Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis
- Jennifer A. Nettleton, PhD (jennifer.a.nettleton{at}uth.tmc.edu)1,
- Pamela L. Lutsey, PhD2,
- Youfa Wang, MD, PhD3,
- João A. Lima, PhD4,
- Erin D. Michos, MD4 and
- David R. Jacobs, Jr, PhD2,5
- From the 1Division of Epidemiology, University of Texas Health Sciences Center, Houston, TX, the
- 2Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
- 3Center for Human Nutrition, Department of International Health and
- 4Division of Cardiology, Johns Hopkins University, Baltimore, MD; the
- 5Department of Nutrition, University of Oslo, Oslo, Norway
Abstract
Objectives: We determined associations between diet soda consumption and risk of incident MetSyn, its components, and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis.
Research Design & Methods: Diet soda consumption was assessed by food frequency questionnaire at baseline (2000-02). Incident type 2 diabetes was identified at three follow-up exams (2002-03, 2004-05, 2005-07) as fasting glucose >126 mg/dL, self-reported type 2 diabetes, or use of diabetes medication. MetSyn (and components) were defined by National Cholesterol Education Program Adult Treatment Panel 3 criteria. Hazard ratios (HR with [95% CI]) for type 2 diabetes, Met Syn, and MetSyn components, were estimated adjusting for demographic, lifestyle, and dietary confounders.
Results: At least daily consumption of diet soda was associated with a 36% greater relative risk of incident MetSyn and a 67% greater relative risk of incident type 2 diabetes compared to non-consumption (1.36 [1.11, 1.66] for MetSyn; 1.67 [1.27, 2.20] for type 2 diabetes). Of MetSyn components, only high waist circumference (men: ≥102 cm; women: ≥88 cm) and high fasting glucose (≥100 mg/dL) were prospectively associated with diet soda consumption. Associations between diet soda consumption and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures, whereas associations between diet soda and MetSyn were not independent of these factors.
Conclusions: Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident MetSyn components and type 2 diabetes.
Footnotes
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- Received October 1, 2008.
- Accepted December 30, 2008.
- Copyright © American Diabetes Association
