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What effect do beverages have on developing diabetes? - International Scientific Forum on Alcohol Research Critique 230

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Of all lifestyle factors that relate to health and disease, probably the most difficult ones to evaluate are dietary factors, including foods, nutrients and beverages.

The latest critique from The ISFAR considers research into the effect of dietary factors on the incidence of diabetes

The latest critique from The ISFAR considers research into the effect of dietary factors on the incidence of diabetes

A recent research paper consists of a meta-analysis - an 'umbrella' analysis - based on 53 previous meta-analyses from prospective cohort observational studies. This analysis includes 153 adjusted summary hazard ratios on dietary behaviours or diet quality indices, food groups and foods, beverages, alcoholic beverages, macronutrients and micronutrients related to the incidence of type 2 diabetes.

Data from previous meta-analyses on very few foods or nutrients are adequate to clearly determine their effects, but among those that have been identified as reducing the risk of diabetes, high-quality evidence was found only for whole grains, cereal fibre and alcohol. As for dietary factors that have strong evidence of increasing the risk of diabetes, the authors of the paper identify only red meat, processed meat, bacon and sugar-sweetened beverages.   

ISFAR members considered this to be a well-done, appropriate analysis in a paper that summarises well the current scientific literature. Some members were concerned about the number of assumptions that scientists must make when doing a simple meta-analysis, especially when attempting an umbrella one; they consider it key to also evaluate single, large prospective studies where adjustments for many confounding socio-economic factors are less likely to be important.

Overall, the results of the research strongly support most of the findings of previous meta-analyses and umbrella analyses and indicate only a few dietary factors for which "high-quality" evidence exists for an association with the risk of developing diabetes.

The clearest evidence from the analyses in this paper, which was based only on prospective cohort studies, is that cereal grains and moderate alcohol lower the risk, while meats and sugar-sweetened beverages increase the risk of diabetes.

Given the complexity of evaluating dietary factors for their relation to disease outcomes, it would be useful for future studies to attempt to measure a multitude of foods, beverages, nutrients and eating patterns, preferably over time, to evaluate further the association with disease.

For now, current evidence suggests that cereals, grains, and moderate alcohol (that decrease risk) and meat and sugar-sweetened beverages (that increase risk) have the most consistent data for a relation to subsequent diabetes mellitus.

To read the full critique, click here.

These critiques are published with the permission of The International Scientific Forum on Alcohol Research.

Click here for all of the critiques from the International Scientific Forum on Alcohol Research


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