Oral Presentation Australian & New Zealand Obesity Society 2016 Annual Scientific Meeting

Consumption of Sugar Sweetened Beverages and Type 2 Diabetes Incidence in Thai Adults: Results from an Eight Year Prospective Study (#33)

Keren Papier 1 2 , Susan Jordan 2 , Cate D'Este 3 , Chris Bain 2 , Cathy Banwell 3 , Vasoontara Yiengprogsawan 4 , Sam-ang Seubsman 5 , Adrian Sleigh 3
  1. Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
  2. Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
  3. National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
  4. Centre for Research on Ageing, Health and Wellbeing and Department of Global Health, Research School of Population Health , The Australian National University, Canberra, ACT, Australia
  5. Thai Health-Risk Transition Study, School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand

Introduction

The global prevalence of type 2 diabetes mellitus (T2DM) is high and increasing in countries undergoing rapid socio-economic development, such as Thailand. Sugar sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, this has not been assessed in Thai adults. We aimed to assess the association between SSB intake and T2DM risk and whether this association was mediated by obesity in a prospective study of Thai adults.

Methods

Data were from Thai Cohort Study participants surveyed in 2005, 2009 and 2013. The sample included participants who were free of diabetes in 2005 and who were followed up in 2009 (n=59,314) and/or in 2013 (n=39,175). We used multivariable logistic regression to assess associations between SSB intake and four and eight year T2DM incidence. We used a counterfactual mediation analysis to explore potential mediation of the SSB intake and T2DM risk relationship.

Results

Frequent consumption of SSBs was associated with increased risk of T2DM in women, but not in men at both the four (SSB intake 1-6 times per week OR=1.7, 95%Confidence Intervals (CI) 1.3-2.4 and >1 per day-OR=2.5, 95%CI 1.5-4.1) and eight year follow-ups  (SSB intake 1-6 times per week OR=1.7, 95%CI 1.2-2.3 and >1 per day OR=3.1, 95%CI 2.0-5.0). The addition of both weight gain and body mass index (BMI) to the full regression model only slightly attenuated these effects. Having a BMI of 25kg/m2 or over in 2009 was a significant mediator of the total effect of SSB intake in 2005 on T2DM risk in 2013 (natural indirect effect 1.10, 95%CI (1.07, 1.13) and mediated 15.9% of the total relationship.

Conclusion

The consumption of SSBs increased the risk of T2DM incidence in women but not in males. Obesity mediated a proportion of this relationship but most of the effect appeared to act through other mechanisms.