Orignal articleSoft drink, 100% fruit juice, and vegetable juice intakes and risk of diabetes mellitus
Introduction
Lifestyle related factors; especially eating habits, strongly affect the development of type 2 diabetes.1 According to community-based studies in Japan, the prevalence of diabetes increased from 2–8% in the 1980s to 6–13% in the 1990s among middle-aged men and from 1–5% in the 1980s to 3–9% in the 1990s among middle-aged women.2 Changes from traditional to westernized lifestyles accompanied by increased intakes of soft drink and juices have contributed to such jump in the prevalence in Asia.3 In cross-sectional4 and longitudinal studies,5 increased intakes of these beverages were linked to obesity in children and adults. Other studies pointed to the associations of soft drink with metabolic disturbances and type 2 diabetes in Asia3 and western countries.6, 7 However, no data reported such associations among Japanese population. With the world wide, and especially the Asian increased intake of these beverages,8 it is important to evaluate the associations of the intakes of these beverages and risk of type 2 diabetes in Japanese ethnic population, which has a low average BMI, and whose soft drink and juices' consumptions are still lower than that of other Asian and Western populations,9 because the identification of the modifiable risk factors for type 2 diabetes is important to set up public health plans to combat this growing global burden.
We conducted a community-based, prospective cohort study with a large number of middle-aged Japanese men and women with an adequate follow-up period to assess the associations of the intakes of soft drink and juices with risk of incident type 2 diabetes.
Section snippets
Study population
The Japan Public Health Center-based prospective study on cancer and cardiovascular disease (JPHC study) Cohort I started in 1990 in 5 prefectures (Iwate, Akita, Nagano, Okinawa and Tokyo). The study design is described in detail elsewhere10 and was approved by the Institutional Review Board of the National Cancer Center, Tokyo, Japan.
At baseline, 43,149 participants aged 40–59 years (20,665 men and 22,484 women) completed a questionnaire upon enrollment in 1990. Follow-up questionnaires were
Results
During the 5-year follow-up of 30,861 participants (13,854 men and 17,007 women) aged 40–59 years, 598 developed type 2 diabetes (1.9%); 366 (2.6%) among men and 232 (1.4%) among women (P < 0.001), and during the 10-year follow-up of 27,585 participants (12,137 men and 15,448 women) aged 40–59 years, 824 developed type 2 diabetes (3.0%); 484 (4.0%) among men and 340 (2.2%) among women (P < 0.001). For both genders, participants who developed diabetes were older, with a higher BMI and more
Discussion
In this large prospective cohort of Japanese men and women, higher soft drink intake was associated with increased risk of type 2 diabetes in women but not in men. The association of soft drink intake and diabetes risk appeared more evident for older women, overweight women, women who were educated more than high school, women with a blue collar job, and premenopausal women. Intakes of 100% fruit and vegetable juices were not associated with risk of type 2 diabetes. The association between soft
Funding
The Japan Public Health Center-based Prospective Study (JPHC) was supported by Grants-in-aid for cancer Research (19shi-2) and a Health Sciences Research Grant (research on Comprehensive Research on Cardiovascular disease) (H19-016) from the Ministry of Health, Labour and welfare of Japan.
Author contribution
Study conception and design (Hiroyasu Iso, Mizoue Tetsuya, Inoue Manami, Noda Mitsuhiko, and Tsugane Shoichiro); data collection (Hiroyasu Iso, Mizoue Tetsuya, Inoue Manami, Noda Mitsuhiko, and Tsugane Shoichiro); statistical analysis (Eshak S. Ehab); drafting the manuscript (Eshak S. Ehab); critical review for intellectual content (Eshak S. Ehab, Hiroyasu Iso, Mizoue Tetsuya, Inoue Manami, Noda Mitsuhiko, and Tsugane Shoichiro). All Authors have read and approved the final manuscript.
Conflict of interest
None declared.
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