摄入更多果汁，人工添加甜味饮料会增加2型糖尿病的风险

StephenW

Nutrition Resource Center
Type 2 diabetes risk rises with more fruit juice, artificially sweetened beverage consumption

Drouin-Chartier JP, et al. Diabetes Care. 2019;doi:10.2337/dc19-0734.
October 8, 2019

Adults who consume larger quantities of sweetened beverages, including fruit juices and those made with artificial sweeteners, are more likely to develop type 2 diabetes than those who drink smaller quantities, according to findings published in Diabetes Care.
Jean-Philippe Drouin-Chartier

“The relationship between the consumption of sugar-sweetened beverages (ie, soft drinks, punches, fruit drinks, sugared iced tea and sports drinks) and type 2 diabetes is supported by substantial epidemiologic evidence,” Jean-Philippe Drouin-Chartier, PhD, a postdoctoral fellow in the department of nutrition at the Harvard T.H. Chan School of Public Health, told Endocrine Today. “Even though consumption of 100% fruit juices has been considered a healthy alternative to sugar-sweetened beverages because of the vitamins and minerals in fruit juices, they typically contain similar amounts of sugar and calories as sugar-sweetened beverages, and epidemiologic evidence suggests that 100% fruit juices are also positively associated with risk of diabetes. This raises concerns for the negative health effects of sugary beverages, regardless of whether the sugar is added or naturally occurring.”

Drouin-Chartier and colleagues assessed sweetened beverage intake among participants in the Nurses’ Health Study (n = 121,701 women), the Nurses’ Health Study II (n = 116,430 women) and the Health Professional’ Follow-up Study (n = 51,529 men). Participants self-reported their intake at 4-year intervals using food frequency questionnaires, with serving sizes of 8 oz used for analysis. Diabetes status was self-reported and confirmed by the researchers at 2-year intervals. These data allowed the researchers to calculate diabetes risk.

Diabetes risk was greater for those who increased their intake of any sugary beverage by more than 0.5 servings per day vs. those who did not have a substantial change (HR = 1.16; 95% CI, 1.01-1.34). Diabetes risk also was greater for those who increased their intake of sugar-sweetened beverages (HR = 1.09; 95% CI, 1.03-1.17), 100% fruit juices (HR = 1.15; 95% CI, 1.07-1.23) and artificially sweetened beverages (HR = 1.18; 95% CI, 1.02-1.36) by more than 0.5 servings per day vs. those who did not have a substantial change.


When examining habitual changes over 4 years, the researchers found that diabetes risk was higher if a participant went from less than one weekly serving of a sugary beverage to one or more daily servings vs. those who maintained weekly servings of less than one (HR = 1.15; 95% CI, 0.98-1.35). Similarly, diabetes risk was 23% greater for those who consistently drank at least one serving per day (95% CI, 15-33) and 9% greater for those who went from drinking one or more daily servings to less than one weekly serving (95% CI, –5 to 25).

The researchers also wrote that “for artificially sweetened beverages, any increase in consumption was associated with a higher risk,” but noted that these findings were less clear cut.

“The findings regarding artificially sweetened beverages should be interpreted with caution due to the possibility of reverse causation — individuals already at high risk for diabetes may switch from sugary beverages to diet drinks — and surveillance bias — high-risk individuals are more likely to be screened for diabetes and thus diagnosed more rapidly,” Drouin-Chartier said.

The researchers furthered stated that diabetes risk was reduced if a participant drank one daily serving of coffee instead of a sugary drink (HR = 0.9; 95% CI, 0.88-0.92) or instead of an artificially sweetened beverage (HR = 0.91; 95% CI, 0.88-0.93). In addition, diabetes risk was reduced if participants drank one daily serving of tea instead of a sugary drink (HR = 0.93; 95% CI, 0.9-0.95) or instead of an artificially sweetened beverage (HR = 0.94; 95% CI, 0.91-0.96). Similarly, diabetes risk was reduced if participants drank one daily serving of 0% to 2% milk instead of a sugary drink (HR = 0.94; 95% CI, 0.91-0.97) or instead of an artificially sweetened beverage (HR = 0.94; 95% CI, 0.91-0.97). Lastly, diabetes risk was reduced if participants drank one daily serving of water instead of a sugary drink (HR = 0.98; 95% CI, 0.95-1) or instead of an artificially sweetened beverage (HR = 0.99; 95% CI, 0.97-1.01).

