This cohort study investigated the association between sugar-sweetened beverage (SSB) and diet soda consumption and the incidence of type 2 diabetes in Japanese men.
The participants were 2,037 employees of a factory in Japan. We measured consumption of SSB and diet soda using a self-administered diet history questionnaire. The incidence of diabetes was determined in annual medical examinations over a 7-year period. Hazard ratios (HRs) with 95 % confidence intervals (CIs) for diabetes were estimated after adjusting for age, body mass index, family history, and dietary and other lifestyle factors.
During the study, 170 participants developed diabetes. The crude incidence rates (/1,000 person-years) across participants who were rare/never SSB consumers, <1 serving/week, ≥1 serving/week and <1 serving/day, and ≥1 serving/day were 15.5, 12.7, 14.9, and 17.4, respectively. The multivariate-adjusted HR compared to rare/never SSB consumers was 1.35 (95 % CI 0.80–2.27) for participants who consumed ≥1 serving/day SSB. Diet soda consumption was significantly associated with the incident risk of diabetes (P for trend = 0.013), and multivariate-adjusted HRs compared to rare/never diet soda consumers were 1.05 (0.62–1.78) and 1.70 (1.13–2.55), respectively, for participants who consumed <1 serving/week and ≥1 serving/week.
Consumption of diet soda was significantly associated with an increased risk for diabetes in Japanese men. Diet soda is not always effective at preventing type 2 diabetes even though it is a zero-calorie drink.
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Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH et al (2006) Epidemic obesity and type 2 diabetes in Asia. Lancet 368:1681–1688
Bray GA, Nielsen SJ, Popkin BM (2004) Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 79:537–543
Ismail AI, Tanzer JM, Dingle JL (1997) Current trends of sugar consumption in developing societies. Community Dent Oral Epidemiol 25:438–443
Basu M (2007) Diabetes, obesity and soft drinks. Natl Med J India 20:102–103
Zenith International’s Report on Global Soft Drinks (2008) Bath. United Kingdom: Zenith International, Ltd
Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC et al (2004) Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 292:927–934
Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB et al (2007) Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation 116:480–488
Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L (2008) Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med 168:1487–1492
Bazzano LA, Li TY, Joshipura KJ, Hu FB (2008) Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 31:1311–1317
Odegaard AO, Koh WP, Arakawa K, Yu MC, Pereira MA (2010) Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study. Am J Epidemiol 171:701–708
de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB (2011) Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr 93:1321–1327
Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB (2010) Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 33:2477–2483
Paynter NP, Yeh HC, Voutilainen S, Schmidt MI, Heiss G, Folsom AR et al (2006) Coffee and sweetened beverage consumption and the risk of type 2 diabetes mellitus: the atherosclerosis risk in communities study. Am J Epidemiol 164:1075–1084
Montonen J, Jarvinen R, Knekt P, Heliovaara M, Reunanen A (2007) Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J Nutr 137:1447–1454
Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr (2009) Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 32:688–694
Sakurai M, Miura K, Takamura T, Ishizaki M, Morikawa Y, Nakamura K et al (2009) J-shaped relationship between waist circumference and subsequent risk for Type 2 diabetes: an 8-year follow-up of relatively lean Japanese individuals. Diabet Med 26:753–759
Nakashima M, Sakurai M, Nakamura K, Miura K, Yoshita K, Morikawa Y et al (2010) Dietary glycemic index, glycemic load and blood lipid levels in middle-aged Japanese men and women. J Atheroscler Thromb 17:1082–1095
Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa SY et al (2012) Dietary glycemic index and risk of type 2 diabetes in middle-aged Japanese men. Metabolism 61:47–55
Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa SY et al (2012) Self-reported speed of eating and 7-year risk of type 2 diabetes mellitus in middle-aged Japanese men. Metabolism 61:1566–1571
The Committee of the Japan Diabetes Society on the diagnostic criteria of diabetes mellitus (2012) Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. J Diabetes Invest 3:39–40
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419
Sasaki S, Yanagibori R, Amano K (1998) Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol 8:203–215
Sasaki S, Ushio F, Amano K, Morihara M, Todoriki O, Uehara Y et al (2000) Serum biomarker-based validation of a self- administered diet history questionnaire for Japanese subjects. J Nutr Sci Vitaminol 46:285–296
Okubo H, Sasaki S, Rafamantanantsoa HH, Ishikawa-Takata K, Okazaki H, Tabata I (2008) Validation of self-reported energy intake by a self-administered diet history questionnaire using the doubly labeled water method in 140 Japanese adults. Eur J Clin Nutr 62:1343–1350
Yamada M, Murakami K, Sasaki S, Takahashi Y, Okubo H (2008) Soft drink intake is associated with diet quality even among young Japanese women with low soft drink intake. J Am Diet Assoc 108:1997–2004
American Diabetes Association (2012) Diagnosis and classification of diabetes mellitus. Diabetes Care 35:S64–S71
Blundell JE, Hill AJ (1986) Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet 1:1092–1093
Rogers PJ, Blundell JE (1989) Separating the actions of sweetness and calories: effects of saccharin and carbohydrates on hunger and food intake in human subjects. Physiol Behav 45:1093–1099
Tordoff MG, Alleva AM (1990) Oral stimulation with aspartame increases hunger. Physiol Behav 47:555–559
Swithers SE, Davidson TL (2008) A role for sweet taste: calorie predictive relations in energy regulation by rats. Behav Neurosci 122:161–173
Brown RJ, Walter M, Rother KI (2012) Effects of diet soda on gut hormones in youths with diabetes. Diabetes Care 35:959–964
Brown RJ, Walter M, Rother KI (2009) Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion. Diabetes Care 32:2184–2186
Wu T, Zhao BR, Bound MJ, Checklin HL, Bellon M, Little TJ et al (2012) Effects of different sweet preloads on incretin hormone secretion, gastric emptying, and postprandial glycemia in healthy humans. Am J Clin Nutr 95:78–83
Ma J, Bellon M, Wishart JM, Young R, Blackshaw LA, Jones KL et al (2009) Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects. Am J Physiol Gastrointest Liver Physiol 296:G735–G739
This research was supported by a Grant-in-Aid from the Ministry of Health, Labor, and Welfare, Health and Labor Sciences research grants, Japan (H18-Junkankitou[Seishuu]-Ippan-012, H19-Junkankitou [Seishuu]-Ippan-012, H19-Junkankitou [Seishuu]-Ippan-021, H20-Junkankitou [Seishuu]-Ippan-013, H22-Junkankitou [Seishuu]-Ippan-005, H23-Junkankitou [Seishuu]-Ippan-005); a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan for Scientific Research (B) (20390188); and the Japan Arteriosclerosis Prevention Fund.
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The authors declare that they have no conflict of interest.
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Sakurai, M., Nakamura, K., Miura, K. et al. Sugar-sweetened beverage and diet soda consumption and the 7-year risk for type 2 diabetes mellitus in middle-aged Japanese men. Eur J Nutr 53, 251–258 (2014). https://doi.org/10.1007/s00394-013-0523-9
- Cohort study