Certain beverages associated with CVD risk in type 2 diabetes patients
For each increase of one unit per day in consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices, risk for cardiovascular disease (CVD) was 11%, 9%, and 16% higher, respectively, a study of U.K. data found. Coffee and tea were not associated with CVD.
Patients with type 2 diabetes who consume sugar-sweetened beverages (fizzy and fruit drinks), artificially sweetened beverages, or natural juices may be at increased risk for cardiovascular disease (CVD), regardless of genetic CVD risk, a recent study found.
Researchers used data from the U.K. Biobank to prospectively evaluate associations between individual beverage intake and risk for CVD and ischemic heart disease in patients with type 2 diabetes. They also evaluated the potential effect of switching one type of beverage with another. Beverage consumption was determined by five repeated online 24-hour dietary questionnaires administered between April 2009 and June 2012. The study results were published Jan. 27 by the Journal of Clinical Endocrinology and Metabolism.
A total of 7,315 patients with type 2 diabetes (mean age, 60.2 years; 41.5% female) were included in the study. Overall, 29.2%, 33.7%, 41.8%, 38.0%, 74.5%, and 77.9% reported drinking sugar-sweetened beverages, artificially sweetened beverages, natural juices, yogurt, coffee, and tea, respectively. There were 878 incident CVD cases identified over a median follow-up of 6.1 years, and of these, 517 were ischemic heart disease. Higher reported intakes of sugar-sweetened beverages, artificially sweetened beverages, and natural juices each had a linear association with higher CVD risk (P>0.05 for nonlinearity). For each increase of one unit per day in consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices, risk for incident CVD was 11%, 9%, and 16% higher, respectively.
When the groups of highest beverage consumption were compared with the lowest, multivariable-adjusted hazard ratios for CVD were 1.54 (95% CI, 1.14 to 2.07) for sugar-sweetened beverages, 1.34 (95% CI, 1.07 to 1.69) for artificially sweetened beverages, and 1.33 (95% CI, 1.01 to 1.76) for natural juices. Results for incident ischemic heart disease were similar. No significant interactions were seen between any of these three beverage categories and CVD genetic risk score. When a half-unit of sugar-sweetened beverages or natural juices daily was replaced with coffee, tea, or yogurt, risk for CVD and ischemic heart disease was 20% to 46% lower. This result was not observed with a reduction in artificially sweetened beverages.
The authors noted that information on diet was collected via 24-hour recall questionnaire and that their study may have been affected by residual confounding, among other limitations. "In this prospective study among participants with T2D [type 2 diabetes], we found that higher intakes of SSBs [sugar-sweetened beverages], ASBs [artificially sweetened beverages], and natural juices were each linearly associated with a higher risk of CVD, regardless of genetic predisposition. Moreover, replacing SSBs or natural juices with coffee, tea, or yogurt, but not ASBs, was associated with a lower CVD risk," they wrote. "These findings underscore the significance of selecting healthy beverages to promote cardiovascular health in individuals with T2D."