Truth on Tuesday

Are Diet Sodas worse than regular Sodas?


I always find this topic interesting.  On the one hand, we have a beverage that contains more sugar than a donut and has single-handedly been recognized as a huge contributor to the obesity epidemic in America (1).  Then, we have our "diet friendly" zero calorie beverage packed full of God knows what.  Recent in the headlines, more and more stories of diet soda consumption is linked to a variety of health issues including stroke, cancer, and even, oddly enough, obesity.  So, which is worse? Our super sugary friend or his ever-appealing, low calorie diet cousin?


If you want to talk about immediate health effects (or which one will kill you first), my money goes on regular soda. Much of this has to do with the amount of sugar and excess calories sodas provide in the typical American diet.   Here's where I lay case:

• According to the USDA, 16% of calories in the typical American’s diet come from refined sugars and half of those calories come from beverages with added sugar
• Soft drink consumption has tripled in the United States in recent decades. This trend parallels the dramatic increases in obesity (2).
• 1 can of soda per day could lead to a weight gain of 15 pounds 1 year (1)
• For each additional daily serving of sugar-sweetened soft drink consumed the risk of obesity increases 1.6 times (3)

Other health risks of regular soda consumption include increased dental caries (cavities), kidney issues, osteoporosis and various metabolic diseases including diabetes, heart disease, and hypertension. 

But hold the phone on diet drinks....

While some studies have linked consumption of diet sodas to both metabolic syndrome and type 2 diabetes (4,5) it is likely that there are various confounding factors that play into this and that diet drink consumption is not, in fact, the cause for these health conditions (6). 

Most studies conclude that consumption of artificially sweetened beverages, such as diet sodas, is unlikely to promote weight gain or metabolic dysfunction--however, some evidence suggests that the intense sweetness of artificial sweeteners, which can be between 160-13,00 times sweeter than sucrose (7), maybe condition the palate toward a greater preference towards sweets and thus may enhance appetite (8). Also, consumers of diet soda may use the zero calorie beverage as rationale for consuming other higher-calorie foods leading to weight gain (9).

It is important to point out that while diet soft drinks appear to be a safe bet to control weight gain, we are unsure of the long term health effects of diet drinks. In addition to the unknown effects of artificial sweeteners, there have been reported concerns about he phosphoric acid in diet sodas and their effect of Iron absorption in women (10). Phosphoric Acid is added to carbonated beverages to keep the pH low, help them stay bubbly, and hold caffeine in the beverage. However, excess intake can set you up for deficiencies in various minerals such as  calcium iron and Magnesium (11). Research has liked diet cola consumption to osteoporosis based on the notion that phosphoric acid interferes with calcium absorption and contributes to imbalances that lead to additional loss of calcium (12).  Other health concerns include decrease kidney function, as a recent review found that consumption of  more than 2 servings per day of artificially sweetened soda is associated with a 2-fold increased odds for kidney function decline in women (13).


The Bottom Line:
STOP DRINKING SO MUCH SODA. Period. Whether it's diet or regular, it's not doing anything good for you.  If you're having a coke at lunch you're adding in excess non-nutritive calories. 150 calories per can- so how many extra calories do you think are in that 32 oz? Well, I'll tell you: 382. That a meal of pure sugar. If you're choosing diet sodas I would just caution you to be aware of the things mentioned above and if you're drinking more than 1 (12 oz. can) a day, it's probably time to cut back. 

PS- this ad is a joke.

1) Malik, V. & Hu, F. (2012). Sweetners and risk of obesity and type 2 diabetes: the role of sugar-sweetened beverages.  Current Diabetes Report.


2) Wolff, E. & Dansiger, M. (2008). Soft drinks and weight gain: how strong is the link? Medscape Journal of Medicine, 10(8), 189.


3) Squires, S. The Amazing Statistics and Dangers of Soda Pop. http://articles.mercola.com/sites/articles/archive/2001/03/10/soda-pop-dangers.aspx


4) Dhingra R, Sullivan L, Jacques PF, et al. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. 2007;116(5):480- 488.
 
5) Nettleton JA, Lutsey PL, Wang Y, et al. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi- Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2009;32 (4):688-694.


6) de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB. Sugarsweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr. 2011;93(6):1321-1327.


7) Brown RJ, de Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes. 2010;5(4):305-312.


8 Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16 (8):1894-1900.


 9) Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putativemechanisms. Am J Clin Nutr. 2009;89(1):1-14.

10) Pynaert, I., Delanghe, J., Temmerman, M., & De Henauw, S., (2007). Iron intake in relation to iron status of young adult women. A

Ann Nutr Metab. 2007;51(2):172-81. Epub 2007 May 29.

11) Johnson, S. (2001). The multifacted and widespread pathology of magnesium deficiency. Medical Hypothesis, 56(2), 163-170.

Med Hypotheses. 2001 Feb;56(2):163-70.

12) Tucker, K., Morita, K., Qiao, N., Hannan, M., Cupples, A., & Kiel, D. (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham osteoporosis study. American Journal of Clinical Nutrition, 84(4), 936-942.

13) Lin, J. & Curhan, G. (2011). Associations of sugar and artifically sweetneded soda with albuminuria and kidney function decline in women. Clinical Journal of American Society of Nephrology, ^, 160-166.