Sugar-sweetened or artificially sweetened beverage consumption, physical activity and risk of type 2 diabetes in US adults
Authors' conclusion
Even when individuals were physically active, a higher consumption of SSBs or ASBs was associated with a higher risk of type 2 diabetes. Meeting physical activity guidelines reduced the impact of SSB and ASB consumption on diabetes risk, underscoring the need to promote physical activity as part of lifestyle modifications to lower diabetes incidence.
Study context
- Population
- US women (Nurses' Health Study 1980–2016; Nurses' Health Study II 1991–2017) and men (Health Professionals Follow-up Study 1986–2016)5,105,351 person-years
- Exposure
- SSB or ASB consumption, alone and jointly with physical activity
- Outcome
- Incident T2D, confirmed by validated supplementary questionnaire
Methodological detailsthree cohorts: Nurses' Health Study, Nurses' Health Study II, Health Professionals Follow-up Study, multivariable Cox proportional hazards regression, SSB and ASB intake from food-frequency questionnaires every 4 years; physical activity collected biennially
- Three cohorts: Nurses' Health Study, Nurses' Health Study II, Health Professionals Follow-up Study
- Multivariable Cox proportional hazards regression
- SSB and ASB intake from food-frequency questionnaires every 4 years; physical activity collected biennially
Main finding
As reported in the abstract
T2D
Each group vs never or rarelyHazard ratio (95% CI)
SSB ≥2 servings/day41% higher risk
1.41(1.33–1.50)
ASB ≥2 servings/day11% higher risk
1.11(1.07–1.16)
- New T2D cases
- 19,940
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Type 2 diabetes, joint SSB consumption and physical activity, among those meeting physical activity guidelines (≥7.5 MET h/week)Meeting physical activity guidelines, ≥2 servings/week of SSBsvs Meeting physical activity guidelines, never or rarely (<1 serving/month)22% higher risk | 1.22 (1.15–1.29) | |
| Type 2 diabetes, joint SSB consumption and physical activity, among those meeting physical activity guidelines (≥7.5 MET h/week)Meeting physical activity guidelines, 1-4 servings/month of SSBsvs Meeting physical activity guidelines, <1 SSB serving/month9% higher risk | 1.09 (1.02–1.15) | |
| Type 2 diabetes, joint ASB consumption and physical activity, among those meeting physical activity guidelinesMeeting physical activity guidelines, ≥2 servings/week of ASBsvs Meeting physical activity guidelines, never or rarely (<1 serving/month)7% higher risk | 1.07 (1.02–1.12) | |
| Type 2 diabetes, not meeting physical activity guidelines (<7.5 MET h/week) by SSB intake vs reference (met guidelines, <1 SSB serving/month)Not meeting guidelines, never or rarely (<1 serving/month) SSBsvs Reference group | 1.22 (1.13–1.31) | |
| Type 2 diabetes, not meeting physical activity guidelines (<7.5 MET h/week) by SSB intake vs reference (met guidelines, <1 SSB serving/month)Not meeting guidelines, 1-4 SSB servings/monthvs Reference group | 1.28 (1.20–1.37) | |
| Type 2 diabetes, not meeting physical activity guidelines (<7.5 MET h/week) by SSB intake vs reference (met guidelines, <1 SSB serving/month)Not meeting guidelines, ≥2 SSB servings/weekvs Reference group | 1.51 (1.43–1.61) | |
| Type 2 diabetes, not meeting physical activity guidelines by ASB intake vs reference (met guidelines, <1 ASB serving/month)Not meeting guidelines, never or rarely (<1 serving/month) ASBsvs Reference group | 1.21 (1.14–1.28) | |
| Type 2 diabetes, not meeting physical activity guidelines by ASB intake vs reference (met guidelines, <1 ASB serving/month)Not meeting guidelines, 1-4 ASB servings/monthvs Reference group | 1.21 (1.13–1.30) | |
| Type 2 diabetes, not meeting physical activity guidelines by ASB intake vs reference (met guidelines, <1 ASB serving/month)Not meeting guidelines, ≥2 ASB servings/weekvs Reference group | 1.30 (1.23–1.37) | |
| 0.512Hazard ratio (log scale) |
Original publication
Sugar-sweetened or artificially sweetened beverage consumption, physical activity and risk of type 2 diabetes in US adults. Diabetologia. Published 8 January 2025. doi:10.
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