Estimated Substitution of Tea or Coffee for Sugar-Sweetened Beverages Was Associated with Lower Type 2 Diabetes Incidence in Case-Cohort Analysis across 8 European Countries in the EPIC-InterAct Study

Fumiaki Imamura, Matthias B Schulze, Stephen J Sharp, Marcela Guevara, Dora Romaguera, Benedetta Bendinelli, Elena Salamanca-Fernández, Eva Ardanaz, Larraitz Arriola, Dagfinn Aune, Heiner Boeing, Courtney Dow, Guy Fagherazzi, Paul W Franks, Heinz Freisling, Paula Jakszyn, Rudolf Kaaks, Kay-Tee Khaw, Tilman Kühn, Francesca R ManciniGiovanna Masala, Maria-Dolores Chirlaque, Peter M Nilsson, Kim Overvad, Valeria M Pala, Salvatore Panico, Aurora Perez-Cornago, Jose R Quirós, Fulvio Ricceri, Miguel Rodríguez-Barranco, Olov Rolandsson, Ivonne Sluijs, Magdalena Stepien, Annemieke M W Spijkerman, Anne Tjønneland, Tammy Y N Tong, Rosario Tumino, Linda E T Vissers, Heather A Ward, Claudia Langenberg, Elio Riboli, Nita G Forouhi, Nick J Wareham

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Abstract

INTRODUCTION: Beverage consumption is a modifiable risk factor for type 2 diabetes (T2D), but there is insufficient evidence to inform the suitability of substituting 1 type of beverage for another.

OBJECTIVE: The aim of this study was to estimate the risk of T2D when consumption of sugar-sweetened beverages (SSBs) was replaced with consumption of fruit juice, milk, coffee, or tea.

METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study of 8 European countries (n = 27,662, with 12,333 cases of incident T2D, 1992-2007), beverage consumption was estimated at baseline by dietary questionnaires. Using Prentice-weighted Cox regression adjusting for other beverages and potential confounders, we estimated associations of substituting 1 type of beverage for another on incident T2D.

RESULTS: Mean ± SD of estimated consumption of SSB was 55 ± 105 g/d. Means ± SDs for the other beverages were as follows: fruit juice, 59 ± 101 g/d; milk, 209 ± 203 g/d; coffee, 381 ± 372 g/d; and tea, 152 ± 282 g/d. Substituting coffee for SSBs by 250 g/d was associated with a 21% lower incidence of T2D (95% CI: 12%, 29%). The rate difference was -12.0 (95% CI: -20.0, -5.0) per 10,000 person-years among adults consuming SSBs ≥250 g/d (absolute rate = 48.3/10,000). Substituting tea for SSBs was estimated to lower T2D incidence by 22% (95% CI: 15%, 28%) or -11.0 (95% CI: -20.0, -2.6) per 10,000 person-years, whereas substituting fruit juice or milk was estimated not to alter T2D risk significantly.

CONCLUSIONS: These findings indicate a potential benefit of substituting coffee or tea for SSBs for the primary prevention of T2D and may help formulate public health recommendations on beverage consumption in different populations.

Original languageEnglish
Pages (from-to)1985-1993
Number of pages9
JournalThe Journal of Nutrition
Volume149
Issue number11
DOIs
Publication statusPublished - 01 Nov 2019
Externally publishedYes

Bibliographical note

Copyright © American Society for Nutrition 2019.

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