Type 2 diabetes rates are clearly climbing, and have tripled in just 10 years.
The rise in sugary drink consumption has paralleled the rise in obesity and type 2 diabetes, which now afflicts ever-younger patients. And while obesity is a risk factor for type 2 diabetes, researchers have wondered whether sugary drinks are an independent risk factor, regardless of weight gain. There's something quite special about sugary drinks' sugar concentration and rate of sugar delivery. We're gorging on growing amounts of sugars, which find their way into many of our processed foods. But the major source of added sugar in the Western diet is – you might be surprised – not desserts, but rather sugary drinks, which account for as much as half the daily calories from sugar, and 10-15 percent of kids’ total daily calories.
A study in the Archives of Internal Medicine looked at the relationship between consumption of sweetened soft drinks and fruit drinks and type 2 diabetes in 44,000 African American women, and found that women who consumed two or more soft drinks a day had a 24 percent increase in incidence of diabetes relative to women who drank less than one soft drink per month, a relationship that remains valid after controlling for obesity.
A meta-analysis, published in Diabetes Care in 2010, pooled more than 310,000 participants, and found that higher intakes of sugary drinks were associated with the development of the metabolic syndrome and type 2 diabetes.
Another recent study in PLoS One looked at the relationship between sugar availability and diabetes prevalence in 175 countries. After accounting for many factors, such as obesity, exercise, poverty, age, etc., the study found that the higher the sugar in the countries’ food supply, the higher the diabetes rates. The article’s conclusion: “every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1%.”
Most of these studies were in North American populations. Now, a new study published in Diabetologia takes a European perspective on the sugary drink diabetes link.
The study, which followed a very large population from 8 countries for 16 years, found about 12,ooo people who developed type 2 diabetes during follow-up, and compared them to 16,000 random controls from the same large cohort. It found that after taking into statistical account confounders such as smoking, education, physical activity, diet etc., drinking what amounts to one can of sugary drink a day increased the risk of diabetes by 22 percent. When the data was adjusted for weight (BMI) and caloric intake, the association was still strong, and the extra risk was 18 percent.
The authors discuss:
“The association between sugar-sweetened soft drinks and diabetes was only slightly attenuated when BMI was included in the model, which could indicate that obesity is neither the only nor the main mediator of the association, and that other mechanisms of action might be involved, such as the glycaemic effect of sugar-sweetened drinks and consequent insulin resistance”
In other words, sugary drinks may lead to obesity, which is a risk factor for diabetes, but sugary drinks consumption is a diabetes risk in and of itself.
“Given the increase in sweet beverage consumption in Europe, clear messages on its deleterious effect on health should be given to the population.”
Full disclosure: I’m vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I’m also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.