November 14 marks World Diabetes Day, an occasion to raise awareness of a disease that the World Health Organization forecasts will be the seventh leading cause of death by 2030. The American Diabetes Association says: “Research has shown that drinking sugary drinks is linked to Type 2 diabetes,” underscoring the importance of drinking habits in addition to diet in treating and preventing the disease.
Yet, as shown in the “Attitudes to Water” online survey (pdf, 4Mb), published by Nestlé Waters and Kantar TNS in September 2017, sugary drinks are very popular, and their effect on health isn’t necessarily widely understood. The cross-country analysis sought to sample attitudes and behaviors around drinking water versus sugary drinks in six countries. It interviewed 3,024 subjects in the United States, Mexico, the United Kingdom, France, Italy and Turkey, or around 500 people per country, aged 18 or over.
Around the world, drinking water is a daily reflex, with an average of 92 percent of respondents drinking it every day. The survey showed that for nearly seven out of 10 respondents, choosing water over other drinks is essential to maintaining health. In Italy and France, results showed, choosing water is as important as eating a balanced diet.
Nonetheless, sugary drinks remain popular. The online survey reported that, on average, a full 68 percent of respondents consumed sugary drinks every day. Some 27 percent of respondents reported drinking at least one liter of sugary drinks daily. This consumption was highest in Mexico (33 percent) and Turkey (42 percent), results that could be partially explained by lack of access to drinkable tap water, according to the study.
The case for water is, however, clear. Florence Constant, Nutrition Development Director at Nestlé Waters, citing a prospective study (*) “Plain-water intake, per se, was not significantly associated with risk of Type 2 Diabetes and substitution of plain water for Sugar Sweetened Beverages (SSBs) or fruit juices was estimated to be associated with lower risk of Type 2 Diabetes. Water consumption should be proposed as an alternative.”
Knowledge vs. Behaviors
Is knowing the same as taking action? When it comes to healthy hydration, the “Attitudes Toward Water” survey revealed a definite gap between knowledge and behavior. While 81 percent of respondents said sugary drinks are not the same for the body as water, a majority of respondents nonetheless reported drinking sugary drinks every day. The proportion ranged from 60 percent in France and the United Kingdom to as high as 80 percent in Mexico and Turkey. Surprisingly, respondents in these two countries, who showed the highest incidence of drinking sugary drinks daily, were also most likely to agree with the statement: “Drinking sugary drinks every day can lead to weight problems/diabetes.”
Clearly more needs to be done to raise awareness of the effect of healthy hydration on individual health, particularly in regard to Type 2 diabetes, which has been linked to obesity. The survey found that, on average, 61 percent of respondents thought that one or two cans of sugary drinks per day increase the risk of developing diabetes. In Turkey, the average was less than half. Overall, only 59 percent of daily consumers of sugary drinks were aware of their personal risk of developing diabetes.
Raising public awareness
“Recommendations are usually done for a balanced diet and regular exercise but not on hydration per se. As part of a healthy lifestyle, it is key to eat well, move and drink well. There are dietary guidelines in many countries, in which water intake should be included” says Florence Constant.
She adds: “Regularly drinking sugar-sweetened beverages throughout the day is not suitable for daily hydration purposes, as they contain ingredients other than water – such as sugar, for example – which may impact health when overconsumed. As water does not contain any calories, plain water should be the first choice when it comes to daily hydration.”
With worldwide obesity rates having doubled since 1980, according to the World Health Organization, the need to encourage the drinking of water and reduce consumption of sugar-sweetened beverages is greater than ever. According to Florence, it’s important to encourage drinking water as a daily routine or ritual.
“It means not only to educate people, but to help give them the taste for water” Of course, in parallel the awareness of a proper hydration has to be raised for healthcare professionals and policy makers.
(*) Prospective study done on a cohort of 82,902 young and middle-aged women in the US to estimate potential benefits of the replacement of Sugar Sweetened Beverages (SSBs) or fruit juices with plain water on Type 2 Diabetes.
Coming in December: Healthy Hydration Day in Italy and Mexico