Soda Linked To Higher Risk of Diabetes, Regardless of Obesity Status

Fumiaki Imamura Ph.D. MRC Epidemiology Unit University of Interview with: Dr. Fumiaki Imamura Ph.D.
MRC Epidemiology Unit
University of Cambridge

Medical Research: What is the background for this study? What are the main findings?

Dr. Imamura: Soft drink consumption is associated with risk of diabetes, but whether or not the association persists after controlling for obesity status is not known. Diet drinks and fruit juice may be good alternatives to soft drinks. However, while obese individuals may consume diet drinks or fruit juice instead of sugar-sweetened soft drinks, evidence was weak to determine whether or not consuming these beverages is associated with risk of diabetes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Imamura: Consumption of soft drinks appeared to be associated with higher risk of diabetes, regardless of obesity status. Although causality of the association remains unknown, it is reasonable to avoid it, based on the findings and known clinical evidence about soft drinks. If the association is causal and everyone takes maximal action to reduce the consumption, a sizable number of diabetes cases would be prevented, eg 4-13% of cases in US. Thus, although an individual benefit may be small, the population benefit can be substantial.

Diet drinks may be candidate alternatives to soft drinks. Although they may be good to reduce caloric intake as shown by some clinical trials, these beverages themselves may not merit primary prevention of diabetes. Fruit juice itself may not, either. It would be advisable to consider water, unsweetened coffee, or unsweetened tea to consume instead of any sweet beverages. Coffee and tea have been shown to be associated with lower risk of type 2 diabetes.

The study did not assess beverage consumption and health outcomes among diabetes patients. Yet, based on the existing evidence, the above recommendation is generally reasonable.

The proportion of diabetes cases attributable to soft drinks was estimated to be 4-13% in US and lesser in UK. This indicates that  more than 80% of diabetes cases are related to other factors. As commonly noted, clinicians and patients should focus on other dietary and lifestyle factors, as well as consumption of soft drinks or sugar.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Imamura: Reducing soft drinks is recommended. But, we do not know what strategies are effective in terms of people’s preference, people’s health and social benefits. Effectiveness of different interventions is one of things to study. Research can include statistical simulation, clinical intervention, and community-based intervention.

Evidence remained relatively limited for non-white populations: for example, people in Latino countries, China, and India: Latino countries have recorded the world highest sales of soft drinks; and China and India are becoming leading countries of diabetes epidemics.

We have insufficient evidence for impact of sweet beverage consumption on vascular diseases, cancer, kidney function, liver diseases, bone health, neurodegenerative diseases, and other chronic conditions; and prognosis of any diseases. We should keep in mind that any social, population-wide intervention influence risks of any diseases.  Thus, further research on different health conditions is warranted.



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Fumiaki Imamura (2015). Soda Associated With Greater Risk of Diabetes, Regardless of Obesity Status

uploaded July 22 2015

Last Updated on July 22, 2015 by Marie Benz MD FAAD