Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women

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Abstract
Type 2 diabetes mellitus affects about 17 million US individuals.1-3 The prevalence of diabetes has increased rapidly during the last decades2,4,5 in parallel to the obesity epidemic.2,5 Coinciding with the increasing prevalence of obesity and type 2 diabetes, soft drink consumption in the United States increased by 61% in adults from 1977 to 19976 and more than doubled in children and adolescents from 1977-1978 to 1994-1998.7 Recent evidence suggests an association between the intake of sugar-sweetened soft drinks and the risk of obesity in children,8 but data among adults are limited. Besides contributing to obesity, sugar-sweetened soft drinks might increase risk of diabetes because they contain large amounts of high-fructose corn syrup, which raises blood glucose similarly to sucrose.9 Soft drinks are the leading source of added sugars in the US diet,10 and each serving represents a considerable amount of glycemic load that may increase risk of diabetes.11 In addition, cola-based soft drinks contain caramel coloring, which is rich in advanced glycation end products that might increase insulin resistance12 and inflammation.13 However, no study has examined the association between the consumption of soft drinks and other sugar-sweetened beverages and risk of type 2 diabetes. We therefore examined the relationships between sugar-sweetened beverage consumption and weight gain and diabetes risk in a large cohort of young and middle-aged women, controlling for potential confounding factors. Because the majority of sugar-sweetened beverages consumed in this cohort are soft drinks, we particularly emphasized soft drink consumption.