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[NOT SO SWEET] Swap out sugary drinks, live longer if you have diabetes

Swapping sugary drinks for coffee, tea or water was linked to fewer deaths from heart disease and other causes among adults with diabetes in a recent study. The findings highlight the role of healthy beverage choices to manage risk, according to the study authors. A greater increase in coffee and tea consumption from before to after a diabetes diagnosis was also associated with lower death rates.

The researchers drew on data from 15,486 health professionals with type 2 diabetes  (average age, 61; 74% women) who were part of two large studies. Beverage consumption was assessed using a validated food questionnaire, and was updated every two to four years. This included sugar-sweetened beverages (SSBs), artificially-sweetened (low-calorie) beverages (ASBs), fruit juice, coffee, tea, low fat and full fat milk, and plain water.

During an average 18.5 years of follow-up, 3,447 cases of cardiovascular disease (CVD) and 7,638 deaths occurred.

After accounting for other lifestyle factors and medical history, the investigators found that participants with the highest intake of SSBs (more than 1 serving a day) had a 20% increased risk of death from any cause compared with participants with the lowest intake (less than 1 serving a month).

In contrast, high intakes of certain beverages (up to 6 servings a day) were associated with lower mortality: 26% lower for coffee, 21% for tea, 23% for plain water, and 12% for low-fat milk.

Similar associations were seen between the individual beverages and CVD rates and mortality. Notably, SSB intake was associated with a 25% higher risk of CVD and a 29% higher risk of CVD-related mortality, whereas intake of coffee and low-fat milk was associated with an 18% and 12% lower risk of CVD, respectively.

The researchers acknowledge that this observational study can’t establish cause. However, they conclude: "Overall, these results provide additional evidence that emphasizes the importance of beverage choices in maintaining overall health among adults with diabetes."

In a linked editorial, Nita Forouhi of the University of Cambridge, UK, notes that questions remain - for example,  the effect of adding sugar to coffee or tea, and the impact of other popular drinks, like milkshakes, smoothies, and hot chocolate.

To read the full study, published in The BMJ, click here

To read the editorial, click here

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