4 days ago
Diet Drinks, Saccharin Tied to Increased Diabetes Risk
ORLANDO, Fla. — Consuming higher amounts of diet drinks and/or saccharin was associated with an elevated risk of developing diabetes, while total artificial sweetener intake, sucralose, and aspartame showed no significant association, according to an analysis of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
30-Year Study
The current analysis, presented at NUTRITION 2025, the annual meeting of the American Society for Nutrition, included 4654 adults (54.4% women, 50.1% White individuals) enrolled in the CARDIA study, with a mean age of 24.9 years at baseline in 1985-86.
Dietary intake was assessed by the CARDIA diet history at year 0, year 7, and year 20. The cumulative average intakes of artificial sweeteners, diet beverages, aspartame, and sucralose were calculated.
Diabetes was defined as a fasting glucose ≥ 126 mg/dL, oral glucose tolerance test 2-hour glucose ≥ 200 mg/dL, A1c ≥ 6.5%, or use of diabetes medications at follow-up visits.
Associations of incident diabetes across quintiles of artificial sweetener, diet beverage, aspartame, or sucralose intakes through year 30 were assessed with time-dependent multivariable Cox proportional hazard regression models.
The models were adjusted for age, sex, race, field center, education, energy intake, physical activity, smoking status, alcohol drinking, diet quality, and family history of diabetes.
Over a median follow-up of 30 years, 691 incident diabetes events occurred. Participants in the fifth quintile of diet beverage intake had a significantly higher risk of developing diabetes than those in the first quintile (hazard ratio [HR], 2.29).
Positive associations were also observed for intakes of saccharin (HR, 2.10).
Adjustment for waist circumference attenuated the associations slightly, but overall, higher intakes of diet beverages and saccharin were associated with an increased risk for incident diabetes.
More Work to Do
This study represents a 'first pass,' as the team still has more work to do, including a mediation analysis, explained coauthor Lyn Steffen, PhD, professor of Epidemiology and Community Health at the University of Minnesota School of Public Health, Minneapolis.
'These findings highlight the need to evaluate the long-term metabolic effect of artificial sweeteners on glucose metabolism,' the authors noted.
A previous CARDIA analysis by Steffen's team suggested that long-term intakes of aspartame, saccharin, or diet soda were related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue.
'I recommend limiting the use of any sweetener,' Steffen told Medscape Medical News. 'For beverages, I suggest unsweetened water, coffee, tea, milk, or small amount of 100% fruit juice — a small amount meaning limited calories, not 12- or 20-fluid-ounce containers.'
CARDIA is supported by the US National Heart, Lung, and Blood Institute. Steffen declared having no relevant competing interests.
