A Prospective Study of Sugar Intake and Risk of Type 2 Diabetes in Women
Article Figures & Tables
Tables
- Table 1—
Baseline distributions of other risk factors for type 2 diabetes according to quintiles of sucrose intake
Quintiles of sucrose intake 1 (lowest) 2 3 4 5 (highest) Median intake (g/day) 25.8 33.6 39.3 45.8 57.2 Age 53.3 ± 6.6 53.6 ± 6.8 53.9 ± 7.0 54.2 ± 7.1 54.4 ± 7.4 Smoking (%) Current 17.6 12.1 10.9 10.5 14.0 Past 41.5 37.5 34.5 34.2 32.0 Never 41.0 50.4 54.6 55.4 54.0 Exercise (%) Rarely/never 39.7 36.7 35.6 37.0 40.5 <1 time/week 19.8 20.1 20.0 20.0 19.8 1–3 times/week 30.5 32.4 33.6 31.4 29.3 ≥4 times/week 9.9 10.8 10.7 11.6 10.7 Alcohol (%) Rarely/never 32.0 39.8 43.0 48.6 56.7 1–3 drinks/month 10.4 12.6 14.4 14.4 14.4 1–6 drinks/week 34.8 35.8 34.5 31.2 25.1 ≥1 drinks/day 22.8 11.9 8.2 5.8 3.8 Postmenopausal (%) 51.9 53.7 53.9 56.3 56.8 Hormone replacement treatment (%) Never 48.6 46.6 48.1 47.7 47.5 Past 9.9 10.6 9.6 9.6 10.7 Current 41.6 42.8 42.3 42.7 41.8 Mean BMI (kg/m2) 26.2 26.0 25.8 25.8 25.5 Multivitamin use (%) 27.7 29.4 30.0 29.7 29.8 History of hypertension 25.4 25.0 24.3 25.0 25.4 History of high cholesterol 24.7 25.7 25.6 28.1 29.1 Family History of diabetes 24.8 25.4 24.8 24.3 24.3 Total energy (kcal) 1,696 ± 527 1,750 ± 519 1,760 ± 526 1,739 ± 538 1,687 ± 558 Total fat (g) 61.5 ± 12.4 58.8 ± 11.4 57.4 ± 11.1 56.4 ± 11.0 54.0 ± 11.6 Saturated fat (g) 21.2 ± 5.3 20.0 ± 4.6 19.5 ± 4.5 19.2 ± 4.5 18.4 ± 4.8 Carbohydrate (g) 194.1 ± 32.2 213.2 ± 28.1 223.2 ± 27.8 231.6 ± 28.1 247.5 ± 31.1 Dietary GI 74.1 ± 5.2 74.7 ± 4.4 75.0 ± 4.3 75.4 ± 4.3 76.5 ± 4.7 Proteins (g) 89.4 ± 15.0 85.6 ± 12.6 81.9 ± 11.8 77.9 ± 11.6 70.4 ± 12.1 Dietary cholesterol (mg) 255.9 ± 82.2 236.0 ± 67.5 224.3 ± 63.8 213.1 ± 62.8 194.9 ± 63.5 Dietary folate (mcg) 419.6 ± 227.2 435.4 ± 219.6 436.7 ± 217.6 433.0 ± 225.1 417.6 ± 231.5 Data are means ± SD, unless otherwise indicated. All covariate values are according to the quintiles of sucrose intake. All the means of nutrients are energy adjusted. History of hypertension was defined as ever diagnosed by physician or self-reported blood pressure >140/90; history of high cholesterol and family history of diabetes were self-reported and validated in a subsample. All the means of nutrients are energy adjusted. Model 1: age and smoking adjusted. Model 2: age, smoking, BMI, vigorous exercise, alcohol use, postmenopausal hormone use, multivitamin use, history of hypertension, high cholesterol, and family history of diabetes.
