A longitudinal study examining the association between intake of sugar-sweetened beverages (SSB) and diet sodas on insulin resistance and incidence of prediabetes was published in November issue of The Journal of Nutrition. Researchers used a subsample of participants from the Framingham Heart Study’s Offspring cohort (n=1685). Data from 126-item food frequency questionnaires (FFQ) collected from the fifth (1991-1995) to the eighth (2005-2008) examinations was used for the analysis. Intake of sugar-sweetened beverages was estimated by including  the FFQ 4 SSB items including “1) caffeinated colas with sugar, 2) caffeine-free colas with sugar, 3) other carbonated beverages with sugar, and 4) fruit punch, lemonade, or other noncarbonated fruit drinks.” Diet soda intake was estimated through the use of 3 FFQ items to include “1) low-calorie colas; 2) low calorie, caffeine-free colas; and 3) other low-calorie carbonated beverages.”  Researchers considered an intake of 360mL to be equivalent to one serving. To assess overall diet quality, researchers utilized the 2010 Dietary Guidelines Adherence Index (DGAI). Primary outcomes of interest were fasting plasma glucose, insulin resistance as determined by homeostasis model of insulin resistance (HOMA-IR), and the development of both prediabetes and type 2 diabetes (T2D).

For the primary statistical analysis, researchers adjusted for baseline fasting plasma glucose, age, sex, current smoking status, physical activity level, hypertension, BMI, DGAI, and intakes of energy, alcohol, and fruit juice. For the secondary analysis, researchers replaced DGAI with individual foods (coffee, whole grains, vegetables, red meat, fish, and nuts) to “explore the potential effects of specific food groups on the associations of beverages with the outcomes.”

Researchers found that at baseline, SSB consumers were more likely to be young, male, current smokers, engaging in more physical activity, consuming more energy from fruit juice and with an overall less healthy diet. Compared to SSB consumers, diet soda consumers were slightly younger, less likely to smoke, had higher BMI, greater waist circumference, a higher fasting glucose, and greater insulin resistance. There was no noted sex differences for the diet soda group.

Of the 1695 participants, 823 developed prediabetes. After adjustment for the previously mentioned potential confounders, it was discovered that those in the highest quartile for SSB consumption (consuming 6 servings of SSB per week or more) had a ~46% higher risk of incident prediabetes than those in the lowest quartile. Interestingly, adjusting for BMI change over the course of the study did not significantly alter the results. Conversely, after adjusting for BMI, BMI change over the course of the study, and all other potential confounders, there was no significant association between diet soda intake and incident prediabetes. As for HOMA-IR, a method used to quantify insulin resistance and beta-cell function, a higher SSB intake was associated with a higher HOMA-IR after adjusting for confounders.  In contrast, diet soda intake was not associated with changes in HOMA-IR after adjusting for confounders.

Researchers conclude “that the long-term consumption of SSBs predicts increased insulin resistance and a higher risk of developing prediabetes, independent of body weight. In contrast, long-term diet soda intake was not associated with elevated insulin resistance or prediabetes risk.”

The post Sugar Sweetened Beverages but Not Diet Soda Consumption is Positively Associated with Insulin Resistance appeared first on FructoseFacts.

An article published in Nutrients sought to estimate intakes of total sugars, added sugars, and free sugars and their main food sources in Dutch children and adults using data from The Dutch National Food Consumption Survey (DNFCS). The DNFCS is “representative for the Dutch population with regard to age and sex within each age group, region, degree of urbanization and education level” and included those aged 7-69 years. The present study had a sample of 3,817 participants. Dietary intake was measured by two non-consecutive 24-h recalls. Dietary quality was assessed using the Dutch Healthy Diet index and food composition was determined using the 2011 Dutch food composition table.

For this study “Added sugars were defined as all sugars that are added during food manufacturing and preparation…Added sugars did not include naturally occurring sugars found in unprocessed products (fruit, vegetables, legumes, potatoes, fish, meat, poultry, and eggs), juices, fruit concentrates, bread and lactose in dairy. Free sugars were defined according to the definition of the WHO as ‘all sugars that are added during food manufacturing and preparation as well as sugars that are naturally present in honey, syrups, fruit juices, and fruit concentrates.’”

Researchers report that the median total sugar intake was 115g/day which contributed 21.5% of the total caloric intake. The median added sugar intake was 64g/day which contributed 12% of the total caloric intake and the median free sugar intake was 74g/day which contributed 14% of the total caloric intake. Researchers note that children (7-18 years old) had a higher overall sugar intake than adults (19-69 years old).

The food groups which contributed the most to intake of total, free, and added sugars across both age groups were “non-alcoholic beverages”, “sweets and candy”, “dairy”, and “cake and cookies.” “Non-alcoholic beverages” contributed most to total and free sugars whereas “sweets and candy” contributed most to added sugars. Of the “non-alcoholic beverages”, “soft drinks” made the largest contribution to sugar intake.

Of the 3,817 participants, one boy, one girl, and 4% of adults were in alignment with the British Scientific Advisory Committee on Nutrition (SACN) and the conditional World Health Organization (WHO) guidelines to not exceed 5% of daily total calories from sugar. When the guideline was relaxed to not exceed 10% of daily total calories from sugar, 5% of boys and girls, 33% of men, and 29% of women were in adherence. Interestingly, the overall diet quality was comparable between adherent and non-adherent men and women; however, the adherent participants were more likely to have higher fiber and vegetable intake and less saturated fat and alcohol consumption.

Researchers conclude that “within the Netherlands, fruit juices and sugar sweetened beverages, including soft drinks, lemonades, and energy-drinks, contributed most to the intake of free sugar, especially in children.”

The post Total, Free, and Added Sugar Consumption and Adherence to Guidelines appeared first on FructoseFacts.