Beverage consumption and mortality among adults with type 2 diabetes: prospective cohort study
Authors' conclusion
Individual beverages showed divergent associations with all cause mortality and CVD outcomes among adults with type 2 diabetes. Higher intake of SSBs was associated with higher all cause mortality and CVD incidence and mortality, whereas intakes of coffee, tea, plain water, and low fat milk were inversely associated with all cause mortality. These findings emphasize the potential role of healthy choices of beverages in managing the risk of CVD and premature death overall in adults with type 2 diabetes.
Study context
- Population
- US health professionals (men and women) with T2D diagnosed at baseline or during follow-up; Nurses' Health Study 1980–2018 and Health Professionals Follow-Up Study 1986–20187,638 deaths
- Participants
- 15,486 professionals
- Exposure
- Highest vs lowest intake category of each beverage
- Outcome
- All cause mortality
- Follow-up
- Average 18.5 years
Methodological detailsmultivariable adjusted, pooled analysis of two cohorts (Nurses' Health Study; Health Professionals Follow-Up Study), beverage intake by validated food frequency questionnaire, updated every 2–4 years
- Multivariable adjusted
- Pooled analysis of two cohorts (Nurses' Health Study; Health Professionals Follow-Up Study)
- Beverage intake by validated food frequency questionnaire, updated every 2–4 years
Main finding
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Incident cardiovascular disease (CVD) with SSB intake
- SSB intake associated with higher risk of incident CVD, HR
- 1.25 (1.03 to 1.51) (95% CI)
CVD mortality with SSB intake
- SSB intake associated with higher CVD mortality, HR
- 1.29 (1.02 to 1.63) (95% CI)
CVD incidence and mortality by beverage
- Similar associations between individual beverages and CVD incidence and mortality
- Significant inverse associations of coffee and low fat milk intake with CVD incidence
Change in consumption after diabetes diagnosis and all cause mortality
- Lower all cause mortality with increased coffee consumption vs no change; similar pattern for tea and low fat milk
Beverage substitution
- Replacing sugar sweetened beverages (SSBs) with artificially sweetened beverages (ASBs) significantly associated with lower all cause and CVD mortality
- Replacing SSBs, ASBs, fruit juice or full fat milk with coffee, tea or plain water consistently associated with lower all cause mortality
Original publication
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