Drinking sugar-sweetened beverages is associated with a greater incidence of type 2 diabetes, independent of obesity, according to a systematic review and meta-analysis.
The researchers analyzed data from prospective design studies that assessed the consumption of beverages and incident type 2 diabetes, recruited adults free of diabetes, and followed study participants for at least 2 years. The data came from 17 cohorts comprising 38,253 cases of type 2 diabetes over 10,126,756 person-years. Using risk estimates, sampling weights, and population size, the researchers estimated the absolute number of incidents of type 2 diabetes over 10 years, the number of incidents of type 2 diabetes attributable to consumption of sugar-sweetened beverages, and the proportion of the disease incidents attributable to drinking of sugar-sweetened beverages. These estimations assumed causality and no change in individuals’ characteristics over time.
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Higher consumption of sugar-sweetened beverages by one serving per day was associated with an 18% greater incidence of type 2 diabetes (95% confidence interval, 8.8%-28%; I2 [for heterogeneity] = 89%), before adjustment for adiposity. When adjusted for potential mediation and confounding by adiposity, the association was weakened to a 13% greater incidence of the disease.
Associations between drinking of artificially sweetened beverages and fruit juice were also found, but findings for artificially sweetened beverages were likely affected by publication bias and residual confounding; for fruit juice, the positive association was not stable and sensitive to study design.
“Under assumption of causality for the association of consumption of sugar-sweetened beverages with incident type 2 diabetes, we provided efficacy estimates that over 10 years two million type 2 diabetes events in the U.S. and 80,000 in the U.K. would be related to consumption of sugar-sweetened beverages,” according to Dr. Fumiaki Imamura of the University of Cambridge School of Clinical Medicine, and his colleagues.
“Future work should seek to improve precision of evidence and characterize efficacy and effectiveness of policy interventions for different populations,” according to the researchers.
Read the full study in the BMJ (doi:10.1136/bmj.h3576).