April 30th, 2015
More Evidence Linking Sugared Drinks to Diabetes
Larry Husten, PHD
A new study uncovers some potentially important new details about the association between sugared drinks and diabetes.
In a paper published in Diabetologia, researchers in the U.K. report on more than 10 years of followup of more than 25,000 adults. During the course of the study 847 participants went on to develop diabetes. Instead of relying on a food-frequency questionnaire, as in most earlier studies, the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study used dietary information obtained from seven-day food diaries filled out by the study participants. According to the authors, diaries are more reliable and allow for a more detailed analysis of different dietary components.
Overall, each 5% increase in the amount of calories coming from sugar-sweetened beverages (SSB) was associated with an 18% increase in diabetes. Soft drinks, sweetened milk beverages, and artificially sweetened beverages (ASB) were all associated with a greater than 20% increase in diabetes. However, the association with artificially sweetened beverages lost statistical significance when the researchers took into account people’s weight, suggesting that the association was likely “an artifact of reverse causality where those who are overweight or obese and at higher risk of chronic disease consume a higher amount of ASB than those at lower risk.” Replacing soft drinks and sweetened-milk drinks with water or unsweetened tea or coffee would significantly cut the rate of diabetes, the authors calculated.
The association of tea and coffee has not been well studied in the past. The new study found that sweetened tea or coffee had no association with diabetes while unsweetened tea or coffee had an inverse association. The study is also the first to link sweetened-milk beverages to diabetes, but the authors write that the association is “unsurprising” since added sugar contributes more than half the sugar contained in milkshakes and flavored milks.
The authors conclude that “it is now timely and appropriate to consider population-based interventions to reduce SSB consumption and increase the consumption of suitable alternative beverages.”
In a press release, the senior author of the paper, Nita Forouhi, said, “The good news is that our study provides evidence that replacing a daily serving of a sugary soft drink or sugary milk drink with water or unsweetened tea or coffee can help to cut the risk of diabetes, offering practical suggestions for healthy alternative drinks for the prevention of diabetes.”
I think what most people are missing in all the “sugar is killing us” press/editoralsl is to look at the studies and figure out a ballpark absolute difference that sugar makes.
I may be doing the math wrong on this but in this study while the relative increase is about 18-20% in looking at Table 2 the ABSOLUTE risk increase of type 2 diabetes (a risk factor not a disease) is approx 0.3%. In other words, 333 would have to drink enough soft drinks every day FOR TEN YEARS (to put them in the top tertile compared to the lowest tertile) for 1 extra person to get type 2 diabetes.
While on a population basis I’m sure one can make a bit of an argument, I think the absolute risk is small enough that people should be told the potential harm (there is also an increase in dental decay and weight etc) and make there own decision.
Or am I missing something?