Total added sugar consumption no risk factor for prediabetes developement

USA: Added sugar consumption is not a risk factor for prediabetes, and risk estimates do not differ by race/ethnicity, states a recent study published in medRxiv.

Diabetes is a preventable diet-related disease. Prediabetes is asymptomatic and progresses to type 2 diabetes (T2D). About 5-10 % of adults with prediabetes progress to T2D annually; 70% develop T2D within their lifetime, while 85 % are unaware of the condition until it progresses to T2D.

Such a health burden should be evaluated for predisposing factors where diet is a primary predictor. Researchers hypothesized that total added sugar consumption increases prediabetes risk to address this medical condition. The prediabetes risk was defined by HbA1c (Haemoglobin A1c) and Fasting Plasma Glucose (FPG).

The study's investigators excluded natural sugar present in dairy and fruits. They defined added sugar as syrups, sugars, fruit juice concentrates, and calorie sweeteners added in processing, preparation, or before food and beverage consumption. These estimates were obtained from the Food Patterns Equivalent Databases (FPED) of the Food and Nutrient Database for Dietary Studies.

The study data was collected from National Health and Nutrition Examination Survey (NHANES), supported by National Centre for Health Statistics (NCHS) and Centres for Disease Control and Prevention. The study included 5306 US adults ≥ 20 years with normoglycemia (41%) and prediabetes (59 %) with an average age of 47 years, with 51.1 % females and 48.9 % males.

The points of focus from the study include:

• Added sugar was calculated as teaspoon equivalents consumed per subject, per day from foods/beverages. 1 teaspoon = 4.2 grams and 1 gram = 4 kilocalories).

• In adults with normoglycemia and prediabetes, the total energy intake from added sugar was 13.9 %, with a p-value of 0.92.

• Among prediabetic and normoglycemic adults, total calories per day and added sugar intake were similar with 2084 vs. 2046 total kcal/day; 71 vs. 73g/day added sugar; 285 vs. 293 kcal/day added sugar.

• Prediabetics had an average HbA1c of 5.6 % with 107 mg/dL of FPG compared to 5.2 % of HbA1c with 93 mg/dL of FPG among normoglycemic adults.

• An individual's chances of having prediabetes do not significantly depend on total calorie intake, BMI, sociodemographic factors, and total added sugar consumed.

• Differences in race and ethnicity status do not relate to prediabetes.

The study concluded, "No significant association exists between added sugar intake and prevalence of prediabetes."

The researchers added," This is the first study examining the existence of an association between usual intake of total added sugar and the prediabetes risk in a large nationally representative sample."

Reference:

Total Added Sugar Consumption is not Significantly Associated with Risk for Prediabetes Among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018. Nadia Markie Sneed, Andres Azuero, Jacqueline Moss, Amy M. Goss, Shannon A Morrison. medRxiv 2022.08.22.22279065; doi: https://doi.org/10.1101/2022.08.22.22279065