Those who want sweet treatment would be best to give up refreshments in favor of naturally occurring sugars to reduce the risk of developing diabetes.
Following a review of more than 150 studies, a Canadian team concluded that sweetened beverages are at greater risk of type 2 diabetes than most foods containing fructose.
The findings, published on Thursday BMJ, Suggests that fruits and other foods containing fructose seem to have no detrimental effect on blood glucose levels, while sweetened drinks and other foods that add excessive amounts of "poor nutrients" to diets can have harmful effects.
While the lead author of the study, Dr. John Sievenpiper of St. Michael's Hospital in Toronto said high-quality studies are still needed, he was hopeful that the evidence would help with public health strategies to reduce consumption sweetened beverages.
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These findings may help guide recommendations on important food sources of fructose in preventing and managing diabetes, he said.
The role of sugars in the development of diabetes and heart disease has often attracted widespread debate, with increasing evidence suggesting that fructose could be particularly harmful to health.
Fructose naturally occurs in a wide range of foods including whole fruit and vegetables, natural fruit juices and honey. Foods such as soft drinks, breakfast cereals, confectionery, sweets and desserts are also added as "free sugars".
Diet guidelines recommend reducing the content of free sugars, especially fructose in sweetened drinks, but it is unclear whether this applies to all food sources of these sugars.
This was that uncertainty that caused Sievenpiper and his team to analyze the results of 155 studies that evaluated the effect of various food sources of fructose sugars on blood glucose levels in people with and without diabetes monitored for up to 12 weeks.
The results were based on four study models: replacement (comparison of sugars with other carbohydrates), addition (energy from added sugars to the diet), decrease (energy from sugar removed from the diet) or ad libitum.
The results showed that most foods containing fructose sugars had no harmful effect on blood glucose levels when food did not provide excess calories. However, a deleterious effect was observed in long-term insulin in some studies.
In addition, their analysis of specific foods has suggested that fruit and fruit juices might have beneficial effects on glycemic control and insulin control, especially in people with diabetes.
The research team said that the low glycemic index (GI) of fructose compared to other carbohydrates and a higher fiber content in fruits could explain improvements in blood sugar levels by slowing down the release of sugars.