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- Title
Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.
- Authors
Tsilas, Christine S.; de Souza, Russell J.; Blanco Mejia, Sonia; Mirrahimi, Arash; Cozma, Adrian I.; Jayalath, Viranda H.; Ha, Vanessa; Tawfik, Reem; Di Buono, Marco; Jenkins, Alexandra L.; Leiter, Lawrence A.; Wolever, Thomas M. S.; Beyene, Joseph; Khan, Tauseef; Kendall, Cyril W. C.; Jenkins, David J. A.; Sievenpiper, John L.; Mejia, Sonia Blanco
- Abstract
<bold>Background: </bold>Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.<bold>Methods: </bold>We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.<bold>Results: </bold>Fiffeen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76-1.09) or fructose (RR 1.04, 95% CI 0.84-1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80-0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories.<bold>Interpretation: </bold>Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates.<bold>Trial Registration: </bold>ClinicalTrials.gov, no. NCT01608620.
- Subjects
TYPE 2 diabetes; SUGAR; FRUCTOSE; SUCROSE; BEVERAGES; DIABETES
- Publication
Canadian Medical Association Journal (CMAJ), 2017, Vol 189, Issue 20, pE711
- Publication type
journal article
- DOI
10.1503/cmaj.160706