Diabetes has become a global health concern, with an increasing number of adults affected worldwide. In 2021, approximately 537 million adults were reported to have diabetes, and this is projected to rise to 783 million by 2045. Adults with type 2 diabetes face an elevated risk of cardiovascular disease (CVD), other health issues, and premature death.
Dietary interventions are crucial in managing blood sugar levels in adults with diabetes. Still, the conventional dietary recommendations for the general population may not directly apply to them due to their altered metabolism. It is, therefore, essential to evaluate the impact of different dietary intakes, including beverages, on disease outcomes and mortality in adults with diabetes.
New research published in The BMJ has found that a higher intake of sugar-sweetened beverages (SSBs) is associated with a higher risk of all-cause mortality and cardiovascular disease (CVD) incidence in individuals with type 2 diabetes. In contrast, coffee, low-fat milk, and plain water consumption were inversely associated with CVD incidence and mortality in this population.
Furthermore, increasing coffee consumption after a diabetes diagnosis was associated with lower mortality. Replacing SSBs with artificially sweetened beverages (ASBs) was also associated with lower all-cause and CVD mortality. Additionally, replacing SSBs or ASBs with coffee, tea, low-fat milk, or plain water was associated with lower all-cause and CVD mortality.
These findings are consistent with previous research conducted in general populations, which has also shown that higher consumption of SSBs is associated with increased risk of weight gain, type 2 diabetes, and all-cause and CVD mortality. In contrast, coffee, tea, and plain water consumption has been associated with a lower risk of CVD, type 2 diabetes, cancer, and mortality in general populations. The evidence regarding milk consumption is mixed, with full-fat milk being associated with a higher risk of all-cause, CVD, and cancer mortality. In contrast, low-fat milk is inversely associated with type 2 diabetes and the risk of stroke.
The researchers suggest that the high fructose content in SSBs may be a key factor contributing to the adverse health outcomes associated with their consumption, including weight gain, insulin resistance, and inflammation. In contrast, coffee and tea contain beneficial bioactive constituents such as chlorogenic acids, melanoidin’s, and catechins, which have antioxidant and anti-inflammatory properties and may help reduce oxidative stress and inflammation. The study also found a slight J-shaped relationship between consumption of certain beverages (SSBs, ASBs, fruit juice, and full-fat milk) and overall mortality, which may be due to underreporting or recent quitting of these beverages.
This research adds to the growing body of evidence suggesting that specific types of beverages, including SSBs, ASBs, coffee, tea, and milk, may have differential effects on health outcomes, including mortality, in individuals with type 2 diabetes. The findings highlight the importance of considering beverage consumption patterns in the management of type 2 diabetes and in promoting healthy dietary choices in this population. Further research is needed to understand the underlying mechanisms better and confirm these findings in other populations.