Sugar-sweetened beverages and Type 2 diabetes: will a reduction in consumption reduce the risk of developing diabetes?

Abstract

Context The number of people with Type 2 diabetes (T2D) is increasing across the globe. By 2035 it is estimated that there will be 592 million people with diabetes worldwide, increasing from 382 million in 2013 [1]. The negative impact of diabetes on the individual’s quality of life has long been established [2] and the impact on economic and health resources is a substantial and growing burden [3]. There is high-quality evidence from intervention trials that healthier lifestyles can prevent or delay the onset of T2D [4]. A shift from a nutrient-based approach to one based on foods has been proposed for dietary guidelines [5], with emerging evidence for roles of certain foods in the development of T2D [6–8]. A ‘food’ item of particular interest is sugar-sweetened beverages (SSBs) [9,10], which, if found to be causally related to T2D, would offer the potential for T2D prevention by reducing or eliminating them from the diet. SSB is a collective term for soft drinks, fruit juice drinks, cordials, iced teas, sports drinks and other similar beverages, which are sweetened with caloric sugars. It has been estimated that the global consumption of soft drinks has increased from 9.5 gallons per person per year in 1997 to 11.4 gallons in 2010 [11]. Although national surveys from both the USA [12] and UK [13] have reported small decreases in SSB consumption (with the exception of a small increase in men aged ≥19 years in the UK) the contribution of SSBs to free sugar intakes is still high and concerning, as for example, SSBs are listed as the highest individual food contributor to energy intakes (5.3%) in the USA [14] and as one of the major sources of non-milk extrinsic sugar in the UK [13].