Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population…

By F. Imamura, Laura O’Connor, Z. Ye, J. Mursu, Y. Hayashino, S. Bhupathiraju, N. Forouhi. British medical journal, 2015

1,175 citations recorded by the source corpus.

Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. Design Systematic review and meta-analysis. Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million). Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages. Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%). Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.

Subfields: Endocrinology, Diabetes and Metabolism, Public Health, Environmental and Occupational Health

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Citations in the corpus

Epidemiology of Obesity and Diabetes and Their Cardiovascular Complications (2016, positive): “SSB consumption was associated with a higher risk of T2D, independent of its effect on weight gain.(64) Although nation-”
Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States (2017, neutral): “9) College N deaths 3 (3, 3) 8 (6, 9) 6 (5, 7) 13 (10, 16) 25 (20, 29) 17 (14, 20) 69 (55, 80) 35 (28, 41) 99 (76, 119) 44 (34, 54) 315 (240, 376) 339 (258, 418) 983 (874, 1090) % ISTK 78.”
Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors (2020, background): “Various dietary factors, such as meat, whole grain products, healthy dietary patterns, sugar-sweetened beverage consumption, and iron-based diets have an obvious relationship with NCDs (11, 12).”
Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity – A Comprehensive Review (2016, positive): “Furthermore, the intake of sugar-sweetened fruit juice, but not 100% fruit juice, is associated with incident diabetes mellitus in longitudinal studies (Figure 6).(257,266) These findings suggest that 100% fruit juice may have other beneficial components, eg, dietary fiber, vitamins, and phytochemic”
Should We Tax Sugar-Sweetened Beverages? An Overview of Theory and Evidence (2019, background): “A meta-analysis of 17 cohort studies found that drinking one more serving of sugar-sweetened beverages per day was associated with a 13 percent higher risk of developing type 2 diabetes (Imamura et al. 2015; see also Malik et al. 2010).”