The Beverage Quality Index and type 2 diabetes risk in women: a prospective analysis of the Mexican Teachers' Cohort.

Abstract

Background: Individual beverages have shown divergent associations with type 2 diabetes. Whether overall beverage quality affects diabetes risk is unknown. Therefore, we estimated the association of a previously developed Beverage Quality Index (BQI) with the incidence of diabetes in Mexican women.

Methods: We included 77,484 female participants from the Mexican Teachers' Cohort without diabetes at baseline (2006-2008). At baseline, diet was assessed using a 140-item food-frequency questionnaire. The BQI included seven components (coffee, milk, juices, sugar-sweetened beverages [SSBs], alcohol, sugar added to beverages, and energy from beverages), with a total theoretical score ranging from 0 to 70. A higher score represents a healthier beverage intake pattern. Data on diabetes incidence were available through 2018 from self-reports or cross-linkage with administrative data. We used multivariable Cox proportional-hazard models adjusted for potential confounders.

Results: Participants' mean (SD) baseline age was 45.9 (7.2) years, and BQI score was 37.3 (8.6), ranging from 9.8 to 69.3. During a median follow-up of 7.6 years, 4521 participants developed diabetes. After multivariable adjustment, when comparing extreme categories (≥55 vs. <25), a higher BQI was suggestively associated with lower diabetes incidence (HR: 0.87; 95% CI: 0.71, 1.06), although the estimate was imprecise. Restricted cubic spline analysis showed no association between the BQI and diabetes incidence (p-nonlinearity = 0.20).

Conclusions: In a cohort of Mexican women, the BQI for overall beverage quality showed no consistent association with diabetes incidence. Further research on beverage quality indices for Mexican populations, including those with high SSB intake, is warranted.