Sugar availability is associated with increased prevalence of diabetes

A recent cross-sectional study, published in the PLoS One, has shown that sugar availability is associated with increased diabetes prevalence. Diabetes prevalence has been increasing dramatically, with nearly 1 in 10 adults worldwide now affected by the condition. Previously, obesity was considered the major risk factor for diabetes, specifically type 2. Obesity was thought to lead to metabolic syndrome, a group of disorders including hypertension, dyslipidemia, and insulin resistance. Metabolic syndrome, in turn, is a primary predictor of type 2 diabetes. However, obesity does not explain differences in global diabetes prevalence. In countries such as the Philippines, Romania, and France, there is a high prevalence of diabetes but low levels of obesity. As a result, research has sought to identify additional, independent risk factors for the disease. Sugar intake has been associated with the development of type 2 diabetes, but its role in diabetes prevalence in populations has previously been unclear. These researchers looked at data in 175 countries, examining the availability of different food items and diabetes prevalence. After accounting for poverty, urbanization, aging, obesity, physical activity, and other potential confounding variables, they found that a rise of 150 kilocalories/person/day in sugar availability (the equivalent of one 12-ounce can of soft drink) was associated with a 1.1 percent increase in diabetes prevalence, a statistically significant relationship. The same increase in total calorie availability was associated with only a 0.1 percent rise in diabetes prevalence, a non-significant result. Hopefully, these results will stimulate the Food and Drug Administration to re-evaluate the toxicity of sugar, and to enact policies that decrease the amount of sugar (particularly fructose) in our food supply, lowering the threshold for what is considered “safe.” While obesity is often associated with diabetes, it appears that it is not the causative factor leading to heightened diabetes prevalence. Rather, it appears that more available sugar is driving an increase in metabolic syndrome and subsequent diabetes, a relationship that is independent of obesity. General overeating is not as noxious as previously hypothesized. Instead, consuming too much sugar seems to be the specific practice that leads to higher diabetes prevalence.*