Table 1

SSB intake and risk of type 2 diabetes and metabolic syndrome

Ref.Population (cases)Age range (years)Duration (years)Dietary assessment methodOutcomeResultsAdjustment for potential confounders
Montonen et al., 2007 (14)2,360 adults, Finnish Mobile Clinic Health Examination, Finland (177)40–6912Diet historyType 2 diabetes*RR (95% CI) between extreme quartiles of median SSB intake (0 vs. 143 g/day): 1.67 (0.98–2.87); Ptrend = 0.01Age, sex, BMI, energy intake, smoking, geographic area, physical activity, family history of diabetes, prudent dietary score, and conservative pattern score
Paynter et al., 2006 (15)12,204 adults ARIC study, U.S. (718 men, 719 women)45–649FFQType 2 diabetesMen: RR (95% CI) between extreme quartiles of SSB intake (<1 8-oz serving/day vs. ≥2 8-oz servings/day): 1.09 (0.89–1.33); Ptrend = 0.68. Women: RR (95% CI) between extreme quintiles of SSB intake: 1.17 (0.94–1.46); Ptrend = 0.05Race, age
Schulze et al., 2004 (16)91,249 women NHS II, U.S. (741)24–448133-item FFQType 2 diabetesRR (95% CI) between extreme quartiles of SSB intake (<1 serving/month vs. ≥1 serving/day: 1.83 (1.42, 2.36); Ptrend = <0.001Age, alcohol intake, physical activity, family history of diabetes, smoking, postmenopausal hormone use, oral contraceptive use, cereal fiber, magnesium, trans fat, ratio of polyunsaturated to saturated fat, diet soft drinks, fruit juice, fruit punch
Palmer et al., 2008 (17)43,960 women BWHS, U.S. (2,713)21–691068-item FFQType 2 diabetes§RR (95% CI) between extreme quintiles of SSB intake (<1 12-oz serving/month vs. ≥ 2 12-oz servings/day: 1.24 (1.06–1.45); Ptrend = 0.002Age, family history of diabetes, physical activity, smoking, education, fruit drinks, orange and grapefruit juice, fortified fruit drinks, Kool-Aid, other fruit juices, red meat, processed meat, cereal fiber, coffee and glycemic index
Bazzano et al., 2008 (18); author correspondence71,346 women NHS, U.S. (4,529)38–6318FFQType 2 diabetesRR (95% CI) between extreme quintiles of SSB intake: (<1 12-oz serving/month vs. 2–3 12-oz servings/day): 1.31 (0.99–1.74); Ptrend = <0.001BMI, physical activity, family history of diabetes, postmenopausal hormone use, alcohol use, smoking, and total energy intake
Odegaard et al., 2010 (19)43,580 adults, Singapore Chinese Health study (2,273)45–745.7FFQType 2 diabetesRR (95% CI) between extreme quintiles of SSB intake: (none vs. ≥2 8-oz servings/week): 1.42 (1.25–1.62); Ptrend = <0.0001Age, sex, dialect, year of interview, educational level, smoking, alcohol, physical activity, saturated fat, dietary fiber, dairy, juice, coffee
De Koning, 2010, personal communication41,109 male health professionals, U.S. (2,760)40–7520FFQType 2 diabetesRR (95% CI) between extreme quartiles of median SSB intake (0 vs. 0.79 serving/day): 1.14 (1.03–1.28); Ptrend = 0.0024Age, smoking, physical activity, alcohol, coffee, family history of type 2 diabetes
Nettleton et al., 2009 (11); author correspondence5,011 adults, MESA, U.S. (413)45–845FFQType 2 diabetesRR (95% CI) between extreme quartiles of SSB intake (0 vs. ≥1 serving/day): 0.86 (0.62–1.17); Ptrend = 0.09Study site, age, sex, race, energy intake, education, physical activity, smoking, at least weekly supplement use, waist circumference
Nettleton et al., 2009 (11); author correspondence3,878 adults, MESA, U.S. (871)45–845FFQMetabolic syndromeRR (95% CI) between extreme quartiles of SSB intake (0 vs. ≥ 1 serving/day): 1.15 (0.92–1.42); Ptrend = 0.65Study site, age, sex, race, energy intake, education, physical activity, smoking, at least weekly supplement use, waist circumference
Dhingra et al., 2007 (13)6,039 adults, Framingham Offspring Study, U.S.A. (1,150)52.94FFQMetabolic syndrome#RR (95% CI) between extreme quartiles of soft drink intake (0 vs. ≥1 12-oz serving/day): 1.39 (1.21–1.59)**Age and sex
Lutsey et al., 2008 (12)9,514 adults ARIC, U.S. (3,782)45–64966-item FFQMetabolic syndromeRR (95% CI) between extreme tertiles of SSB intake (0 vs. 1 median serving/day): 1.09 (0.99–1.19); Ptrend = 0.07Age, sex, race, education, center, total calories, smoking, physical activity, intake of meat, dairy, fruits and vegetables, whole grains, and refined grains
  • ARIC, Atherosclerosis Risk in Communities Study; BWHS, Black Women's Health Study; MESA, Multi-Ethnic Study of Atherosclerosis; NHS, Nurses' Health Study.

  • *National register confirmed by medical record.

  • †Presence of one of the following: 1) fasting glucose ≥126 mg/dl, 2) nonfasting glucose ≥200 mg/dl, 3) current use of hypoglycemic medication, and 4) self-report physician diagnosis.

  • ‡Self-report of physician diagnosis and supplemental questionnaire.

  • §Confirmed self-report of physician diagnosis.

  • ‖Presence of one of the following: 1) fasting glucose ≥126 mg/dl, 2) current use of hypoglycemic medications; and 3) self-report physician diagnosis.

  • ¶Metabolic syndrome diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria/American Heart Association guidelines as the presence of three or more of the following: 1) waist circumference ≥102 (men) or ≥88 cm (women), 2) triglycerides ≥150 mg/dl, 3) HDL cholesterol ≤40 (men) or ≤50 mg/dl (women), 4) blood pressure ≥130/85 mmHg or antihypertensive treatment, and 5) fasting glucose ≥100 mg/dl or antihyperglycemic treatment/insulin.

  • #Metabolic syndrome diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel III definition/American Heart Association guidelines as the presence of three or more of the following: 1) waist circumference ≥102 (men) or ≥88 cm (women), 2) triglycerides ≥150 mg/dl, 3) HDL cholesterol ≤40 (men) or ≤50 mg/dl (women), 4) blood pressure ≥135/85 mmHg or antihypertensive treatment, and 5) fasting glucose ≥100 mg/dl or antihyperglycemic treatment/insulin.

  • **Includes diet and nondiet soft drinks.