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Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages.
Diabetologia. 2015 Jul; 58(7):1474-83.D

Abstract

AIMS/HYPOTHESIS

This study aimed to evaluate the association of types of sugar-sweetened beverages (SSB) (soft drinks, sweetened-milk beverages, sweetened tea/coffee), artificially sweetened beverages (ASB) and fruit juice with incident type 2 diabetes and determine the effects of substituting non-SSB for SSB and the population-attributable fraction of type 2 diabetes due to total sweet beverages.

METHODS

Beverage consumption of 25,639 UK-resident adults without diabetes at baseline (1993-1997) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study was assessed using 7-day food diaries. During 10.8 years of follow-up 847 incident type 2 diabetes cases were verified.

RESULTS

In adjusted Cox regression analyses there were positive associations (HR [95% CI] per serving/day]) for soft drinks 1.21 (1.05, 1.39), sweetened-milk beverages 1.22 (1.05, 1.43) and ASB 1.22 (1.11, 1.33), but not for sweetened tea/coffee 0.98 (0.94, 1.02) or fruit juice 1.01 (0.88, 1.15). Further adjustment for adiposity attenuated the association of ASB, HR 1.06 (0.93, 1.20). There was a positive dose-response relationship with total sweet beverages: HR per 5% energy 1.18 (1.11, 1.26). Substituting ASB for any SSB did not reduce the incidence in analyses accounting for energy intake and adiposity. Substituting one serving/day of water or unsweetened tea/coffee for soft drinks and for sweetened-milk beverages reduced the incidence by 14%-25%. If sweet beverage consumers reduced intake to below 2% energy, 15% of incident diabetes might be prevented.

CONCLUSIONS/INTERPRETATION

The consumption of soft drinks, sweetened-milk beverages and energy from total sweet beverages was associated with higher type 2 diabetes risk independently of adiposity. Water or unsweetened tea/coffee appear to be suitable alternatives to SSB for diabetes prevention. These findings support the implementation of population-based interventions to reduce SSB consumption and increase the consumption of suitable alternatives.

Authors+Show Affiliations

Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, PO Box 285, Cambridge, CB2 0QQ, UK, laura.oconnor@mrc-epid.cam.ac.uk.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25944371

Citation

O'Connor, Laura, et al. "Prospective Associations and Population Impact of Sweet Beverage Intake and Type 2 Diabetes, and Effects of Substitutions With Alternative Beverages." Diabetologia, vol. 58, no. 7, 2015, pp. 1474-83.
O'Connor L, Imamura F, Lentjes MA, et al. Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia. 2015;58(7):1474-83.
O'Connor, L., Imamura, F., Lentjes, M. A., Khaw, K. T., Wareham, N. J., & Forouhi, N. G. (2015). Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia, 58(7), 1474-83. https://doi.org/10.1007/s00125-015-3572-1
O'Connor L, et al. Prospective Associations and Population Impact of Sweet Beverage Intake and Type 2 Diabetes, and Effects of Substitutions With Alternative Beverages. Diabetologia. 2015;58(7):1474-83. PubMed PMID: 25944371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. AU - O'Connor,Laura, AU - Imamura,Fumiaki, AU - Lentjes,Marleen A H, AU - Khaw,Kay-Tee, AU - Wareham,Nicholas J, AU - Forouhi,Nita G, Y1 - 2015/05/06/ PY - 2014/11/28/received PY - 2015/03/06/accepted PY - 2015/5/7/entrez PY - 2015/5/7/pubmed PY - 2016/3/11/medline SP - 1474 EP - 83 JF - Diabetologia JO - Diabetologia VL - 58 IS - 7 N2 - AIMS/HYPOTHESIS: This study aimed to evaluate the association of types of sugar-sweetened beverages (SSB) (soft drinks, sweetened-milk beverages, sweetened tea/coffee), artificially sweetened beverages (ASB) and fruit juice with incident type 2 diabetes and determine the effects of substituting non-SSB for SSB and the population-attributable fraction of type 2 diabetes due to total sweet beverages. METHODS: Beverage consumption of 25,639 UK-resident adults without diabetes at baseline (1993-1997) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study was assessed using 7-day food diaries. During 10.8 years of follow-up 847 incident type 2 diabetes cases were verified. RESULTS: In adjusted Cox regression analyses there were positive associations (HR [95% CI] per serving/day]) for soft drinks 1.21 (1.05, 1.39), sweetened-milk beverages 1.22 (1.05, 1.43) and ASB 1.22 (1.11, 1.33), but not for sweetened tea/coffee 0.98 (0.94, 1.02) or fruit juice 1.01 (0.88, 1.15). Further adjustment for adiposity attenuated the association of ASB, HR 1.06 (0.93, 1.20). There was a positive dose-response relationship with total sweet beverages: HR per 5% energy 1.18 (1.11, 1.26). Substituting ASB for any SSB did not reduce the incidence in analyses accounting for energy intake and adiposity. Substituting one serving/day of water or unsweetened tea/coffee for soft drinks and for sweetened-milk beverages reduced the incidence by 14%-25%. If sweet beverage consumers reduced intake to below 2% energy, 15% of incident diabetes might be prevented. CONCLUSIONS/INTERPRETATION: The consumption of soft drinks, sweetened-milk beverages and energy from total sweet beverages was associated with higher type 2 diabetes risk independently of adiposity. Water or unsweetened tea/coffee appear to be suitable alternatives to SSB for diabetes prevention. These findings support the implementation of population-based interventions to reduce SSB consumption and increase the consumption of suitable alternatives. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/25944371/Prospective_associations_and_population_impact_of_sweet_beverage_intake_and_type_2_diabetes_and_effects_of_substitutions_with_alternative_beverages_ L2 - https://doi.org/10.1007/s00125-015-3572-1 DB - PRIME DP - Unbound Medicine ER -