Sugar-sweetened beverage and diet soda consumption and the 7-year risk for type 2 diabetes mellitus in middle-aged Japanese men

A Letter to the Editor to this article was published on 09 April 2014



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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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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Correspondence to M. Sakurai.

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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).

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  • Cohort study
  • Epidemiology
  • Incidence
  • Nutrition