(04-04-11) Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men.

de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB.

Departments of Nutrition and Epidemiology, Harvard School of Public Health,
Boston, MA.
Abstract
BACKGROUND: Sugar-sweetened beverages are risk factors for type 2 diabetes;
however, the role of artificially sweetened beverages is unclear.

OBJECTIVE: The objective was to examine the associations of sugar- and
artificially sweetened beverages with incident type 2 diabetes.

DESIGN: An analysis of healthy men (n = 40,389) from the Health Professionals
Follow-Up study, a prospective cohort study, was performed. Cumulatively
averaged intakes of sugar-sweetened (sodas, fruit punches, lemonades, fruit
drinks) and artificially sweetened (diet sodas, diet drinks) beverages from
food-frequency questionnaires were tested for associations with type 2 diabetes
by using Cox regression.

RESULTS: There were 2680 cases over 20 y of follow-up. After age adjustment,
the hazard ratio (HR) for the comparison of the top with the bottom quartile of
sugar-sweetened beverage intake was 1.25 (95% CI: 1.11, 1.39; P for trend <
0.01). After adjustment for confounders, including multivitamins, family
history, high triglycerides at baseline, high blood pressure, diuretics, pre-
enrollment weight change, dieting, total energy, and body mass index, the HR
was 1.24 (95% CI: 1.09, 1.40; P for trend < 0.01). Intake of artificially
sweetened beverages was significantly associated with type 2 diabetes in the
age-adjusted analysis (HR: 1.91; 95% CI: 1.72, 2.11; P for trend < 0.01) but
not in the multivariate-adjusted analysis (HR: 1.09; 95% CI: 0.98, 1.21; P for
trend = 0.13). The replacement of one serving of sugar-sweetened beverage with
1 cup (??237 mL) of coffee was associated with a risk reduction of 17%.

CONCLUSION: Sugar-sweetened beverage consumption is associated with a
significantly elevated risk of type 2 diabetes, whereas the association between
artificially sweetened beverages and type 2 diabetes was largely explained by
health status, pre-enrollment weight change, dieting, and body mass index.

Source: Am J Clin Nutr. 2011 Mar 23. [Epub ahead of print]

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