Soft drinks

Avoid

2 studies · 1 recommendation

Last updated: February 25, 2026

Avoid2 studies

Regular soft drink consumption significantly increases type 2 diabetes risk by 21% per daily serving

Two large European prospective studies totaling over 35,000 participants consistently link soft drink intake to elevated type 2 diabetes risk. In the EPIC-Norfolk cohort (25,639 adults, 847 diabetes cases, 10.8-year follow-up), each daily serving of soft drinks carried a hazard ratio of 1.21 (95% CI 1.05–1.39), persisting after adiposity adjustment. The EPIC-InterAct case-cohort (9,682 diabetes cases across seven European countries) identified sugar-sweetened beverages as a key driver of dietary patterns associated with increased diabetes risk, with protective pattern adherence yielding HRs of 0.87–0.91. Substituting one daily serving with water or unsweetened tea/coffee reduced incidence by 14–25%. Population modeling estimated that reducing sweet beverage intake below 2% of total energy could prevent 15% of incident diabetes cases, with a clear dose-response relationship (HR 1.18 per 5% energy from sweet beverages).

Evidence

Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages.

Authors: Forouhi, Nita G, Imamura, Fumiaki, Khaw, Kay-Tee, Lentjes, Marleen AH, O'Connor, Laura, Wareham, Nicholas J

Published: January 1, 2015

In a prospective cohort of 25,639 UK adults from the EPIC-Norfolk study followed for a mean of 10.8 years, 847 incident type 2 diabetes cases were verified. Adjusted Cox regression showed soft drinks carried HR 1.21 (95% CI 1.05–1.39) per serving/day, persisting after adjustment for adiposity. Substituting one serving/day of water or unsweetened tea/coffee for soft drinks reduced incidence by 14–25%. Total sweet beverage energy showed a dose-response relationship: HR 1.18 (95% CI 1.11–1.26) per 5% energy. Population modeling estimated that if sweet beverage consumers reduced intake to below 2% of energy, 15% of incident diabetes cases might be prevented.

View Source →

Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study.

Authors: InterAct Consortium

Published: February 1, 2014

In the EPIC-InterAct case-cohort (9,682 diabetes cases, 12,595 subcohort participants, seven European countries), RRR-derived dietary patterns characterized by low sugar-sweetened beverage intake showed significant inverse associations with type 2 diabetes. HRs per 1-SD increase in pattern adherence were 0.91 (95% CI: 0.86–0.96) and 0.87 (95% CI: 0.82–0.92) after multivariable adjustment including body size. Sugar-sweetened beverages were specifically identified among the food groups driving these reduced rank regression patterns associated with elevated diabetes risk.

View Source →