This site complies with the HONcode standard for trustworthy health information:
verify here.

Rewarding for
you and us
Defeat Diabetes Foundation

Defeat Diabetes
Foundation
150 153rd Ave,
Suite 300
Madeira Beach, FL 33708

Non-Diet Soda Ups Diabetes Risk with or without Weight Gain

Posted: Tuesday, November 09, 2010

Two sugary drinks a day increases risk as much as smoking for diabetes. Even if it doesn't make you fat, overloading on sugary drinks can still cause metabolic problems like diabetes, according to a new meta-analysis.

According to Vasanti Malik, ScD, of Harvard, "People who drank one or two sugar-sweetened beverages a day, like soda or vitamin water, had a 26% increased risk of developing Type 2 diabetes, compared with those who barely drank any."

Malik stated that, "Part of sugar-sweetened beverages' contribution to diabetes is via obesity, but there are other pathways as well… And the findings provide further evidence that patients should replace sugary drinks with healthier alternatives like water in order to reduce their risk of both obesity and chronic diseases."

Larry Cantley, MD, of Wake Forest University, which was not part of the study, added that the findings are "very important… A lot of decisions [to avoid junk food] have been guided by weight," he said. "We now have outcomes data to say that you can actually have a higher risk of diabetes by making these kinds of choices."

High intake of sugar-sweetened beverages has long been associated with weight gain and an increased risk of obesity. That risk has only grown as the global consumption of these drinks increases.

While it's been thought that the drinks can lead to ill health effects directly through weight gain, mechanistic research has revealed risk factors beyond the weight gain. For instance, sweetened beverages have been linked to increases in serum glucose as well as rapid and dramatic fluctuations in insulin, a cascade linked to glucose intolerance, insulin resistance, beta-cell dysfunction, and inflammation.

A recent study has also suggested that fructose, the main sweetener in these drinks, may be linked to high blood pressure as well as increases in LDL and triglycerides.

Since the direct relationship between these beverages and metabolic disease is not as well understood, the researchers conducted a meta-analysis of 11 studies: three that focused on the metabolic syndrome, and eight looking at Type 2 diabetes.

Dr. Frank Hu (Harvard School of Public Health) noted that smoking is associated with roughly a 30% to 40% increased risk of developing diabetes. "So for those who drink two to three sodas per day, their risk of developing Type 2 diabetes would be increased by 30% to 40%, which is not very different from the increased risk associated with cigarette smoking."

The studies, which included data from 310,819 patients, most often relied on food frequency questionnaires to evaluate dietary intake. The researchers found that patients with the highest intake of sugary drinks -- one or two servings per day -- had a 26% increased risk of developing diabetes (95% CI 1.12 to 1.41), compared with those who eschewed sugary drinks -- none or less than one serving per month.

There was a similar risk pattern for the metabolic syndrome with those drinking the most sodas or sugar-sweetened beverages having a 20% increased risk of developing the condition (95% CI 1.02 to 1.42).

Since obesity may mediate this relationship, the researchers attempted to control for its effects. When they excluded the three studies that controlled for body mass index (BMI) and total energy intake, there was a "slight increase in the magnitude of the association between diabetes and sugar-sweetened beverages," Malik said.

"One of the studies included in our analysis found that when adjusting for BMI, the association decreased by about half, suggesting that the association between [sugary drinks] and diabetes is partly mediated by body weight, but there is an independent association as well," she added.

The researchers also cautioned that higher levels of sugar-sweetened beverage intake could be a marker of an overall unhealthy diet. Those who drink too many sodas may also eat too much saturated or trans fats and not enough fiber, they said.

They concluded that the data "provide empirical evidence that intake of sugar-sweetened beverages should be limited to reduce obesity-related risk of chronic metabolic diseases."

Cantley added that the results could be stratified better, to look at patients who are "ultra-high" consumers of sugary drinks -- downing six to eight cans of Coke a day, for example.

"How much higher would the risk be if we took the really high consumers and focused on them?" he said. "The population [in this study] is diluted out by people drinking one or two beverages a day, which could underestimate how bad it might be."

Finally, the authors' conclusions were based on a meta-analysis of studies that were not designed to answer the research question they were investigating, so the findings should be interpreted cautiously.
Practice Pearls:

* Explain that a meta-analysis of 11 studies found that the risk of both Type 2 diabetes and metabolic syndrome was higher for those consuming one or two sugar-sweetened beverages a day compared with individuals drinking none or less than one a month.

* Note that when BMI was included in the analysis, the association was less but not eliminated, leading the researchers to conclude that sugary drinks are a risk factor for diabetes and metabolic syndrome independent of weight gain.

Source: http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=10029&catid=53&Itemid=8, Malik VS, et al "Sugar-sweetened beverages and risk of metabolic syndrome and Type 2 diabetes" Diabetes Care 2010; 33(11): 2477-2483.