Added Sugar Consumption Is Not Relevantly Associated With an Increased Odds of Prediabetes in U.S. Adults

Abstract

ObjectivesTo examine whether self-reported added sugar consumption is associated with an increased risk for prediabetes in U.S. adults. MethodsA secondary data analysis was performed using National Health and Nutrition Examination Survey data collected between 2013–2018 in a subsample of adults (≥20 years) with prediabetes (HgbA1c 5.7% to 6.4%) and normoglycemia (HgbA1c < 5.7%) who did not have a diagnosis of type 2 diabetes (HgbA1c ≥ 6.5%). Mean usual intake of added sugar (g/day) was estimated from two 24-h dietary recalls. Survey-weighted logistic regression was used to test whether (1) total mean intake (g/day) of added sugar or (2) tertiles of added sugar as an overall percentage of added sugar intake (<10%,10–15%, >15% g/day) were associated with an increased odds of prediabetes. ResultsIn the sample of 10,671 adults, 34% were identified as having prediabetes, consuming an estimated average of 49.4 g/day of added sugar. In unadjusted models, added sugar was not relevantly associated with an increased odds of prediabetes [total: (OR = 1.001, P = 0.625); tertiles (reference: <10%): 10–15% (OR = 1.119, P = 0.206), >15% (OR = 1.057, P = 0.531)]. Similarly, in adjusted models that controlled for age, gender, race/ethnicity, total energy intake, physical activity status, smoking status, BMI, and socioeconomic covariates, added sugar was not relevantly associated with an increased odds of prediabetes [total: (OR = 1.001, P = 0.601); tertiles (reference: < 10%): 10–15% (OR = 1.032, P = 0.763), >15% (OR = 1.053, P = 0.665)]. ConclusionsResults indicate that self-reported added sugar consumption does not appear to relevantly increase the odds of prediabetes in adults. Because prediabetes is an early indicator of type 2 diabetes risk, it is possible that exposure to added sugar over time contributes to the significant associations observed in individuals with type 2 diabetes and not prediabetes. Funding SourcesUniversity of Alabama at Birmingham Graduate School and School of Nursing.