Article Summary Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. JAMA. 2004;292:927-934. Objective: To determine the relationship between consumption of sugar-sweetened soft drinks, weight gain, and increased risk of type 2 diabetes in women. Methods: The Nurses’ Health Study II was initiated in 1989 as a prospective cohort study of 116,671 female nurses aged 24 to 44 years. Through 1999, participants received biennial questionnaires. Follow-up rate exceeded 90% for every 2-year period. For this analysis, the responses of 51,603 women were examined following exclusion criteria that included women with a history of diabetes, cancer other than nonmelanoma skin cancer, or cardiovascular disease at baseline. Responses to the biennial 133-item dietary questionnaire, including items on daily consumption of sugar-sweetened soft drinks, diet drinks, and fruit drinks, was assessed for years 1991, 1995, and 1999. Nondietary information included information on age, weight, smoking status, contraceptive and HRT use, as well as weekly energy expenditure. Mean weight changes defined by soft-drink consumption, age adjustment over the course of the study period, and other lifestyle or dietary alterations were evaluated. Body-mass index (BMI) and total caloric intake were adjusted using separate models. Results: Based on responses to the biennial questionnaires, women who consumed >1 sugar-sweetened soft drink and/or fruit-punch drink daily generally had a tendency to expend less energy, smoke more, consume more overall calories, and have a lower intake of protein. Total carbohydrate intake, including sucrose and fructose and overall glycemic index, were higher in this cohort. During the >716,000 person-years of follow-up, 741 new cases of type 2 diabetes were documented, with age-adjusted relative risk of 1.98 (95% CI 1.60–2.44) for women who consumed >1 sugar-sweetened soft drink/day compared with those who consumed <1/month. Increases in BMI accounted for approximately 50% of the excess risk. Conclusion: This study found a positive association between the regular consumption of sugar-sweetened soft drinks, larger weight gain, and an increase in risk for type 2 diabetes.