Carbohydrates and Health

Sucrose (g/day) and type 2 diabetes mellitus
• No association
• Limited evidence
6.31 Four cohort studies were identified that presented evidence on glucose or fructose
intake in relation to incidence of type 2 diabetes mellitus, of which three were
included in a meta-analysis (Meyer et al., 2000; Montonen et al., 2007; Schulze et
al., 2008). One study could not be included in a meta-analysis as it did not report
the necessary data (Janket et al., 2003). No further cohort studies were identified
in the update search (Cardio-metabolic review, diabetes and glycaemia chapter).
6.32 The heterogeneity was above the pre-specified cut-off of 75% for studies
investigating glucose (I 2 =80%) or fructose (I 2 =83%) intakes in relation to incidence
of type 2 diabetes mellitus and, therefore, the meta-analysis pooled estimate
is not presented. Two studies specify that glucose and fructose are analysed
individually rather than as part of sucrose (Meyer et al., 2000; Montonen et al.,
2007), but this is not stated in the other two studies (Janket et al., 2003; Schulze
et al., 2008). Two of the studies report an association between higher glucose or
higher fructose intakes and higher incidence of type 2 diabetes mellitus (Meyer
et al., 2000; Montonen et al., 2007), while the other two studies observe no
significant association (Janket et al., 2003; Schulze et al., 2008).
6.33 Three of the cohort studies also report data on lactose intake in relation to
incidence of type 2 diabetes mellitus (Meyer et al., 2000; Janket et al., 2003;
Montonen et al., 2007). As one study did not report the necessary data to be
included in a meta-analysis (Janket et al., 2003), an insufficient number of studies
was available to enable a meta-analysis to be performed. All of these studies
report no significant association between lactose intake and the incidence of type
2 diabetes mellitus.
Glucose, fructose or lactose (g/day) and type 2 diabetes mellitus
• No association
• Limited evidence
6.34 There is a lack of evidence from trials exploring the effect of individual sugars on
cardio-metabolic health outcomes to enable a conclusion to be drawn (see Table
6.2). A commentary on the evidence base for fructose consumption and health
outcomes is provided in Annex 3.
Sugars-sweetened beverages
Type 2 diabetes mellitus
6.35 Six cohort studies were identified that presented evidence on the relationship
between sugars-sweetened beverage consumption and the incidence of type 2
diabetes mellitus (Schulze et al., 2004b; Paynter et al., 2006; Dhingra et al., 2007;
Montonen et al., 2007; Palmer et al., 2008; Nettleton et al., 2009). These were
not combined into a meta-analysis in the cardio-metabolic health review due to
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