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Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

  • D. Romaguera
  • T. Norat
  • P. A. Wark
  • A. C. Vergnaud
  • M. B. Schulze
  • G. J. van Woudenbergh
  • D. Drogan
  • P. Amiano
  • E. Molina-Montes
  • M. J. Sanchez
  • B. Balkau
  • A. Barricarte
  • J. W. J. Beulens
  • F. Clavel-Chapelon
  • S. P. Crispim
  • G. Fagherazzi
  • Paul Franks
  • V. A. Grote
  • I. Huybrechts
  • R. Kaaks
  • T. J. Key
  • K. T. Khaw
  • Peter Nilsson
  • K. Overvad
  • D. Palli
  • S. Panico
  • J. R. Quiros
  • O. Rolandsson
  • C. Sacerdote
  • S. Sieri
  • N. Slimani
  • A. M. W. Spijkerman
  • A. Tjonneland
  • M. J. Tormo
  • R. Tumino
  • S. W. van den Berg
  • P. R. Wermeling
  • R. Zamora-Ros
  • E. J. M. Feskens
  • C. Langenberg
  • S. J. Sharp
  • N. G. Forouhi
  • E. Riboli
  • N. J. Wareham
Publishing year: 2013
Language: English
Pages: 1520-1530
Publication/Series: Diabetologia
Volume: 56
Issue: 7
Document type: Journal article
Publisher: Springer Verlag

Abstract english

Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence. In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.


  • Endocrinology and Diabetes
  • Artificially sweetened soft drinks
  • Case-cohort study
  • Europe
  • Juices
  • and nectars
  • Prospective study
  • Sugar-sweetened soft drinks
  • Sweet
  • beverages
  • Type 2 diabetes incidence


  • Diabetes and Endocrinology
  • Internal Medicine
  • ISSN: 1432-0428
Paul Franks
E-mail: paul [dot] franks [at] med [dot] lu [dot] se

Principal investigator

Genetic and Molecular Epidemiology

+46 40 39 11 49



Lund University Diabetes Centre, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00