Just 1 Sugary Drink a Day Raises Risk of Early Death in Type 2 Diabetes
For each sweetened beverage consumed per day, the risk of premature death went up by 8 percent for people with T2D.
If you have type 2 diabetes, replacing a sugary soda, energy drink, or even fruit juice with coffee, unsweetened tea, or water may help you live longer.
That’s according to a new Harvard study, which found that people with type 2 diabetes (T2D) who regularly drink sugar-sweetened beverages may be more likely to die early and develop heart disease.
But there’s good news, too: Consuming beverages like coffee, tea, low-fat cow’s milk, and plain water was linked to a lower risk of dying prematurely, according to the findings, published on April 19, 2023, in The BMJ.
First Study to Look at Sugary Drinks, Mortality, and Heart Disease Risk Specifically in People With T2D
While many studies have linked consumption of sugary drinks with health outcomes such as poor cardiometabolic health, weight change, and early death, those studies have primarily been among the general population, according to the authors.
“This is the first large-scale epidemiological study that systematically examined common beverages in relation to mortality and CVD [cardiovascular disease] outcomes specifically among diabetes patients,” says lead author Qi Sun, MD, ScD, associate professor in the departments of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health in Boston.
These findings may help people with T2D and their doctors, because even though it’s been generally accepted that people living with diabetes may especially benefit from drinking healthy beverages, there hasn’t been much data to back that up, says Dr. Sun.
Replacing a Soda With Tea or Water May Reduce the Risk of Early Death
More than 1 in 10 Americans lives with type 2 diabetes, according to the latest data from the Centers for Disease Control and Prevention (CDC). An additional 1.4 million American adults are diagnosed each year.
For the latest study, researchers used an average of 18.5 years of health data from 9,252 women participating in the Nurse’s Health Study and 3,519 men participating in the Health Professionals Follow-Up Study, all of whom had been diagnosed with T2D at baseline or at some point during the study.
Every two to four years, researchers collected information on how often the participants consumed sugar-sweetened beverages, including sodas, fruit punch, and lemonade, artificially sweetened beverages, fruit juice, coffee, tea, low-fat cow’s milk, full-fat cow’s milk, and plain water.
Participants with T2D who drank sugar-sweetened beverages like soda or lemonade on a regular basis had a higher risk of developing cardiovascular disease, dying prematurely, or both, compared with those who regularly consumed healthier beverages, including coffee, tea, low-fat milk, and plain water.
Each additional daily serving of a sugary beverage was associated with an 8 percent higher all-cause mortality among those with type 2 diabetes.
On the positive side, the risk of heart disease and death from heart disease or any cause went down in people who regularly consumed any of the healthier beverages mentioned above. Replacing one daily serving of a sugary drink with a healthier beverage was associated with up to an 18 percent lower risk of all-cause mortality and up to 24 percent lower risk of heart disease-related death.
Drinking Diet Drinks May Also Reduce Early Death Risk
Drinking artificially sweetened beverages like diet sodas, instead of sugary ones, was also associated with healthier outcomes, but less so. Replacing one daily serving of a sugary drink with an artificially sweetened beverage was associated with an 8 percent lower risk of death from any cause and a 15 percent lower risk in heart disease mortality.
“These findings suggest that when participants have a healthy dietary habit for a few years, we will see some positive changes in health and disease risk,” says Sun.
These findings align with what is generally known: Sugar-sweetened beverages are bad for your health, says Leonor Corsino, MD, an endocrinologist and diabetes and metabolism specialist at Duke Health in Durham, North Carolina, who was not involved in this study. “It’s been shown before in other studies and it’s in alignment with what we tell our patients.”
A study published in 2019 in JAMA Network Open looked at sugary beverage consumption in over 13,000 adults (not just people with T2D) and followed them for six years. Investigators found that each additional serving of sugary beverages was associated with an 11 percent all-cause mortality risk and each additional serving of fruit juice was associated with a 24 percent higher all-cause mortality risk.
If You Have T2D, ‘You Should Make the Switch’
What this new research adds is that the large group that was studied already had type 2 diabetes, says Dr. Corsino.
“This study gives us further evidence to tell our patients with type 2 diabetes that avoiding these beverages is beneficial to health. It also suggests that replacing them with other types of drinks that don’t have a high sugar content is also beneficial,” she says.
However, it’s important to note that this study proves an association between different types of beverages and health outcomes — it doesn’t prove that the sugary beverages are causing the early death, says Corsino. “It gives us an idea that they might be related, but it’s not definite.”
That being said, there are a lot of studies that do show this connection, she says. “I think the next step is educating the public that these drinks have a detrimental impact on your health. If you have type 2 diabetes, they’re not a great choice, and you should make the switch,” says Corsino.
Expert Advice on How to Kick Your Soda Habit
Sugary drinks are the top source of added sugars in the average American diet, representing almost half of all added sugars we consume, according to Healthy Food America, a nonprofit dedicated to promote scientifically based food policies. One 20-ounce Coke has approximately 120 percent of the daily maximum recommended sugar under the U.S. Food and Drug Association's guidelines for a healthy diet.
These drinks offer little to no health benefits and are considered a major driver of obesity and diabetes, according to the organization.
The take home message of these findings, according to Sun: People with T2D should be picky about what beverages they drink to keep their body hydrated.
Don’t be frustrated if you can’t quit sugary drinks cold turkey, says Corsino. “Although some people can make that change right away, for many others, it takes time. Many people have been consuming these drinks for years or decades and it’s hard to change that habit overnight,” she says.
“If you are trying to cut down on sugary drinks, try a slow transition from sugar sweetened beverages to maybe the diet [and] artificial beverages, and then transition to water,” she says.