Diet soda and sugar-sweetened soda consumption in relation to incident diabetes in the Northern Manhattan Study

Hannah Gardener, Yeseon P. Moon, Tatjana Rundek, Mitchell S.V. Elkind, Ralph L Sacco

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Artificially (diet) and sugar-sweetened (regular) soda consumption have been associated with an increased risk of diabetes, but the literature on diet soda is inconsistent and the mechanisms unclear. Objective: We examined the relation between diet soda and regular soda consumption with the risk of incident diabetes in a longitudinal multiethnic population-based cohort. Methods: The study population included 2019 participants (mean ± SD age: 69 ± 10 y; 64% women; 23% white, 22% black, 53% Hispanic) in the Northern Manhattan Study who were free of diabetes and stroke at baseline. Soda consumption was assessed by a food-frequency questionnaire at baseline and examined continuously and categorically ( < 1/mo: sugar-sweetened = 908, diet = 1615; 1/mo-6/wk: sugar-sweetened = 830, diet = 298; daily: sugar-sweetened = 281, diet = 106). Weibull regression models were used to estimate the associations between soda consumption and incident diabetes, adjusting for demographics and vascular risk factors including body mass index (BMI) and calorie consumption. Results: During a mean ± SD follow-up of 11 ± 5 y, 368 participants developed diabetes. Sugar-sweetened soda was positively associated with incident diabetes (per soda per day HR = 1.15, 95% CI: 1.02, 1.31). The observed association between diet soda and elevated risk of diabetes was largely explained by BMI at the time of diet assessment, though the association remained strong and independent of BMI among those who were overweight or obese (daily compared to < 1/mo: HR = 1.63, 95% CI: 1.04, 2.55). Conclusions: This study supports the importance of sugar-sweetened beverage consumption in the diabetes epidemic. However, the results support previous studies suggesting that switching to artificially sweetened diet beverages may not lower the risk of diabetes, as diet soda consumption cannot be ruled out as an independent diabetes risk factor.

Original languageEnglish (US)
Article numbernzy008
JournalCurrent Developments in Nutrition
Volume2
Issue number5
StatePublished - May 1 2018

Fingerprint

diabetes
Diet
sugars
diet
body mass index
Body Mass Index
Beverages
beverages
risk factors
food frequency questionnaires
stroke
Hispanic Americans
blood vessels
Population
demographic statistics
Stroke
Demography
Food

Keywords

  • Artificially sweetened beverages
  • Diabetes
  • Diet
  • Soda
  • Sugar-sweetened beverages

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Food Science

Cite this

Diet soda and sugar-sweetened soda consumption in relation to incident diabetes in the Northern Manhattan Study. / Gardener, Hannah; Moon, Yeseon P.; Rundek, Tatjana; Elkind, Mitchell S.V.; Sacco, Ralph L.

In: Current Developments in Nutrition, Vol. 2, No. 5, nzy008, 01.05.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Artificially (diet) and sugar-sweetened (regular) soda consumption have been associated with an increased risk of diabetes, but the literature on diet soda is inconsistent and the mechanisms unclear. Objective: We examined the relation between diet soda and regular soda consumption with the risk of incident diabetes in a longitudinal multiethnic population-based cohort. Methods: The study population included 2019 participants (mean ± SD age: 69 ± 10 y; 64{\%} women; 23{\%} white, 22{\%} black, 53{\%} Hispanic) in the Northern Manhattan Study who were free of diabetes and stroke at baseline. Soda consumption was assessed by a food-frequency questionnaire at baseline and examined continuously and categorically ( < 1/mo: sugar-sweetened = 908, diet = 1615; 1/mo-6/wk: sugar-sweetened = 830, diet = 298; daily: sugar-sweetened = 281, diet = 106). Weibull regression models were used to estimate the associations between soda consumption and incident diabetes, adjusting for demographics and vascular risk factors including body mass index (BMI) and calorie consumption. Results: During a mean ± SD follow-up of 11 ± 5 y, 368 participants developed diabetes. Sugar-sweetened soda was positively associated with incident diabetes (per soda per day HR = 1.15, 95{\%} CI: 1.02, 1.31). The observed association between diet soda and elevated risk of diabetes was largely explained by BMI at the time of diet assessment, though the association remained strong and independent of BMI among those who were overweight or obese (daily compared to < 1/mo: HR = 1.63, 95{\%} CI: 1.04, 2.55). Conclusions: This study supports the importance of sugar-sweetened beverage consumption in the diabetes epidemic. However, the results support previous studies suggesting that switching to artificially sweetened diet beverages may not lower the risk of diabetes, as diet soda consumption cannot be ruled out as an independent diabetes risk factor.",
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