Main Article Content
Background: The consumption of sugar-sweetened beverages has been increasing continuously worldwide. Drinking sugar-sweetened beverages has been suspected to be a risk factor of developing diabetes mellitus but results from previous were conflicting.
Objective: To performed a systematic review and meta-analysis aiming to estimate the effect size of sugar-sweetened beverages on the risk of developing diabetes mellitus.
Methods: Medicine and Scopus databases were comprehensively searched for relevant studied. Two reviewers selected studies based on titles and abstracts. Observational studies published in English were selected, if they met all of these following criteria: 1) considered sugar-sweetened beverages as an interested risk factor, 2) measured the outcomes as having or not having diabetes mellitus, 3) provided adequate data for pooling the effect size. Odds ratios or relative riskd of having type 2 diabetes mellitus of each study were pooled by using random effect model, if heterogeneity between studies presents. If not, the fixed effect model with inverse variance method was used. Sources of heterogeneity were assessed by fitting co-variables (such as age of patient, study design, assessment method) one by one in meta-regression.
Results: Eight out of 1439 studies were finally eligible in our review. Compared with never or seldom drinking, drinking sugar-sweetened beverages equal or more than on serving per week significantly increased risk of having diabetes mellitus with pooled odds ratio of 1.30 (95% CI, 1.05 - 1.62). Pooling odds ratio adjusted with body mass index still showed the significant risk effect of drinking sugar-sweetened beverages equal or more than one serving per week with pooled adjusted odds ratio of 1.25 (95% CI, 1.19 - 1.31).
Conclusions: Results from our study suggested that drinking sugar-sweetened beverages equal or more than one serving per week significantly increased risk of having diabetes mellitus. This risk effect still persisted even after adjusting the effect of body mass index.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2. Apovian CM. Sugar-sweetened soft drinks, obesity, and type 2 diabetes. JAMA. 2004;292(8):978-979.
3. Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 2007;97(4):667-675.
4. Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010;121(11):1356-1364. doi:10.1161/CIRCULATIONAHA.109.876185.
5. Dennis EA, Flack KD, Davy BM. Beverage consumption and adult weight management: a review. Eat Behav. 2009;10(4):237-246. doi:10.1016/j.eatbeh.2009.07.006.
6. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav. 2010;100(1):47-54. doi:10.1016/j.physbeh.2010.01.036.
7. Mattes RD, Shikany JM, Kaiser KA, Allison DB. Nutritively sweetened beverage consumption and body weight: a systematic review and meta-analysis of randomized experiments. Obes Rev. 2011;12(5):346-365. doi:10.1111/j.1467-789X.2010.00755.x.
8. Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477-2283. doi:10.2337/dc10-1079.
9. Weed DL, Althuis MD, Mink PJ. Quality of reviews on sugar-sweetened beverages and health outcomes: a systematic review. Am J Clin Nutr. 2011;94(5):1340-1347. doi:10.3945/ajcn.111.015875.
10. Heidemann C, Hoffmann K, Spranger J, et al. A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)--Potsdam Study cohort. Diabetologia. 2005;48(6):1126-1134.
11. McNaughton SA, Mishra GD, Brunner EJ. Dietary patterns, insulin resistance, and incidence of type 2 diabetes in the Whitehall II Study. Diabetes Care. 2008;31(7):1343-1348. doi:10.2337/dc07-1946.
12. Nettleton JA, Steffen LM, Ni H, Liu K, Jacobs DR Jr. Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2008;31(9):1777-1782. doi:10.2337/dc08-0760.
13. Schulze MB, Hoffmann K, Manson JE, et al. Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr. 2005;82(3):675-684.
14. Liu E, McKeown NM, Newby PK, et al. Cross-sectional association of dietary patterns with insulin-resistant phenotypes among adults without diabetes in the Framingham Offspring Study. Br J Nutr. 2009;102(4):576-583. doi:10.1017/S0007114509220836.
15. Isacco L, Lazaar N, Ratel S, et al. The impact of eating habits on anthropometric characteristics in French primary school children. Child Care Health Dev. 2010;36(6):835-842. doi:10.1111/j.1365-2214.2010.01113.x.
16. Nöthlings U, Boeing H, Maskarinec G, et al. Food intake of individuals with and without diabetes across different countries and ethnic groups. Eur J Clin Nutr. 2011;65(5):635-641. doi:10.1038/ejcn.2011.11.
17. Chen L, Hu FB, Yeung E, Willett W, Zhang C. Prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care. 2009;32(12):2236-2241. doi:10.2337/dc09-0866.
18. de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr. 2011;93(6):1321-1327. doi:10.3945/ajcn.110.007922.
19. Odegaard AO, Koh WP, Arakawa K, Yu MC, Pereira MA. Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study. Am J Epidemiol. 2010;171(6):701-708. doi:10.1093/aje/kwp452.
20. Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med. 2008;168(14):1487-1492. doi:10.1001/archinte.168.14.1487.
21. Schulze MB, Manson JE, Ludwig DS, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA. 2004;292(8):927-934.
22. Montonen J, Järvinen R, Knekt P, Heliövaara M, Reunanen A. Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J Nutr. 2007;137(6):1447-1454.
23. Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2009;32(4):688-694. doi:10.2337/dc08-1799.
24. Paynter NP, Yeh HC, Voutilainen S, et al. Coffee and sweetened beverage consumption and the risk of type 2 diabetes mellitus: the atherosclerosis risk in communities study. Am J Epidemiol. 2006;164(11):1075-1084.
25. Fagherazzi G, Vilier A, Saes Sartorelli D, Lajous M, Balkau B, Clavel-Chapelon F. Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 2013;97(3):517-523. doi:10.3945/ajcn.112.050997.
26. InterAct Consortium, Romaguera D, Norat T, et al. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia. 2013;56(7):1520-1530. doi:10.1007/s00125-013-2899-8.
27. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84(2):274-288.
28. Janssens JP, Shapira N, Debeuf P, et al. Effects of soft drink and table beer consumption on insulin response in normal teenagers and carbohydrate drink in youngsters. Eur J Cancer Prev. 1999;8(4):289-295.