Diabetes Risk: Caffeine or No Caffeine?

Alvin B. Lin, MD, FAAFP
 
Dr. Lin is an associate professor of family and community medicine at University of Nevada School of Medicine and an adjunct professor of family medicine and geriatrics at Touro University Nevada College of Medicine. He also serves as an advisory medical director for Infinity Hospice Care and as medical director of Lions HealthFirst Foundation. Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at http://alvinblin.blogspot.com/.

I've spent the last 3 days reviewing studies of non-pharmacologic options based upon human outcomes, so I thought I'd write about the effect of beverage choices on diabetes risk. Given that the risk (prevalence) of diabetes continues to increase, it seems appropriate to consider what we can easily do to minimize risk, since no one seems to be interested in healthy eating & regular physical activity, but rather in quick fixes such as pills & dietary supplements.

It turns out that an observational study was published early online 3 weeks ago in the American Journal of Clinical Nutrition in which the authors concluded that sugar-sweetened beverages were associated with higher risk of diabetes while coffee, regardless of caffeine content, was associated w/lower risk of diabetes. To arrive at their conclusions, the authors followed 74,749 women from the Nurses' Healthy Study and 39,059 men from the Professionals Follow-Up Study for over two decades. Beverage consumption was divided into caffeine vs caffeine-free as well as sub-groupings of sugar-sweetened vs artificially sweetened beverages, basically a 2x2 analysis performed separately for both men & women.

When all was said and done, the only anomalous finding that stood out was the consumption of caffeine-free artificially sweetened beverages being associated with higher risk of diabetes in women. Bottom line: caffeine vs caffeine-free isn't as important a distinction as sugar-sweetened vs artificially sweetened beverages when it comes to diabetes risk in both men and women. But remember that this was an observational study and as such, is only good for developing hypotheses, as it cannot prove cause and effect. Regardless, I think it prudent to err on the side of caution and consider switching to coffee (not Starbucks' frappuccinos). And in case you've forgotten, don't forget that coffee consumption has also been linked to lower risk of heart failure, prostate cancer, and basal cell skin cancer!