New research suggests that high consumption of sugar-sweetened beverages, which has been linked to increased risk for type 2 diabetes, is actually part of an overall poor diet.
As a result, the study researchers contend that care must be taken when associating such beverages to disease risk.
“Other studies have found similar things. However, this is the first time it is seen in such a large study for so many beverages in a systematic way,” said lead study investigator Louise Brunkwall, MPH, who is a nutritionist with Lund University in Malmö, Sweden.
Brunkwall, who presented the study findings at EASD 2015, the annual meeting of the European Association for the Study of Diabetes, noted that consumption of several beverages has been associated with risk for type 2 diabetes.
For instance, high coffee and tea consumption has been linked to a decreased risk for type 2 diabetes. In contrast, high consumption of sugar-sweetened beverages has been associated with an increased risk. The results regarding juice and artificially sweetened beverages have been inconclusive, according to Brunkwall.
She and her colleagues theorized that high consumption of these beverages — sugar-sweetened beverages, artificially sweetened beverages, juice, coffee and tea — may be associated with certain characteristics of the overall diet that should be teased out when analyzing associations between beverage consumption and disease.
The researchers evaluated data on 25,112 individuals from the Swedish Malmö Diet and Cancer Cohort. Sixty percent of the cohort was women, and all participants were aged 45 to 74 years. Mean BMI was 25.6, and all participants were free from diabetes, cardiovascular disease or cancer.
The researchers analyzed intake of beverages, macronutrients and 24 food groups using a modified diet history method that included a 7-day food record, a 168-item questionnaire and a 45-minute interview.
They then used computer modeling adjusted for age, sex, season, method, BMI, leisure time physical activity, total energy intake, smoking, education and alcohol intake to examine food intakes across five intake groups of the different beverages.
Brunkwall and her team found that a high consumption of sugar-sweetened beverages was significantly associated with lower intakes of foods generally perceived as healthy.
Specifically, the study demonstrated that the largest differences in intake between high and low consumers of sugar-sweetened beverages were seen for fruits, vegetables, yogurt, breakfast cereals, fiber-rich bread and fish.
Conversely, results indicated that high consumption of both tea and juice was significantly associated with higher intakes of foods perceived as healthy.
The study also showed that high consumption of artificially sweetened beverages was significantly associated with higher intakes of low-fat products, such as low-fat milk and margarines.
High consumption of coffee was found to be associated with higher intakes of meat and high-fat margarine and a lower intake of breakfast cereals.
“People consuming unhealthy beverages also consume unhealthy food to a higher extent and the other way around. Therefore, it would not be enough to only focus on the beverages; the overall diet is the important thing. I would also like to add that it will be important to be aware of these associations when reading future studies about single foods or single beverages,” Brunkwall told Endocrinology Advisor.
“It is more or less the same as for the clinical implications. I think it is of great importance for any clinician to be aware of the complexity of diet and diet studies. The whole diet has to be taken into account when discussing improvements or treatments. To just switch beverages will only take the patient so far.”
- Brunkwall L et al. Abstract 190: Overall dietary characteristics of individuals with high consumption of beverages previously associated with risk of type 2 diabetes. Presented at: EASD 2015; Sept. 14-18, 2015; Stockholm.