Diet Soft Drinks Not Linked to Type 2 Diabetes

The study adds weight to the significant research using low-calorie sweeteners that has shown intake of these ingredients does not affect the development of type 2 diabetes. The authors concluded, "This supports our hypothesis that participants use artificially sweetened beverages as dieting aids or because of poor health. A lack of adjustment for these [health and lifestyle] factors may therefore have contributed to illusory associations [between diet soda consumption and type 2 diabetes] in other studies." They further noted, "The association between artificially sweetened beverages and type 2 diabetes was largely explained by health status, pre-enrollment weight change, dieting, and body mass index."

The researchers followed 40,389 adult men enrolled in the Health Professionals Follow-Up study from 1986 until 2006, to examine the associations between the normal consumption of sugar-sweetened beverages and diet soft drinks and the development of type 2 diabetes.

The data from 2,680 reported cases of type 2 diabetes developed over the 20-year study seemed to indicate that both types of beverages were associated with an increased incidence of type 2 diabetes. However, after adjusting for the health and lifestyle factors, including family history of type 2 diabetes, smoking, physical activity, high triglycerides, high blood pressure, diuretic use, body mass index (BMI), and total calorie intake, the Harvard University researchers found no significant association between diet soft drinks and incidence of type 2 diabetes.

Major health organizations including the American Diabetes Association and the American Dietetic Association support the use of low-calorie sweeteners for people with diabetes to control calorie intake. The American Dietetic Association states in its position paper on the use of nutritive and nonnutritive sweeteners, "Nonnutritive sweeteners are appropriate in medical nutrition therapy for people with diabetes and may help control energy intake." The statement further notes, "Nonnutritive sweeteners do not affect glycemic response and can be safely used by those with diabetes." "When used as part of an overall healthy diet, low-calorie sweeteners, diet soft drinks and other light products can be beneficial tools in helping people control caloric intake and weight," adds Beth Hubrich, a registered dietitian with the Calorie Control Council, an international trade association.   

American Journal of Clinical Nutrition, May 2011