Greenwood, DC orcid.org/0000-0001-7035-3096, Threapleton, DE orcid.org/0000-0002-5884-3372, Evans, CEL orcid.org/0000-0002-4065-4397 et al. (4 more authors) (2014) Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose–response meta-analysis of prospective studies. British Journal of Nutrition, 112 (5). pp. 725-734. ISSN 0007-1145
Abstract
The intake of sugar-sweetened soft drinks has been reported to be associated with an increased risk of type 2 diabetes, but it is unclear whether this is because of the sugar content or related lifestyle factors, whether similar associations hold for artificially sweetened soft drinks, and how these associations are related to BMI. We aimed to conduct a systematic literature review and dose–response meta-analysis of evidence from prospective cohorts to explore these issues. We searched multiple sources for prospective studies on sugar-sweetened and artificially sweetened soft drinks in relation to the risk of type 2 diabetes. Data were extracted from eleven publications on nine cohorts. Consumption values were converted to ml/d, permitting the exploration of linear and non-linear dose–response trends. Summary relative risks (RR)
were estimated using a random-effects meta-analysis. The summary RR for sugar-sweetened and artificially sweetened soft drinks were
1·20/330 ml per d (95% CI 1·12, 1·29, P,0·001) and 1·13/330 ml per d (95% CI 1·02, 1·25, P¼0·02), respectively. The association with
sugar-sweetened soft drinks was slightly lower in studies adjusting for BMI, consistent with BMI being involved in the causal pathway. There was no evidence of effect modification, though both these comparisons lacked power. Overall between-study heterogeneity was high. The included studies were observational, so their results should be interpreted cautiously, but findings indicate a positive association
between sugar-sweetened soft drink intake and type 2 diabetes risk, attenuated by adjustment for BMI. The trend was less consistent for
artificially sweetened soft drinks. This may indicate an alternative explanation, such as lifestyle factors or reverse causality. Future research
should focus on the temporal nature of the association and whether BMI modifies or mediates the association.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2014, CUP. This is an author produced version of a paper published in The British Journal of Nutrition. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Sugar; soft drinks; meta-analyses; type-2 diabetes |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) The University of Leeds > Faculty of Environment (Leeds) > School of Food Science and Nutrition (Leeds) > FSN Nutrition and Public Health (Leeds) The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Funding Information: | Funder Grant number Food Standards Agency SACN 01 004 Food Standards Agency SACN 01 004 |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Jun 2014 10:09 |
Last Modified: | 20 Jun 2021 08:37 |
Published Version: | http://dx.doi.org/10.1017/S0007114514001329 |
Status: | Published |
Publisher: | Cambridge University Press |
Refereed: | Yes |
Identification Number: | 10.1017/S0007114514001329 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:79489 |