Most studies which find a link between sugar intake and risk of type 2 diabetes focus on sugar sweetened beverages (SSB) intake, presumably because SSB's allow for a high sugar intake without feeling of satiety and provide a rapid rise in blood sugar.

Are there any studies which relate (added) sugar intake from solid foods to diabetes type 2?

Studies which show a clear link between SSB intake and development of diabetes type 2:




  • 1
    keep in mind that foods are likely to offer something other than sugar (nuts in a chocolate bar, wheat in a cookie) which will help mediate the body's response. Jul 2, 2017 at 14:49
  • 1
    Can you please edit your question to explain why you have included those 3 links and what we can expect to find at the other end? Are they studies about beverages only, and do they not include a section on why they did beverages only? Jul 2, 2017 at 14:50
  • Vote to close as unclear what you're asking for the reasons @KateGregory pointed out: Those links make it pretty unclear what you want.
    – Narusan
    Jul 4, 2017 at 14:21
  • The links I provided demonstrate that: 1: On an population level there seems to be an association between SSB intake and risk of diabetes type 2. 2. In an experimental design markers of diabetes type 2 (such as fasting glucose levels) where evident after a short period (3 weeks) of treatment with liquid sugar ingestions even at low doses. Jul 4, 2017 at 20:03
  • Now the questions which arise from these studies are: 1. Is this effect caused by the sugar or the rapid rise of blood sugar caused by consuming liquid sugars. 2. Are there any studies which find the same effect for solid foods which contain added sugar. I hope my question is clearer now. Jul 4, 2017 at 20:08

1 Answer 1


I assume by "(added) sugar intake from solid foods" you mean something like, "Is higher-than-average sugar consumption from foods (separate from beverages) associated with increased risk of Type II diabetes?" - If that is not correct, please let me know.


Before listing citations to some relevant studies, some brief background information will provide important context for you and others reading this thread.

As you know, the body breaks down carbohydrates (sugars, starches, fiber) into glucose. Consequently, health professionals encourage diabetic patients to not only monitor total carbohydrate intake, but also the types of carbohydrates consumed as well.

One of the most common ways to gauge the impact of a carbohydrate on glucose levels is the glycemic index (GI), and its companion glycemic load (GL).

I mention this fact because while sweet foods, e.g., candy bars, cake, ice cream, etc., tend to have a high glycemic index (GI) and glycemic load (GL), this is not always the case (e.g., watermelon is sweet, but has a low GL), and non-sweet foods high in starch can carry a high glycemic load.


Glycemic index diet: What's behind the claims on the Mayo Clinic website.

Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2008). International tables of glycemic index and glycemic load values: 2008. Diabetes Care, 31(12), 2281–2283. https://doi.org/10.2337/dc08-1239

The University of Sydney (Australia) - http://www.GlycemicIndex.com - "The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and, therefore insulin levels."

You can look up many foods' GI and GL on the University of Sydney's glycemic index search engine.


Here are some articles published in peer-reviewed medical journals that directly address your question (the first two citations), or a related aspect of your inquiry:

CITATION: AlEssa, H. B., Bhupathiraju, S. N., Malik, V. S., Wedick, N. M., Campos, H., Rosner, B., … Hu, F. B. (2015). Carbohydrate quality and quantity and risk of type 2 diabetes in US women. American Journal of Clinical Nutrition, 102(6), 1543–1553. https://doi.org/10.3945/ajcn.115.116558

QUOTE: "Diets with high starch, low fiber, and a high starch-to-cereal fiber ratio were associated with a higher risk of T2D."

CITATION: Tsilas, C. S., de Souza, R. J., Mejia, S. B., Mirrahimi, A., Cozma, A. I., Jayalath, V. H., … Sievenpiper, J. L. (2017). Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Canadian Medical Association Journal, 189(20), E711–E720. https://doi.org/10.1503/cmaj.160706


BACKGROUND: Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.

METHODS: We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

RESULTS: Fifteen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76-1.09) or fructose (RR 1.04, 95% CI 0.84-1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80-0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories.

INTERPRETATION: Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates.

CITATION: Reeds, J., Mansuri, S., Mamakeesick, M., Harris, S. B., Zinman, B., Gittelsohn, J., … Hanley, A. (2016). Dietary patterns and type 2 diabetes mellitus in a First Nations community. Canadian Journal of Diabetes, 40(4), 304–310. https://doi.org/10.1016/j.jcjd.2016.05.001

QUOTE: "At follow up, 86 participants had developed incident type 2 diabetes. FA [factor analysis] revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes."

CITATION: Malik, V. S., Li, Y., Tobias, D. K., Pan, A., & Hu, F. B. (2016). Dietary protein intake and risk of type 2 diabetes in US men and women. American Journal of Epidemiology, 183(8), 715–728. https://doi.org/10.1093/aje/kwv268

QUOTE: "Substituting 5% of energy intake from vegetable protein for animal protein was associated with a 23% (95% CI: 16, 30) reduced risk of T2D [Type 2 Diabetes]. In conclusion, higher intake of animal protein was associated with an increased risk of T2D, while higher intake of vegetable protein was associated with a modestly reduced risk."

  • These are interesting articles. Do you know of any articles which directly compare sugar intake from solid foods vs. liquid sugar intake? I believe the rapid rise in blood sugar rather than the total sugar content is a risk factor for type 2 diabetes, but I have not proof for this. Jul 4, 2017 at 20:24
  • A mechanism of biological plausibility would be that with a rapid rise in blood sugar the body releases too much insulin because the blood sugar is too high. When blood sugar rises more slowly the amount of insulin released fits the amount of glucose more adequately. Therefore liquid sugar intake could cause insulin resistance, but I'm only speculating. Jul 4, 2017 at 20:29
  • 2
    That--rapid spikes in glucose increases risk of Type 2 Diabetes--is certainly a tenable hypothesis. You might want to look at the research on glycemic load for some insights. Jul 4, 2017 at 22:01
  • This answer is very good. I only know had time to look into the sources you provided in detail. Very interesting, thank you! Feb 27, 2018 at 11:13

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service and acknowledge you have read our privacy policy.

Not the answer you're looking for? Browse other questions tagged or ask your own question.