- Table 2—
RR of type 2 diabetes according to quintiles of sugar intake in the whole cohort of the WHS
Quintiles of sugar intake P for trend 1 (lowest) 2 3 4 5 (highest) Total sugar Case subjects 215 190 183 167 163 Person-years 44,414 44,580 44,464 44,607 44,457 Model 1 1.0 0.87 (0.72–0.84) 0.84 (0.68–1.02) 0.75 (0.61–0.92) 0.73 (0.59–0.89) 0.0007 Model 2 1.0 0.94 (0.77–1.15) 0.88 (0.72–1.08) 0.92 (0.74–1.14) 0.86 (0.69–1.06) 0.17 Sucrose Case subjects 196 194 175 188 165 Person-years 44,362 44,298 44,549 44,567 44,746 Model 1 1.0 0.99 (0.81–1.21) 0.89 (0.72–1.09) 0.95 (0.77–1.16) 0.82 (0.66–1.01) 0.06 Model 2 1.0 1.00 (0.81–1.23) 0.98 (0.79–1.22) 1.00 (0.81–1.24) 0.84 (0.67–1.04) 0.16 Fructose Case subjects 208 189 175 177 169 Person-years 44,564 44,515 44,479 44,587 44,379 Model 1 1.0 0.90 (0.74–1.1) 0.83 (0.68–1.02) 0.83 (0.68–1.02) 0.79 (0.65–0.97) 0.02 Model 2 1.0 0.99 (0.81–1.22) 1.04 (0.85–1.29) 1.03 (0.83–1.27) 0.96 (0.78–1.19) 0.86 Glucose Case subjects 203 192 178 168 177 Person-years 44,693 44,426 44,470 44,626 44,308 Model 1 1.0 0.95 (0.78–1.16) 0.87 (0.71–1.06) 0.81 (0.66–0.99) 0.85 (0.70–1.05) 0.04 Model 2 1.0 1.08 (0.88–1.33) 1.02 (0.82–1.26) 0.96 (0.77–1.19) 1.04 (0.85–1.28) 0.91 Lactose Case subjects 198 205 186 157 172 Person-years 44,671 44,458 44,545 44,528 44,321 Model 1 1.0 1.05 (0.86–1.27) 0.94 (0.77–1.15) 0.79 (0.64–0.97) 0.86 (0.70–1.06) 0.02 Model 2 1.0 1.08 (0.88–1.32) 1.03 (0.83–1.26) 0.86 (0.69–1.07) 0.99 (0.8–1.22) 0.33 Starch Case subjects 199 179 200 185 155 Person-years 44,477 44,655 44,580 44,517 44,292 Model 1 1.0 0.91 (0.76–1.11) 1.03 (0.85–1.26) 0.96 (0.49–1.18) 0.83 (0.67–1.02) 0.19 Model 2 1.0 0.95 (0.77–1.17) 1.05 (0.85–1.28) 1.06 (0.86–1.30) 0.88 (0.71–1.09) 0.61 Data are RR and RR (95% CI). All covariate values are according to the quintiles of sucrose intake.
- Table 3—
RR of type 2 diabetes according to quintiles of sugar intake in a subcohort of women (n = 22,243) without history of hypertension and high cholesterol levels at baseline
Quintiles of sugar intake P for trend 1 (lowest) 2 3 4 5 (highest) Total sugar Case subjects 70 51 64 45 41 Person-years 26,133 26,293 26,148 26,270 26,182 Model 1 1.0 0.75 (0.52–1.07) 0.95 (0.67–1.33) 0.66 (0.45–0.96) 0.59 (0.40–0.88) 0.009 Model 2 1.0 0.86 (0.59–1.24) 1.10 (0.77–1.57) 0.85 (0.57–1.25) 0.77 (0.52–1.15) 0.26 Sucrose Case subjects 68 52 55 55 41 Person-years 26,045 26,169 26,204 26,225 26,382 Model 1 1.0 0.83 (0.58–1.19) 0.84 (0.58–1.19) 0.78 (0.55–1.13) 0.60 (0.41–0.88) 0.03 Model 2 1.0 0.84 (0.58–1.21) 0.85 (0.59–1.22) 0.73 (0.50–1.05) 0.59 (0.39–0.88) 0.05 Fructose Case subjects 55 56 66 44 50 Person-years 26,262 26,251 26,186 26,144 26,182 Model 1 1.0 0.85 (0.57–1.26) 1.27 (0.89–1.83) 1.07 (0.74–1.56) 0.95 (0.64–1.40) 0.47 Model 2 1.0 1.16 (0.77–1.74) 1.61 (1.11–2.33) 1.17 (0.79–1.71) 1.24 (0.84–1.85) 0.30 Glucose Case subjects 60 54 61 48 48 Person-years 26,296 26,166 26,270 26,224 26,069 Model 1 1.0 0.84 (0.57–1.23) 1.06 (0.74–1.52) 0.95 (0.65–1.37) 0.83 (0.57–1.22) 0.27 Model 2 1.0 1.05 (0.71–1.55) 1.30 (0.89–1.87) 1.02 (0.70–1.49) 1.12 (0.76–1.65) 0.55 Lactose Case subjects 63 58 62 42 46 Person-years 26,291 26,211 26,244 26,212 26,068 Model 1 1.0 0.69 (0.47–1.03) 1.03 (0.72–1.45) 0.94 (0.66–1.35) 0.76 (0.52–1.12) 0.06 Model 2 1.0 0.77 (0.51–1.14) 1.17 (0.81–1.68) 1.03 (0.72–1.49) 0.93 (0.62–1.38) 0.34 Starch Case subjects 55 58 62 61 35 Person-years 26,218 26,282 26,252 26,204 26,070 Model 1 1.0 1.11 (0.77–1.60) 1.21 (0.84–1.74) 1.20 (0.83–1.74) 0.72 (0.47–1.10) 0.34 Model 2 1.0 1.17 (0.81–1.71) 1.31 (0.90–1.90) 1.26 (0.87–1.83) 0.78 (0.50–1.21) 0.59 Data are RR or RR (95% CI). All covariate values are according to the quintiles of sucrose intake. All the means of nutrients are energy-adjusted. Model 1: age and smoking adjusted. Model 2: age, smoking, BMI, vigorous exercise, alcohol use, postmenopausal hormone use, multivitamin use, history of hypertension, high cholesterol, and family history of diabetes.
