Journal
DIABETOLOGIA
Volume 56, Issue 7, Pages 1520-1530Publisher
SPRINGER
DOI: 10.1007/s00125-013-2899-8
Keywords
Artificially sweetened soft drinks; Case-cohort study; Europe; Juices and nectars; Prospective study; Sugar-sweetened soft drinks; Sweet beverages; Type 2 diabetes incidence
Categories
Funding
- EU FP6 programme [LSHM_CT_2006_037197]
- NL Agency grant [IGE05012]
- Board of the UMC Utrecht (the Netherlands)
- Dutch Ministry of Public Health, Welfare and Sports (VWS)
- Netherlands Cancer Registry (NKR)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (the Netherlands)
- Swedish Research Council
- Novo Nordisk
- Swedish Heart Lung Foundation
- Swedish Diabetes Association
- Danish Cancer Society
- Deutsche Krebshilfe
- Associazione Italiana per la Ricerca sul Cancro
- Asturias Regional Government
- Health Research Fund (FIS) of the Spanish Ministry of Health
- CIBER en Epidemiologia y Salud Publica (CIBERESP), Spain
- Murcia Regional Government [6236]
- AIRE-ONLUS Ragusa
- AVIS-Ragusa
- Sicilian Regional Government
- Medical Research Council [MC_UU_12015/1, MC_UP_A100_1003, MC_UU_12015/5] Funding Source: researchfish
- MRC [MC_UU_12015/1, MC_UP_A100_1003, MC_UU_12015/5] Funding Source: UKRI
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Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence. In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.
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