Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose–response meta-analysis of prospective studies

• Published in: British journal of nutrition 2014-09, Vol.112 (5), p.725-734
• Main Authors: Greenwood, D. C., Threapleton, D. E., Evans, C. E. L., Cleghorn, C. L., Nykjaer, C., Woodhead, C., Burley, V. J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Artificial sweeteners; Biological and medical sciences; Body Mass Index; Carbonated Beverages - adverse effects; Carbonated Beverages - analysis; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes. Impaired glucose tolerance; Dietary Sucrose - administration & dosage; Dietary Sucrose - adverse effects; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Health risks; Heterogeneity; Human and Clinical Nutrition; Humans; Life Style; Literature reviews; Male; Medical sciences; MEDLINE; Middle Aged; Prospective Studies; Risk Factors; Soft drinks; Sugar; Sweetening Agents - administration & dosage; Sweetening Agents - adverse effects; Systematic review; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114514001329

The intake of sugar-sweetened soft drinks has been reported to be associated with an increased risk of type 2 diabetes, but it is unclear whether this is because of the sugar content or related lifestyle factors, whether similar associations hold for artificially sweetened soft drinks, and how these associations are related to BMI. We aimed to conduct a systematic literature review and dose–response meta-analysis of evidence from prospective cohorts to explore these issues. We searched multiple sources for prospective studies on sugar-sweetened and artificially sweetened soft drinks in relation to the risk of type 2 diabetes. Data were extracted from eleven publications on nine cohorts. Consumption values were converted to ml/d, permitting the exploration of linear and non-linear dose–response trends. Summary relative risks (RR) were estimated using a random-effects meta-analysis. The summary RR for sugar-sweetened and artificially sweetened soft drinks were 1·20/330 ml per d (95 % CI 1·12, 1·29, P