Use of sugar in coffee, tea may not increase risk of incident diabetes or mortality

Tea and coffee are among the most consumed nonalcoholic hot beverages worldwide. Sugar addition to tea or coffee is a common practice. However, there is no clarity on the association between the use of sugar in coffee or tea and adverse events. Johan Clausen, Affiliation Steno Diabetes Center Copenhagen, Herlev, Denmark, and colleagues aimed to investigate the association between the sugar addition to tea or coffee, and the risk of all-cause mortality, cancer mortality, cardiovascular mortality, and incident diabetes mellitus (DM).

For this purpose, the researchers included participants from the prospective Copenhagen Male Study from 1985 to 1986, without cancer, cardiovascular disease, or DM at inclusion, who reported regular tea or coffee consumption. Using study questionnaires, they derived self-reported number of tea and coffee cups and sugar use. The quantity of sugar used was not reported.

The primary outcome of the study was all-cause mortality and secondary endpoints were cancer mortality, cardiovascular mortality, and incident diabetes. Cox regression analysis was used to analyze the association between adding sugar and all-cause mortality.

Age, smoking status, daily alcohol intake, systolic blood pressure, body mass index, number of cups of coffee and/or tea consumed per day and socioeconomic status were included as covariates. Vital status of patients up until 22.03.2017 was assessed. Sugar could be added to either coffee, tea or both.

The researchers reported the following findings:

• A total of 2923 men (mean age at inclusion: 63±5 years) were included, of which 34.5% added sugar.
• In 32 years of follow-up, 88.3% of the participants died, 87.5% in the non-sugar group versus 89.9% in the sugar group.
• The hazard ratio of the sugar group compared to the non-sugar group was 1.06 for all-cause mortality.
• An interaction term between the number of cups of coffee and/or tea per day and adding sugar was 0.99.
• A subgroup analysis of coffee-only drinkers showed a hazard ratio of 1.11. The interaction term was 0.98.
• Hazard ratios for the sugar group compared to the non-sugar group were 1.11 for cardiovascular disease mortality, 1.01 for cancer mortality and 1.04 for incident diabetes mellitus.

"In the present population of Danish men, adding sugar in tea and/or coffee was not significantly associated with increased risk of incident diabetes or mortality," the researchers concluded.

Reference:

Treskes, R. W., Clausen, J., Marott, J. L., Jensen, G. B., Holtermann, A., Gyntelberg, F., & Jensen, M. T. (2023). Use of sugar in coffee and tea and long-term risk of mortality in older adult Danish men: 32 years of follow-up from a prospective cohort study. PLOS ONE, 18(10), e0292882. https://doi.org/10.1371/journal.pone.0292882