Beverage consumption modifies the risk of type 2 diabetes associated with ambient air pollution exposure

Evidence on how beverage consumption modifies associations between air pollution (AP) exposure with the type 2 diabetes (T2D) risk remains scarce, which we aimed to investigate in this study.

A total of 77,278 adults from the UK Biobank cohort were enrolled. Annual average concentrations of fine particulate matter (PM_2.5 and PM₁₀) and nitrogen oxides (NO₂ and NO_X) were estimated to represent the long-term AP exposure using the land use regression model. The consumption of beverages (alcoholic beverages, juice, sugar-sweetened beverages [SSB], coffee, and tea) was estimated with the 24-hour dietary assessment. The AP-T2D and beverage-T2D risks were assessed using Cox regression models. Modifying effects of beverage consumption on AP-T2D associations were evaluated through stratified analysis and heterogeneity test.

During a median follow-up of 12.19 years, 1486 T2D events were recorded. One interquartile range increase of PM_2.5, NO₂, and NO_X raised the T2D risk with the hazard ratios (HR) and 95 % confidence intervals (95 % CI) being 1.09 (1.03, 1.16), 1.14 (1.06, 1.21), and 1.09 (1.04, 1.15), respectively. For beverages, compared with non-consumption, daily consumption (>0 cup) of red wine, > 0-3 cups of white wine, ground coffee, and herbal tea, and > 0-1 cup of spirits were associated with a 13 %-37 % reduced T2D risk, while > 0 cup of SSB were associated with a 21 %-122 % elevated T2D risk. Beverage consumption modified AP-T2D associations, as compared with non-consumption, > 0-3 cups of red wine, white wine, ground coffee, and herbal tea had a lower attenuated T2D risk associated with NO₂ and/or NO_X. Conversely, those with > 1 cup of SSB had a higher T2D risk associated with both NO₂ and NO_X (P_heter <0.05).

This study highlights the significant role of beverage consumption in mitigating or exacerbating the T2D risk associated with long-term NO₂ and NO_X exposure.