Drinking sugar-sweetened beverages increases the risks of cardiovascular disease and death in people with type 2 diabetes, but switching to coffee, tea, or low-fat milk might lower these risks.

That’s the finding of a new U.S. study where researchers examined data on almost 15,500 people with type 2 diabetes from two major studies. They found that those who drank the most sugary beverages had a 20% increased risk of death from any cause (“all-cause death”) and a 25% higher risk of cardiovascular disease than those who drank the least of these products.

The research, published in The BMJ on Wednesday, also showed that drinking coffee, tea, plain water, and low-fat milk reduced the risk of all-cause death and that switching from sugar-sweetened drinks to those beverages lowered mortality. “Overall, these results provide additional evidence that emphasizes the importance of beverage choices in maintaining overall health among adults with diabetes,” wrote senior author Le Ma PhD, of the Department of Nutrition at Harvard’s T.H. Chan School of Public Health in Boston, and colleagues.

Choice of Drink Matters; Having Diabetes Doesn’t Mean Restrictions

However, Nita Forouhi, MD, PhD, from the University of Cambridge School of Clinical Medicine in the United Kingdom warned that the findings “cannot be considered cause and effect” despite the large-scale analysis. Moreover, questions remain, such as the impact of beverage consumption on coronary heart disease risk, stroke risk, and cancer mortality, with the current study providing “inconclusive” data on the latter.

There was also no data on adding sugar to tea or coffee, “so the comparative health effects of unsweetened and sweetened hot beverages remain unclear,” Forouhi points out. Also unknown is whether the type of tea consumed has an effect. Despite these and other reservations, she says, “Choice of beverage matters.” “The case for avoiding sugar-sweetened beverages is compelling, supported by various fiscal measures in more than 45 countries. It is reasonable to shift the focus to drinks most likely to have positive health impacts: coffee, tea, plain water, and low-fat milk.”

Healthy Drinks for Those With Type 2 Diabetes

It was estimated in 2021 that there were 537 million adults worldwide who had type 2 diabetes, a figure set to increase to 783 million by 2045, say the paper’s authors. People with type 2 diabetes have an increased risk of cardiovascular disease, among many other health conditions, and an increased risk of premature death. Dietary changes can play an essential role in managing those risks.

Recommendations on the healthy drinks are largely based on evidence from the general population, and data are limited on the best options for adults with type 2 diabetes, who have altered metabolism, the researchers note.