News & Press
Response to article by the InterAct Consortium in Diabetologia
April 2013
This study does not show that sugary drinks cause diabetes, as has been mis-reported in a number of the media headlines. Whilst this research has a large sample of over 28,500 participants, this type of study has limitations and is unable to show any cause and affect relationships. A single estimate of soft drink intake does not account for any changes in dietary habits or reformulation during the subsequent 16 years of the study. Experts have reviewed the scientific evidence and have clearly stated that sugar does not cause diabetes.
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April 2013
Response to InterAct Consortium article in Diabetologia
Sugar Nutrition UK welcomes the opportunity to respond to the article by the Interact consortium, published in Diabetologia, and its press release.
Whilst the European Prospective Investigation into Cancer and Nutrition provides researchers, such as the InterAct Consortium, with valuable data on a wide range of diet and lifestyle factors from a vast number of participants from across Europe, there are still – as with all prospective research – limitations as to what this is able to determine. In this case it is important to note that this paper does not show that sweetened drinks cause diabetes, as this type of analysis is unable to determine any causality. Therefore caution should be taken in interpreting the results and implying these to recommendations.
As acknowledged by the authors, a significant and major limitation of the research is that the study only measured dietary intake via a single questionnaire that was given to participants at the start of the study.
In this questionnaire participants were asked to estimate their intake over the previous year. This method is acknowledged to be prone to significant measurement errors. When comparing recorded intakes with biological markers, these questionnaires have been shown to have more than double the amount of error compared to a diet diary#.
The researchers then compared the results of this single questionnaire with incidence of diabetes in the participants over the following 16 years. Over a 16-year period, it is likely that many of the participants would have changed their eating patterns in some respect, but this was not measured or accounted for in this study.
Whilst the press release only provides information on the findings of sugar-sweetened beverages, it must be noted that this study also found a larger influence of artificially sweetened drinks on diabetes risk, before adjusting for BMI – a known correlate of diabetes risk. This therefore highlights the complexity of investigating diet and disease risk relationships, due to dietary choices being related and indicators of wider lifestyle choices. For example consumers of sweetened beverages also report consuming less fruit and vegetables and consuming more red and processed meat.
Expert Committees* including the World Health Organisation and UK Department of Health have reviewed the scientific evidence in relation to sugar and diabetes, and have all concluded that the evidence does not implicate sugar consumption in the causation of diabetes. Additionally, experts including the British Dietetic Association and the World Health Organisation agree that a moderate amount of sugar can be eaten as part of a healthy balanced diet. Diabetes UK also clearly state, on their website, that ‘eating sweets and sugar does not cause diabetes’.
References
- The InterAct Consortium (2013) Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia. DOI 10.1007/s00125-013-2899-8
- Imperial College London (2013) Press Release: Study shows drinking one 12oz sugar-sweetened soft drink a day can increase the risk of type 2 diabetes by 22 percent. http://www.eurekalert.org/pub_releases/2013-04/d-ssd042313.php
- #Day N et al. (2001) Epidemiological assessment of diet: a comparison of a 7-day diary with a food frequency questionnaire using urinary markers of nitrogen, potassium and sodium. Int J Epidemiol. 30(2):309-17.
- *Department of Health (1989) Dietary Sugars and Human Disease. Committee on Medical Aspects of Food Policy. Report on Health and Social Subjects No 37. HMSO, London.
- *European Food Safety Authority (2010) Scientific Opinion on dietary reference values for carbohydrates and dietary fibre The EFSA Journal 2010 8(3) 1462.
- *FAO Rome (1998) Report of a Joint FAO/WHO Expert Consultation. Carbohydrates in Human Nutrition. FAO Food and Nutrition Paper No 66.
- *Institute of Medicine of the National Academies (2002) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) The National Academies Press, Washington.
- *World Health Organization and Food and Agriculture Organization (2003) Diet, nutrition and the prevention of chronic diseases. Report of a Joint FAO/WHO Expert Consultation. WHO Technical Report Series 916. WHO Geneva, Switzerland.
- British Dietetic Association - Food Facts: Sugar www.bda.uk.com/foodfacts/Sugar.pdf
- Diabetes UK – www.diabetes.org.uk
Media inquiries: Tel> 020 7189 8301 Email> [email protected]
Sugar Nutrition UK is an association principally funded by UK sugar manufacturers and is involved in promoting nutrition research and raising awareness among academics, health professionals, the media and the public about sugars and their role in health.