverages, independent of obesity status, according to recent study findings published in The BMJ.

“Of soft drinks, zero [consumption] is the best [way] to reduce body weight and to reduce risk of diabetes,” Fumiaki Imamura, PhD, of the Medical Research Council Epidemiology Unit at the University of Cambridge School of Clinical Medicine, told Endocrine Today. “Thus, doctors and patients may first want to discuss behaviors of drinking soft drinks and other beverages and what to modify. We would note that modification of beverage choices may be easier than that of overall diet. Thus, it can be a good start to further achieve modifications of overall diets and lifestyle. Benefits for such modifications may not become apparent quickly, but certainly can be good for health.”

Fumiaki Imamura

Fumiaki Imamura

Imamura and colleagues conducted a systematic review and meta-analysis of 17 observational studies to estimate the effect of regular consumption of sugar-sweetened beverages, artificially sweetened beverages or fruit juice on the risk for type 2 diabetes during a 10-year period.

“The study did not evaluated diabetes patients or other specific disease conditions,” Imamura said. “Yet, based on biology and a few studies on heart disease and mortality, it is certainly reasonable to cut down the consumption among people with diabetes and other chronic conditions.”

Before adjustment for adiposity, researchers found an 18% greater incidence of type 2 diabetes with higher consumption of sugar-sweetened beverages by one serving per day. After adjustment for potential mediation and confounding by adiposity, the risk was 13% per serving per day. Higher consumption of artificially sweetened beverages by one serving per day revealed a 25% greater incidence before adjustment for adiposity and an 8% greater incidence after adjustment. There was a 7% greater incidence for type 2 diabetes for higher consumption of fruit juice by one serving per day after adjustment for adiposity.

“Observational cohort studies support that consumption of sugar-sweetened beverages is associated with incident type 2 diabetes, and independently of adiposity,” the researchers wrote. “This finding was stable in sensitivity analyses assessing the influence of population characteristics, potential residual confounding, and publication bias. By contrast, although artificially sweetened beverages and fruit juice showed a positive association with incident diabetes, the quality of evidence is limited by potential bias and heterogeneity by study design.”

According to the researchers, the results suggest potential efficacy in a reduction of sugar-sweetened beverage consumption.

“Moreover, findings support that neither artificially sweetened beverages nor fruit juice are suitable alternatives to sugar-sweetened beverages for the prevention of type 2 diabetes,” the researchers wrote.

The researchers further carried out estimation of how many diabetes cases would be attributable to the consumption of sugar-sweetened beverages, evaluating data from the recent national surveys in the United States and United Kingdom. More than half (54.4%) of adults in the United States and nearly half (49.4%) of those in the United Kingdom consumed sugar-sweetened beverages. When unadjusted for adiposity, the 10-year estimated risk attributable to consumption of sugar-sweetened beverages in the United States would lead to 2.6 million excess events of type 2 diabetes and 126,000 excess events in the United Kingdom. After adjustment for adiposity, consumption would lead to 1.8 million excess events in the United States and 79,000 in the United Kingdom.

“Diet drinks may be candidate alternatives to soft drinks to lower energy intake and body weight,” Imamura said. “Thus, consumption of these beverages is conceivable, but these behaviors themselves may not be the best to avoid diabetes. Instead, unsweetened coffee, tea and water are good choices, based on available evidence from many different studies.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.