Sugar-Sweetened Soda Consumption Increases Diabetes Risk Among Mexican Women

https://doi.org/10.1093/jn/nxy298Get rights and content
Under an Elsevier user license
open archive

ABSTRACT

Background

Epidemiological evidence supports an association between sugar-sweetened soda consumption and diabetes. However, evidence regarding this association is limited in countries that have recently undergone a nutritional transition.

Objective

We estimated the association between sugar-sweetened soda consumption and incident diabetes. We also determined if the association between sugar-sweetened soda and diabetes differs as a result of

Methods

We used data from the Mexican Teachers’ Cohort including 72,667 women aged ≥25 y, free of diabetes, cardiovascular disease, and cancer at baseline. We assessed sugar-sweetened soda consumption using a validated food frequency questionnaire (FFQ) at baseline. Diabetes was self-reported. We used Cox proportional hazard regression models to estimate the association between quintiles of sugar-sweetend soda and diabetes. We also estimated the associaiton by increasing one serving per day (355 mL) of sugar-sweetened soda.We conducted prespecified subgroup analysis by potential effect modifiers, namely markers of energy balance of early life factors, family history of diabetes, and Amerindian admixture.

Results

During a median follow-up of 2.16 y (IQR 0.75–4.50) we identified 3,155 incident cases of diabetes. The median consumption of sugar-sweetened soda was 1.17 servings per day (IQR 0.47– 4.00). In multivariable analyses, comparing extreme quintiles showed that higher sugar-sweetened soda consumption was associated with diabetes incidence (HR = 1.32; 95% CI: 1.17, 1.49), and each additional serving per day of sugar-sweetened soda was associated with an increase of 27% in diabetes incidence (HR = 1.27; 95% CI: 1.16, 1.38). The soda–diabetes association was stronger among women who experienced intrauterine and childhood over-nutrition (high birth weight, no short stature, higher adiposity in premenarche, and higher adiposity at age 18–20 y old).

Conclusion

Sugar-sweetened soda consumption is associated with an increased risk of diabetes among Mexican women in a magnitude similar to that reported in other populations. The stronger association among individuals with markers of early life over-nutrition reinforce the need for early life interventions.

Key Words

sugar-sweetened soda
incident diabetes
Mexico
women
early life factors

Abbreviations

HFCS
high-fructose corn syrup
LRT
likelihood ratio test
MTC
Mexican Teachers’ Cohort
SES
socio-economic status
SSB
sugar-sweetened beverages

Cited by (0)

ML and RL-R have a nonrestricted investigator-initiated grant from AstraZeneca. DS, ML, and RL-R received limited salary support from Bloomberg Philanthropies through an institutional grant to the National Institute of Public Health in Mexico. This work is also supported by the American Institute for Cancer Research (05B047) and Consejo Nacional de Ciencia y Tecnología (S0008-2009-1:000000000115312 and SALUD-2013-01-202637).