Coffee consumption, additive use, and risk of type 2 diabetes-results from 3 large prospective United States cohort studies.

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS American Journal of Clinical Nutrition Pub Date : 2025-01-18 DOI:10.1016/j.ajcnut.2025.01.017

Matthias Henn, Andrea J Glenn, Walter C Willett, Miguel A Martínez-González, Qi Sun, Frank B Hu

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Abstract

Background: Consumption of coffee has been consistently associated with lower risk of type 2 diabetes (T2D). However, it is unknown whether the use of additives may modify the association.

Objectives: This study aimed to analyze the association between coffee consumption and risk of T2D by considering the addition of sugar, artificial sweeteners, cream, or a nondairy coffee whitener.

Methods: We used 3 large prospective cohorts-Nurses' Health Study (NHS; 1986-2020), NHS II (1991-2020), and the Health Professionals Follow-up Study (HPFS 1991-2020). Self-reported coffee consumption, additive use, and T2D incidence were confirmed using validated questionnaires. Time-dependent Cox proportional hazards regression models were used to calculate hazard ratios (HRs) with multivariable adjustment.

Results: During 3,665,408 person-years of follow-up, we documented 13,281 incident T2D cases. After multivariable adjustment, each additional cup of coffee without any additive was associated with 10% lower risk of T2D (HR: 0.90; 95% CI: 0.89, 0.92) in the pooled analysis of the 3 cohorts. The inverse association did not change among participants who added cream. Among participants who added sugar to coffee (on average 1 teaspoon per cup), the association was significantly weakened (HR: 0.95; 95% CI: 0.93, 0.97; interaction term HR: 1.17; 95% CI: 1.07, 1.27). A similar pattern was observed among those who used artificial sweeteners (HR: 0.93; 95% CI: 0.90, 0.96; interaction term HR: 1.13; 95% CI: 1.00, 1.28). The association between coffee consumption and T2D risk among those who used coffee whitener was also attenuated, although the interaction was not significant (HR: 0.95; 95% CI: 0.91, 1.00; interaction term HR: 1.16; 95% CI: 0.66, 2.06).

Conclusions: Adding sugar or artificial sweetener significantly attenuates the magnitude of the inverse association between higher coffee consumption and T2D risk, whereas the use of cream do not alter the inverse association.

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咖啡消费、添加剂使用和2型糖尿病风险——来自美国三个大型前瞻性队列研究的结果

背景：饮用咖啡一直与2型糖尿病（T2D）的风险降低有关。然而，目前尚不清楚添加剂的使用是否会改变这种关联。目的：通过考虑添加糖、人工甜味剂、奶油或非乳制品咖啡增白剂，研究咖啡消费量与T2D风险之间的关系。方法：我们使用了三个大型前瞻性队列——护士健康研究（NHS 1986 - 2020）、护士健康研究II （NHS II 1991 - 2020）和卫生专业人员随访研究（HPFS 1991 - 2020）。自我报告的咖啡摄入量、添加剂使用和T2D发病率通过有效的问卷得到证实。采用时变Cox比例风险回归模型计算多变量调整后的风险比。结果：在3,665,408人年的随访中，我们记录了13,281例T2D事件。多变量调整后，每多喝一杯不含任何添加剂的咖啡，患T2D的风险降低10% (HR 0.90；95% CI 0.89 ~ 0.92)。在添加奶油的参与者中，这种负相关没有改变。在向咖啡中添加糖（平均每杯1茶匙）的参与者中，这种关联显著减弱(HR 0.95；95% CI 0.93 ~ 0.97；相互作用项HR 1.17；95% CI 1.07 - 1.27)。在使用人工甜味剂的人群中也观察到类似的模式(HR 0.93；95% CI 0.90 ~ 0.96；相互作用项HR 1.13；95% CI 1.00 - 1.28)。在使用咖啡增白剂的人群中，咖啡摄入量与T2D风险之间的关联也有所减弱，尽管这种相互作用并不显著(HR 0.95, 95% CI 0.91至1.00；相互作用项1.16；95% CI 0.66 - 2.06)。结论：添加糖或人工甜味剂显著减弱了高咖啡摄入量与T2D风险之间的负相关关系，而使用奶油并没有改变这种负相关关系。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.