Regular Consumption of Sugar-Sweetened Beverages Is Associated with Excess Risk for Type 2 Diabetes

Summary and Comment |
August 13, 2015

Regular Consumption of Sugar-Sweetened Beverages Is Associated with Excess Risk for Type 2 Diabetes

  1. Paul S. Mueller, MD, MPH, FACP

Adjusting for baseline adiposity attenuated, but didn't eliminate, excess risk.

  1. Paul S. Mueller, MD, MPH, FACP

Is consuming sugar-sweetened beverages, artificially sweetened beverages, and fruit juice associated with excess risk for developing type 2 diabetes? To answer this question, researchers performed a systematic review and meta-analysis of 17 multinational cohort studies (>460,000 adults; age range, 19–84). Median follow-up ranged from 3.4 to 21.1 years. About 28,000 study patients developed type 2 diabetes.

Higher consumption of sugar-sweetened beverages was associated with significantly higher risk for type 2 diabetes: 18% higher risk per 1 serving daily. After adjustment for baseline adiposity, risk was still 13% higher. Consuming artificially sweetened beverages also was associated with higher risk (25% and 8% higher risk per 1 serving daily, before and after adjusting for adiposity) as was consuming fruit juices (5% and 7% higher risk per 1 serving daily, before and after adjustment). However, the researchers could not exclude publication bias, confounding, and differential ascertainment of diabetes cases for the studies in which artificially sweetened beverages and fruit juices were assessed.

Comment

In this meta-analysis, regular consumption of sugar-sweetened beverages was associated with excess risk for type 2 diabetes, independent of adiposity. The authors estimate that, of the 20.9 million “diabetes events” predicted to occur during 10 years in the U.S., nearly 1.8 million would be attributable to consumption of sugar-sweetened beverages. Although the evidence is less clear regarding artificially sweetened beverages and fruit juices, the study authors reasonably conclude these beverages are unlikely to be healthy alternatives to sugar-sweetened beverages. The findings also lend credence to the dietary advice, “don't drink your calories.”

Editor Disclosures at Time of Publication

  • Disclosures for Paul S. Mueller, MD, MPH, FACP at time of publication Consultant / advisory board Boston Scientific (Patient Safety Advisory Board) Editorial boards Medical Knowledge Self-Assessment Program (MKSAP 17 General Internal Medicine Committee); MKSAP 17 General Internal Medicine (author/contributor) Leadership positions in professional societies American Osler Society (Vice President)

Citation(s):

Reader Comments (2)

wan mohd hamidi wan sulaiman Other Healthcare Professional, Pharmacology/Pharmacy, Cyberjaya University College of Medical Sciences, Malaysia

high consumption of sugar-sweetened beverages and lacks of physical activities (another confounder) will contribute more risks to get diabetes and other cardiovascular diseases.

American Beverage Association, ABA Communications

Regarding the primary study cited here related to diabetes, this research has numerous limitations, as explained in detail here: http://bit.ly/1VF4kBu. Frankly, this study is not the result of clinical trials; therefore, these findings cannot be read as proving a direct link between sugary drinks and type 2 diabetes. As we’ve consistently said, diabetes is caused by a complex combination of risk factors; not uniquely beverage intake. Therefore, it’s inaccurate and misleading to make such a leap based on inconclusive findings.
-American Beverage Association

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