- When it comes to managing the risk of developing type 2 diabetes, there is no safe level of sugar-sweetened beverage consumption, according to a new study.
- At the same time, the study finds that moderate consumption of sugars contained in solid foods or eaten with them may actually lower the risk of developing diabetes.
- The study supports a beneficial role of sugar in a balanced, healthy diet, as long as it does not include sweetened liquids such as soft drinks or fruit drinks.
Although a sweet tooth is often associated with an increased risk of developing type 2 diabetes, a new meta-study shows that the link between sugar and the condition is more nuanced than one might think.
While sugars consumed in sweetened beverages significantly increase one’s risk of developing type 2 diabetes, sugars eaten in foods do not. In fact, they may even have a slight protective effect against developing the condition, a new study indicates.
This new, large meta-study is the work of researchers at Brigham Young University in Provo, Utah, in collaboration with colleagues at Paderborn University and the University of Freiburg in Germany.
The researchers included in their analysis the findings of 29 studies conducted in Europe, the United States, Asia, Australia, and Latin America.
The study is published in the journal Advances in Nutrition.
This study confirmed previous research, finding that the consumption of sugar-sweetened drinks, such as soft drinks, sports drinks, and energy drinks, was closely linked to the development of type 2 diabetes.
The meta-study found that for each 12-ounce daily serving of a sugar-sweetened drink, the risk of diabetes increased by 25% relative to their existing level of risk.
Fruit juice is considered by many to be a Healthy alternative to such drinks and may contain fewer potentially harmful additives. However, it still contains a significant amount of sugar.
With each serving of fruit juice, the risk of diabetes increased by 5%, in the meta-study.
Some may be surprised by the study’s finding regarding the connection, or relative lack thereof, between sugar consumed in or with foods and the risk of developing diabetes.
We were not surprised by the meta-study’s findings, said lead author Karen Della Corte, PhD, Assistant Professor of Nutrition, Dietetics, and Food Science at Brigham Young University.
“Our hypothesis was shaped by emerging research on glycemic response, liver metabolism, and the concept of the food matrix. [It] was based on the idea that sugar’s impact depends on how it’s delivered — not just how much you eat, but what else comes with it,” she said.
No ‘safe’ lower limit“What did surprise us was how consistently the harmful associations with sugary drinks showed up across so many diverse populations — and that this increased risk was evident even with just one serving per day. That suggests there’s really no safe lower limit when it comes to sugary beverages.”
— Karen Della Corte, PhD
Della Corte also reported her team was intrigued by the extent to which the moderate intake of sugars in solid foods was not only not associated with harm, but may even be beneficial in terms of diabetes risk.
“That challenged the popular narrative that all sugar is inherently harmful, and it highlighted the importance of food context — including fiber, protein, and other nutrients — in how the body processes sugar,” Della Corte said.
When we consume sugars in drinks, they enter our bodies in a much different manner than they do when they’re ingested with food.
Della Corte explained, “When sugar is dissolved in liquid, it floods the system fast — and this rapid delivery overwhelms the body’s ability to process it in a healthy way.”
“One key reason,” she said, “is that sugary drinks deliver large amounts of sugar quickly and without any of the components that normally slow down digestion, like fiber, protein, or fat.”
These nutrients, on the other hand, do typically accompany sugars when they are eaten.
“Liquid sugars are absorbed quickly, leading to sharp blood sugar spikes and insulin responses,” added Michelle Routhenstein, MS RD CDCES CDN, Preventive Cardiology Dietitian and Heart Health Expert at EntirelyNourished.com, who was not involved in the study.
As our system is overwhelmed by liquid sugars, particularly fructose common in sugary drinks, a pathway to T2D is easy to imagine.
How sugary drinks heighten diabetes risk“When the liver is hit with a sudden, high dose of fructose, it can’t keep up. When overwhelmed, it diverts more of the excess fructose into fat production, a process known as ‘de novo lipogenesis.’ This buildup of fat in the liver can interfere with insulin signaling and contribute to metabolic dysfunction, leading to an increased risk of type 2 diabetes.”
— Karen Della Corte, PhD
When sugars are consumed as an ingredient in foods, or eaten with foods, it is absorbed more slowly and readily by the body.
Routhenstein pointed out that sugars in beverages “also don’t make us feel full, so people tend to consume more overall calories.”
The meta-study clearly shows that avoiding sugar-sweetened drinks is a sensible precaution to take to avoid type 2 diabetes. It also clearly supports the idea that sugar has a place in a healthy diet.
“One point I’d like to emphasize is that this study challenges the idea that ‘all sugar is bad’ in a blanket sense. Our results show that the health effects of sugar depend heavily on how it’s consumed. That opens the door to more nuanced nutrition guidance that focuses on carbohydrate quality, not just quantity.”
— Karen Della Corte, PhD
Routhenstein agreed:
“This study reinforces the idea that carbohydrates, including sugars, are an important part of the diet, and how we consume them really matters.”
“I don’t support very low-carb diets because research shows they are often linked to high LDL and apoB levels, and can cause fast progression of plaque formation in the arteries,” she noted.
“Instead,” Routhenstein concluded, “I focus on helping patients choose carbs wisely — pairing them with fiber, protein, and healthy fats to slow sugar absorption and support overall health. It’s about balance and quality, not simply cutting out sugar completely.”
