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Assuming no weight gain, does a large amount of refined sugar intake increase the risk of diabetes?
To put it another way: In theory, if you took two identical subjects, and they each consumed the same amount of calories, but Subject A received 5% of their calories from refined sugar, while Subject B received 25% of their calories from refined sugar, would Subject B have an increased risk of diabetes?
A common conclusion from studies is that high intake of sugars is associated with increased risk of diabetes type 2, but it is not clear if this is due to sugar intake itself or due to associated weight gain.
1. Malik VS et al, 2010, Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes, a meta analysis (PubMed Central)
In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes.
Comment: It is not clear, if this effect is due to weight gain or sugar intake itself.
2. Greenwood DC et al, 2014, Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies (PubMed)
The intake of sugar-sweetened soft drinks has been reported to be associated with an increased risk of type 2 diabetes, but it is unclear whether this is because of the sugar content or related lifestyle factors, whether similar associations hold for artificially sweetened soft drinks, and how these associations are related to BMI.
3. Schulze MB et al, 2004, Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women (JAMA)
Higher consumption of sugar-sweetened beverages is associated with a greater magnitude of weight gain and an increased risk for development of type 2 diabetes in women, possibly by providing excessive calories and large amounts of rapidly absorbable sugars.
4. Imamura F et al, 2015, Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction (The BMJ)
Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes.
5. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: What is the relationship between the intake of added sugars and the risk of type 2 diabetes? (Health.gov)
Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.
A JAMA study found that women nearly doubled their diabetes risk when they increased the number of sugar-added drinks they consumed from 1 or fewer a week to 1 or more per day over a 4-year period. Rapidly absorbed sugars--like those in colas--may damage the pancreas cells that secrete insulin. In contrast, real-fruit drinks were not associated with increased diabetes risk, perhaps because of the other nutrients absorbed along with the sugar.
Another study by UCSF, Specifically, more sugar was correlated with more diabetes: For every additional 150 calories of sugar available per person per day, the prevalence of diabetes in the population rose 1 percent, even after controlling for obesity, physical activity, other types of calories and a number of economic and social variables. A 12-ounce can of soda contains about 150 calories of sugar. In contrast, an additional 150 calories of any type caused only a 0.1 percent increase in the population’s diabetes rate.
