Findings were similar for sugar-sweetened and artificially-sweetened beverages in terms of the chances of developing diabetes variants.
The study found that drinking more than two daily 200ml servings more than doubled the chances of developing type 2 diabetes as well as latent autoimmune diabetes in adults (LADA)—a form of diabetes that has a slower course of onset.
Higher consumption of these soft drinks equated to a 20% higher type 2 diabetes risk for each daily serving.
The findings linking sugar and artificially-sweetened beverages with diabetes support a body of evidence that has postulated this association for some time.
A recent meta-analysis found that the risk increases by 13% for an increment of each serving per day in intake.
Artificially-sweetened beverages have been implicated too, although it may be that they exert their influence via alternative pathways. These include weakened glucose tolerance activated by modifications in gut microbiota.
Karolinska carry out study
The team from the Karolinska Institute began looking at rates of soft drink consumption in 2,874 Swedish adults and compared them with diabetes cases.
The results were adjusted for age, sex, family history of diabetes, education, lifestyle, diet, energy intake and BMI.
“The associations were similar in separate analyses of sugar-sweetened and artificially sweetened beverages for the risk of LADA as well as type 2 diabetes,” the study noted.
“The excess risk seems not to be fully explained by caloric intake or BMI, opening up for other explanations possibly including direct adverse effects of sweetened beverages on glucose homeostasis and insulin sensitivity.”
Industry reaction
The recent sugar tax imposed on the soft drinks industry in the UK was designed in part to prevent cases of chronic conditions developing—particularly in the relatively young—as excess consumption of drinks high in sugar were blamed.
“These kinds of beverages should be put on hold for children,” said Tam Fry from the National Obesity Forum and advisor for UK charity Action on Sugar.
“I believe that parents should put them off limits and steer their kids to water which is, and always will be, the best option.”
Commenting on the study, Fry expressed reservations, commenting that such a study needed to be replicated before it could be widely accepted.
“The use of self-reported data often flaws research of this kind. Having said that these findings should not be lightly dismissed.”
In a policy statement drawn up by The Association of UK Dietitians, the use of artificial sweeteners was considered safe to consume up to the Acceptable Daily Intake (ADI) in the general population ‘with the exception of foods for infants and young children, and are authorised and approved for use by EFSA.’
They believed that artificial sweeteners could assist in the management of weight and in the management of other health conditions such as diabetes mellitus in some individuals although a tailored individualised approach was required.
They also recommended clearer labelling regarding the ADI set by EFSA on food products and beverages so consumers were better informed.
Source: European Journal of Endocrinology
Published online ahead of print, doi: 10.1530/EJE-16-0376
“Sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes.”
Authors: Josefin Löfvenborg et al.