“The study provides further evidence demonstrating the health benefits associated with decreasing sugary beverage consumption and replacing these drinks with healthier alternatives like water, coffee or tea. The study results are in line with current recommendations to replace sugary beverages with noncaloric beverages free of artificial sweeteners,” Drouin-Chartier said. – by Phil Neuffer

StephenW

营养资源中心
摄入更多果汁，人工添加甜味饮料会增加2型糖尿病的风险

Drouin-Chartier JP等。糖尿病护理。 2019; doi：10.2337 / dc19-0734。
十月8，2019

根据《糖尿病护理》（Diabetes Care）发表的研究结果，成年人比那些少喝甜味饮料（包括果汁和人造甜味剂的成年人）更容易患上2型糖尿病。
让·菲利普·德鲁因·夏蒂埃

Jean-Philippe Drouin-Chartier博士说：“糖的饮料（即软饮料，果汁饮料，果汁饮料，加糖的冰茶和运动饮料）与2型糖尿病之间的关系得到了广泛的流行病学证据支持，”哈佛大学营养学系博士后陈公共卫生学院告诉《今日内分泌》。 “尽管由于果汁中的维生素和矿物质，食用100％果汁被认为是健康的替代品，但它们通常所含糖和卡路里的量与含糖饮料相似，并且流行病学证据表明， 100％果汁也与糖尿病风险呈正相关。不管糖是添加糖还是天然糖，这都引起人们对含糖饮料对健康的负面影响的担忧。”

Drouin-Chartier及其同事评估了“护士健康研究”（n = 121,701名女性），“护士健康研究II”（n = 116,430名女性）和“卫生专业人员”后续研究（n = 51,529名男性）参与者的甜味饮料摄入量。 ）。参与者使用食物频率问卷以4年为间隔自我报告摄入量，每份8盎司的量用于分析。糖尿病状态是自我报告的，并由研究人员每隔2年确认一次。这些数据使研究人员能够计算出糖尿病风险。

与那些没有实质性改变的人相比，那些每天摄入任何含糖饮料增加超过0.5份的人患糖尿病的风险更大（HR = 1.16； 95％CI，1.01-1.34）。对于那些增加摄入含糖饮料（HR = 1.09; 95％CI，1.03-1.17），100％果汁（HR = 1.15; 95％CI，1.07-1.23）并人工增甜的人来说，糖尿病风险也更大。与那些没有实质性改变的人相比，每天增加0.5份（HR = 1.18； 95％CI，1.02-1.36）的饮料。


研究人员在检查4年的习惯变化时发现，如果参与者从每周少于一次的含糖饮料转变为每天一次或多次的含糖饮料，而与那些每周少于一次的糖饮料相比，则患糖尿病的风险更高（HR = 1.15； 95％CI，0.98-1.35）。同样，每天至少喝一餐的人的糖尿病风险也增加23％（95％CI，15-33），而从每天喝一餐或多餐到每周少于一餐的人，则糖尿病风险增加9％（ 95％CI，–5至25）。

研究人员还写道：“对于人造甜味饮料，消费量的任何增加都会带来更高的风险，”但他们指出，这些发现并不清楚。

“有关人工甜味饮料的发现应谨慎解释，因为可能存在反向因果关系-已经患有糖尿病的高危人群可能会从含糖饮料转换为低糖饮料-且存在监控偏见-高风险人群更容易被筛查Drouin-Chartier说。

研究人员进一步指出，如果参与者每天喝一杯咖啡代替含糖饮料（HR = 0.9; 95％CI，0.88-0.92）或代替人工甜味饮料（HR = 0.91; 95％），则糖尿病风险会降低。 CI，0.88-0.93）。此外，如果参与者每天喝一杯茶代替含糖饮料（HR = 0.93; 95％CI，0.9-0.95）或代替人工甜味饮料（HR = 0.94; 95％CI，0.91），则糖尿病风险降低。 -0.96）。同样，如果参与者每天喝一份0％至2％的牛奶代替含糖饮料（HR = 0.94; 95％CI，0.91-0.97）或代替人工甜味饮料（HR = 0.94; 95），则降低糖尿病风险。 ％CI，0.91-0.97）。最后，如果参与者每天喝水代替含糖饮料（HR = 0.98; 95％CI，0.95-1）或代替人工甜味饮料（HR = 0.99; 95％CI，0.97- 1.01）。

“该研究提供了进一步的证据，证明了与减少含糖饮料的消费以及用更健康的替代品（如水，咖啡或茶）替代这些饮料相关的健康益处。该研究结果符合当前的建议，即用不含人工甜味剂的无热量饮料代替含糖饮料。” Drouin-Chartier说。 –由Phil Neuffer