Sugary Drinks, Not Fruit Juice Linked to Insulin Resistance

Consumption of sugar-sweetened drinks, not including 100 percent fruit juice, may be associated with insulin resistance, even in otherwise healthy adults

Steady increases in consumption of sugar-sweetened beverages over the last several decades, as well as rates of Type 2 diabetes mellitus, led nutritional epidemiologists at the Jean Mayer USDA Human Nutrition Research Center on Aging to explore the relationship between sugar-sweetened beverage consumption and insulin resistance, a precursor to Type 2 diabetes. Their findings suggest that higher consumption of sugar-sweetened drinks, but not 100 percent fruit juice, may be associated with insulin resistance, even in otherwise healthy adults.

“Study participants who consumed two or more sugar-sweetened beverages per day had significantly higher fasting blood levels of insulin as compared to participants who did not report consuming any such beverages, regardless of age, sex, weight, smoking status, or other dietary habits,” says senior author Paul Jacques, professor at the Friedman School of Nutrition Science. “Higher fasting levels of insulin mean these study participants are more at risk for developing Type 2 diabetes. In contrast,” he says, “consumption of 100 percent fruit juice was not significantly related to any of our measures of insulin resistance.”

Study participants were 2,500 healthy men and women in the Framingham Offspring Study, a community-based study of cardiovascular disease among offspring of people in the original Framingham Heart Study. Participants reported their usual dietary intake for the previous year, which researchers used to determine average intakes of sugar-sweetened drinks (regular and caffeine-free colas and other carbonated beverages containing sugar), diet soft drinks (low-calorie colas with and without caffeine and other low-calorie carbonated beverages), and fruit juice (e.g., apple juice or apple cider, orange juice, and grapefruit juice). One serving of a sugar-sweetened drink or diet soda was considered equivalent to 12 fluid ounces, or a regular-sized can of soda. One serving of fruit juice was considered equivalent to six fluid ounces.

The researchers obtained blood samples from participants who fasted for at least eight hours, and measured the participants’ blood levels of insulin as well as glucose. High fasting glucose levels, like high fasting insulin levels, are a pre-cursor to Type 2 diabetes. “Unlike fasting insulin levels, fasting glucose levels were not significantly different between those who consumed sugar-sweetened drinks and those who did not,” says Jacques, “However, participants consuming two or more daily servings of 100 percent fruit juice had modestly lower fasting glucose levels, compared with those who did not consume fruit juice.” Although this observation might be due to the additional nutrients or other phytochemicals found in the juices, Jacques notes this also may be a consequence of the healthier lifestyle and dietary habits of fruit juice consumers. They were less likely to smoke than non-consumers, and consumed diets relatively lower in saturated fat and higher in total fiber.

Despite these results, Nicola McKeown, PhD, corresponding author, does not advise increasing consumption of fruit juice. “While 100 percent fruit juice can be a healthful beverage, too much fruit juice can add excess calories and sugar to the diet. Whole fruit is often a better choice.”

Yoshida M, McKeown NM, Rogers G, Meigs JB, Saltzman E, D’Agostino R, Jacques PF. Journal of Nutrition. 2007 (September); 137:2121-2127. “Surrogate Markers of Insulin Resistance are Associated with Consumption of Sugar-Sweetened Drinks and Fruit Juice in Middle and Older-Aged Adults.”
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DID YOU KNOW:
Hemoglobin A1c can predict type 2 diabetes in women: Among healthy middle-aged and older women, the hemoglobin A1c level — a measure of blood sugar control — is an independent predictor of type 2 diabetes, a study shows. They observed a graded increase in risk for both diabetes and heart-related events, such as heart attack, with increasing levels of HbA1c. HbA1c remained a strong predictor of diabetes, but not heart-related events, in analyses adjusting for multiple factors that might influence the results. American Journal of Medicine, August 2007.  See This Week’s Item #9

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