- Table 4—
RR of type 2 diabetes according to quintiles of sugar intake in the WHS stratified by BMI
BMI <25 kg/m2 BMI ≥25 kg/m2 Case subjects/person-years Multivariate RR∗ (95% CI) Case subjects/person-years Multivariate RR∗ (95% CI) Total sugars Q1 21/20,942 1.0 189/22,512 1.0 Q2 25/21,664 1.18 (0.65–2014) 158/22,030 0.91 (0.73–1.13) Q3 20/22,926 0.84 (0.44–1.57) 156/20,637 0.91 (0.73–1.13) Q4 25/24,124 0.86 (0.46–1.59) 136/19,676 0.94 (0.74–1.18) Q5 26/24,877 0.86 (0.47–1.58) 137/18,647 0.88 (0.70–1.11) P for trend — P = 0.36 — P = 0.38 Sucrose Q1 (lowest) 25/21,653 1.00 164/21,830 1.00 Q2 19/22,322 0.69 (0.37–1.29) 170/21,060 1.10 (0.88–1.35) Q3 17/23,031 0.62 (0.33–1.16) 157/20,648 1.02 (0.82–1.27) Q4 28/23,230 0.87 (0.49–1.54) 154/20,388 1.00 (0.81–1.26) Q5 (highest) 28/24,296 0.77 (0.44–1.36) 131/19,579 0.87 (0.70–1.12) P for trend — P = 0.70 — P = 0.25 Fructose Q1 24/20,493 1.00 178/23,135 1.00 Q2 16/21,693 0.69 (0.36–1.31) 167/21,930 1.05 (0.84–1.30) Q3 25/23,097 1.04 (0.58–1.86) 145/20,423 1.05 (0.84–1.32) Q4 22/24,141 0.83 (0.45–1.0) 149/19,499 1.09 (0.87–1.36) Q5 30/25,107 0.90 (0.51–1.59) 137/18,517 1.00 (0.79–1.26) P for trend P = 0.94 P = 0.87 Glucose Q1 22/20,562 1.00 176/23,142 1.00 Q2 17/21,878 0.78 (0.41–1.49) 170/21,696 1.13 (0.91–1.40) Q3 27/23,017 1.15 (0.64–2.05) 141/20,576 1.00 (0.80–1.26) Q4 20/23,969 0.77 (0.41–1.45) 143/19,696 1.02 (0.81–1.28) Q5 31/25,105 1.04 (0.59–1.85) 146/18,394 1.08 (0.86–1.35) P for trend P = 0.87 P = 0.85 Lactose Q1 31/23,175 1.00 161/20,510 1.00 Q2 18/22,703 0.63 (0.35–1.13) 178/20,833 1.17 (0.94–1.45) Q3 27/22,946 0.87 (0.51–1.48) 154/20,640 1.05 (0.83–1.31) Q4 22/22,586 0.67 (0.38–1.18) 131/21,172 0.88 (0.70–1.13) Q5 19/23,122 0.60 (0.34–1.08) 152/20,349 1.06 (0.84–1.33) P for trend — P = 0.13 — P = 0.57 Starch Q1 25/22,759 1.0 170/20,604 1.0 Q2 20/22,513 0.75 (0.42–1.37) 155/21,367 0.96 (0.77–1.20) Q3 20/22,288 0.91 (0.50–1.64) 174/21,535 1.06 (0.85–1.32) Q4 25/22,932 1.10 (0.63–1.92) 157/20,665 1.03 (0.83–1.29) Q5 27/24,039 1.03 (0.59–1.81) 120/19,331 0.85 (0.67–1.08) P for trend — P = 0.54 — P = 0.98 Multivariate RR was adjusted for smoking, BMI, exercise, alcohol use, history of hypertension, high cholesterol, and family history of diabetes.
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