Diet Coke WON’T stop you getting diabetes
An article published in Daily Mail on 3rd Nov 2016, reported on the study conducted at Karolinska Institute in Sweden that studied 2,874 adults who had completed a year-long diary about their intake of drinks. They reported that the Karolinska team found that drinking just two glasses of diet drinks a day more than doubles the risk of developing diabetes. Those who had two or more sweetened drinks a day were 2.4 times more likely to develop type 2 diabetes. They went on to say that these drinks included sugary beverages and artificially sweetened ones, such as Diet Coke or sugar free cordials.
Considering that we have been told for years that to cut down calories and lower our risk of diabetes and heart disease we must cut down on sugary drinks, this obviously came as a shock to most of us. So what did the study find?
The investigators analysed the data from the questionnaires sent to the study participants with latent autoimmune disease in adults (LADA), which is a hybrid form of diabetes that features type 1 and type 2 like diabetes, as well as type 2 diabetics. Individuals who consumed more than 2 sugar-sweetened and artificially sweetened beverages in a day had considerably higher body mass index than others to start with, and also had more unhealthy lifestyles such as smoking, low physical exercise and unhealthier food choices. People who consumed more than 2 servings of sweetened beverages had a much higher risk of LADA. Similar effects were seen in type 2 diabetics and the risk of type 2 diabetes increased by 20% for each daily serving of sweetened beverages, irrespective of the sweetener used (sugar or sweetener). Importantly, water consumption (as an indicator of thirst) did not increase the risk of LADA or type 2 diabetes, suggesting that it is the consumption of sweetened drinks that has a direct association with the disease progression.
The headline in the Daily Mail article is then correct in that just cutting down sugar in the beverages we chose is not enough to be protective against these 2 forms of diabetes. However, emphasis should be given to the fact that these are correlational studies which just report an association between two factors rather than being able to say that one causes another directly. In many cases, just by having enough participants, one could find an association between many factors. What is important, and as authors of the original article point out, and as the NHS choices blog also covers nicely, is that the lifestyle factors play a major role in body weight regulation and diabetes development. LADA and type 2 diabetes study participants all had significantly higher body mass index than control subjects and those consuming more than 2 sweetened beverages were the most overweight. It is well known that obesity is a number one risk factor for development of diabetes, and these participants also consumed significantly more biscuits, sweets and salty snacks, ate significantly less fish, whole grain, vegetables and fruits. Overall to improve one’s health, we should all replace sweetened drinks with water and eat a healthier, more balanced diet as well as exercise.
Original article reference:
Josefin E Löfvenborg, Tomas Andersson, Per-Ola Carlsson, Mozhgan Dorkhan, Leif Groop, Mats Martinell, Tiinamaija Tuomi, Alicja Wolk, Sofia Carlsson.
European Journal of Endocrinology, online 21 October 2016, doi: 10.1530/EJE-16-0376