A small, long-term study of nearly 500 children in Massachusetts found that regular consumption of sugary drinks and 100 percent fruit juice during childhood and adolescence was associated with a higher risk of type 2 diabetes in boys than girls. This preliminary study was presented at the American Heart Association's 2024 Epidemiology and Prevention│Lifestyle and Cardiometabolic Health Science Conference.
Lead researcher Dr. Soren Harnois-Leblanc said: "While these findings are preliminary, they support existing evidence of a potential relationship between drinks with added sugar and the long-term risk of type 2 diabetes in children. Pediatricians and other health care professionals should caution young patients and their parents about sugary drinks and juices when discussing healthy eating habits."
According to a 2022 fact sheet on sugary drinks released by the American Heart Association, nearly two-thirds of children and teens in the United States drink at least one sugary drink every day, such as soda, lemonade or energy drinks. The information also states that in addition to weight gain, eating too many foods with added sugar, especially sugary drinks, can increase the risk of heart disease, high blood pressure, type 2 diabetes and tooth decay.
Researchers used data from Project Viva, a long-term study of women and their children in eastern Massachusetts that began in 1999, to explore whether drinking sugary drinks, 100 percent fruit juice and eating fresh fruit were associated with markers of type 2 diabetes. The researchers calculated average consumption of sugar-sweetened beverages, 100% fruit juices and fresh fruit during childhood and adolescence based on dietary records and assessed their potential association with three markers of type 2 diabetes: insulin resistance, fasting blood glucose levels and HbA1c levels. These markers are measured in a single blood test during fasting in late teens (around age 17).
Key findings and gender differences
Analysis found
Across boys' childhood and adolescence, each serving of sugar-sweetened beverages (about 8 ounces) per day was associated with a 34% increase in insulin resistance; a 5.6 mg/dL increase in fasting blood glucose levels; and a 0.12% increase in HbA1c levels in late adolescence.
Drinking 100% juice throughout childhood and adolescence led to a 0.07% increase in HbA1c levels per daily serving of 100% juice in late adolescence for the boys in the study, but only a modest 0.02% increase for the girls.
Harnois-Leblanc noted that consuming fresh fruit during childhood and adolescence did not appear to have a positive or negative impact on the risk of developing type 2 diabetes among the boys or girls in the study.
The association between boys' regular consumption of sugary drinks and increased insulin resistance, fasting blood sugar levels and HbA1c levels remained when other health, family and social factors were taken into account. These factors include socioeconomic status, child and mother's body mass index, mother's age when the child was born, maternal and paternal history of type 1 or type 2 diabetes, overall diet quality and other lifestyle behaviors.
"While boys and girls differ in many aspects of biology and behavior, I expected to find an association between sugar-sweetened beverage and fruit juice consumption and increased insulin resistance, blood sugar, and HbA1c levels in late adolescent girls. I was also surprised that eating whole fruits did not reduce levels of these type 2 diabetes markers," Harnois-Leblanc said. "The next step is to use more advanced statistical tools that will allow us to better understand the potential causal role of sugary drinks and juices, and to examine whether the relationships also differ among children of different races and/or ethnicities."
Research background and details:
The researchers analyzed data on the children of 2,128 pregnant women who gave birth to children while participating in the "Long Live Project." Of these, 972 children met the inclusion criteria for this study (a questionnaire completed by parents at the child's 3-year examination, no personal or parental history of type 1 or type 2 diabetes, and parental history of type 2 diabetes assessed separately). Harnois-Leblanc noted that of the 972 children, 455 had fasting blood samples collected during a study visit in late adolescence.
There were 240 girls and 215 boys among the children participating in the study.
Project Viva is a long-term study of women and their children in eastern Massachusetts that began enrollment in 1999. The study focuses on improving maternal and infant health by examining the potential impact of various life and health factors during and after pregnancy on the health of the mother and the health of her children, including a review of diet and nutrition. Children were followed from birth through late adolescence, and most recently until age 20.
The researchers assessed how often children drank sugary drinks, juices and ate fresh fruit (in standard serving sizes) based on questionnaires parents filled out when their children were approximately 3, 8 and 13 years old. They also measured fasting blood sugar, insulin and HbA1c levels in late adolescence (mean age 17.4 years).
This study has several limitations. While research has found that regular consumption of sugary drinks and juices is associated with the development of markers of type 2 diabetes, it does not prove that these drinks cause type 2 diabetes. Additionally, the small number of people involved in the study may have affected the strength of the association between sugary drinks and juice and an increased risk of type 2 diabetes.
"Diet and cardiometabolic health is a complex issue, with many factors changing over time and interacting in different ways, and this study is just one piece of the puzzle," Harnois-Leblanc said.
"This study shows that increased consumption of sugar-sweetened beverages, including juices, during childhood and adolescence is associated with increased risk markers for late adolescent diabetes in boys, but not girls," said Penny M. Kris-Etherton, Ph.D., a member of the American Heart Association's Nutrition Committee. "It is striking that many of the risk markers for type 2 diabetes are increased in boys at such an early age."
Chris Etherton, professor emeritus of nutritional sciences at Penn State, was a co-author of the association’s 2018 scientific recommendations on low-calorie sweetened beverages and cardiometabolic health. "Importantly, while fruit intake does not appear to be protective, it is not associated with an increased risk of type 2 diabetes," she said. "These findings support current dietary recommendations from the association and many organizations to limit or eliminate sugary beverages in favor of whole fruits, which are rich in nutrients, especially those lacking in the average American diet. (Shortage nutrients are vitamins and nutrients that people are missing from food every day; long-term deficiencies of certain vitamins and nutrients have been linked to adverse health outcomes)."
Compiled from /ScitechDaily