title: A prospective study of sugar intake and risk of type 2 diabetes in women.
abstract: OBJECTIVE
  To investigate prospectively whether intake of total or type of sugar is associated with the risk of developing type 2 diabetes. The contribution of sugar intake to the pathogenesis of type 2 diabetes has not been settled in the context of primary prevention because of limited prospective data.
  
  
  METHODS
  The Women's Health Study is a randomized controlled trial of aspirin and vitamin E in the prevention of cardiovascular disease and cancer. A validated semiquantitative food frequency questionnaire was completed by 39,345 women aged 45 years and older. The main outcome was the incidence of type 2 diabetes. The predictor was sugar intake, including sucrose, glucose, fructose, and lactose. Using Cox proportional hazard models, multivariate RRs of type 2 diabetes for increasing quintiles of sugar intake compared with the lowest quintile were estimated.
  
  
  RESULTS
  Compared with the lowest quintile of sugar intake, the RRs and 95% CIs for the highest quintiles were 0.84 (0.67-1.04) for sucrose, 0.96 (0.78-1.19) for fructose, 1.04 (0.85-1.28) for glucose, and 0.99 (0.80-1.22) for lactose, after adjustment for known risk factors for type 2 diabetes. Similar findings of no association were obtained in subgroup analyses stratified by BMI.
  
  
  CONCLUSIONS
  Intake of sugars does not appear to play a deleterious role in primary prevention of type 2 diabetes. These prospective data support the recent American Diabetes Association's guideline that a moderate amount of sugar can be incorporated in a healthy diet.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sok-Ja
authors.initials: SJ
authors.lastname: Janket
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Howard
authors.initials: H
authors.lastname: Sesso
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Simin
authors.initials: S
authors.lastname: Liu
mesh_terms: D000428:Alcohol Drinking; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004040:Dietary Carbohydrates; D019422:Dietary Sucrose; D004311:Double-Blind Method; D002149:Energy Intake; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D019422:Dietary Sucrose