Soda – 3 Questions about a Summertime Favorite

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Last year, Joslin Diabetes Center participated in the Soda-Free Summer Campaign sponsored by the Boston Health Department.

We received la lot of questions about soda (aka, pop, tonic, etc.) during the course of the campaign. Here are three of that we were asked a number of times.

If you have a question, let us know in the comment section to this blog; we’ll try to answer it.

I am trying hard to give up soda. I am 42 and drink about 4 cans a day. At the beginning of the summer I decided to switch from regular soda to a form that has 0 calories and states 0 sugar. Is this really any better?

Choosing diet soda over regular soda is considered prudent in terms of reducing the amount of sugar and calories you consume.

There is a growing body of research indicating that we are not as sensitive to detecting calories that come in liquid form.  When we ingest liquid calories instead of solid food, the brain does not signal the appetite center as readily to tell us we are full and we continue to eat, which can lead to weight gain.

There is some evidence that this effect is enhanced when high fructose corn syrup (HFCS) is used as a sweetener.  HFCS is ubiquitous in sodas and other sugar-sweetened beverages and its presence in the diet has skyrocketed in recent years.

In addition, excess sugar has been definitively linked to dental caries and there is incipient research that HFCS may have a role in the development of cardiovascular disease and diabetes through its role in promoting weight gain and possibly by raising the level of uric acid in the body.

Diet soda provides no nutrients and contains artificial sweeteners, which while not considered harmful, provide no benefits to the body.  Increasing your intake of water or liquids such as milk, which provides protein and micronutrients, such as calcium, are better beverages choices.    There has been some preliminary studies looking at a role for diet soda in the genesis of obesity but this is simply a theory at present.

Why is soda directly linked to type 2 diabetes?

It isn’t.  At present there is no definitive research that indicates that there is a causal relationship between drinking regular or diet soda and the risk of developing diabetes.

There are epidemiological studies that demonstrate that people who drink more soda tend to gain more weight and obesity is a proven risk factor for diabetes.  For example, a study by Dimeglio and Mattes found that participants who drank 450 additional calories as a sweetened soda gained appreciably more weight than those participants who consumed 450 calories as jelly beans

In another study, the PREMIER trial, a weight loss of .49 kg (approximately 1 pound) was achieved by decreasing consumption of sugar-sweetened beverages by one serving a day.

In addition to the evidence that liquid calories are not as strong appetite suppressors as solid calories, there is research indicating that fructose itself doesn’t dampen hunger urges as well as glucose because, unlike glucose, fructose is not readily transported into the brain.

Furthermore, scientists are looking at the link between uric acid and metabolic syndrome (symptoms of which include high blood pressure, obesity, lipid abnormalities and glucose elevations,) often a precursor to diabetes. Fructose is digested and adsorbed through a different metabolic pathway than glucose and causes a rise in uric acid levels.  It also has the ability to promote the storage of calories as triglyceride (a type of fat) which in excess promotes obesity.

How much soda puts me at risk?

There are no definitive numbers but many of the epidemiological studies draw a distinction between daily and less than daily use.

The 2005 US Dietary Guidelines provide recommendations for discretionary calorie intake.  Based on these guidelines, The American Heart Association suggests most women limit their intake of added sugars to about 100 calories (approximately 25 grams) and men limit to about 150 calories (37.5 grams).

Americans exceed this amount at all calorie levels.  That’s about six teaspoons of added sugar a day for women and nine for men.   A regular soda has about 150 calories and approximately nine teaspoons of sugar.   Although there are no established guidelines for diet beverages, moderation in this area also seems reasonable.

11 Responses to Soda – 3 Questions about a Summertime Favorite

  1. Lori Bonfiglio says:

    But drinking aspartame actually enhances one’s desire for sweet and or fattening food, and the ramifications of ingesting aspartame on a daily basis are horrendous!! Better to not drink ANY soda of any sort! Pure poison no matter how you look at it!!!!

    • Eric Cook says:

      “the ramifications of ingesting aspartame on a daily basis are horrendous!! ”
      Aspartame has been found to be safe for human consumption by more than ninety countries worldwide with FDA officials describing aspartame as “one of the most thoroughly tested and studied food additives the agency has ever approved” and its safety as “clear cut”.

      • Mary Collins says:

        I agree that drinking chemicals is Not a good thing. The last 50 years of chemically-enhanced food/drink is an ongoing experiment w/us as the test subjects. No thanks – I’ll pass.

  2. Stone Muthe says:

    I was diagnosed with type 2 diabetes in October last year and was treated for the same and the sugar went back to normal the following month. In fact, the doctor concluded that I no longer need medicine as mine was probably a bout or may be the pancreas had swollen. However, though the sugar remains within range (about 5.2), sometimes I feel a burning sensation in the hands and also feel like I have some particles in my right eye. Is it likely to be diabetic related? Could diabetes have affected one side of the body (RHS) than the other? An amayse test done recorded 19 and the doctor concluded my pancreas was okay (not damaged).

    • joslin reply says:

      Dear Mr. Muthe:
      Diabetes can cause both eye and nerve damage but this is usually a consequence of long-term diabetes in poor control. You may want to discuss your syptoms with your health care provider.

  3. Mike tierney says:

    Why when I exercise fairly strenuously does my glucose reading spike so much

    • joslin reply says:

      Dear Mr.

      strenuous exercise can indeed increase blood glucose initially. This is because there is an imbalance between the amount of glucose in the blood stream and the amount of insulin. Vigorous exercise calls upon the liver to release more gluocose which drives the blood glucose up. However as exercise continues the muscle cells become much more senstitive to the effects of insulin and glucose is driven from the blood stream into the cells,lowering the blood sugar. The effects of exercise can last up to 24 to 48 hours.

    • P Smith says:

      A rise in blood sugar during or shortly after vigorous exercise can also mean that you are hitting a low during exercise and your body is releasing glucose to compensate for that low. You may want to try to eat something small and light, with some but not a lot of carbs to counteract this if it is occuring regularly. (Since I am sure your goal, like mine is to actually bring down your glucose from exercise rather than raise it!). If I am running into this problem, I usually have a celery or carrot stick, or half stick of string cheese about 10 mins before I exercise. Rest assured, if you keep up the vigorous exercise, it will eventually all work out as it will raise your metabolism and help lower your overall blood glucose. (At least that is my experience.) Hope this helps.

  4. Michelle says:

    Does caffeine in diet sodas raise blood sugar? And if it does, how does somebody figure out the insulin dosage to cover the spike in blood sugar that results?

  5. Jen says:

    Everyone is different in regards to caffeine I have found out. I need to cover for caffeine in coffee, especially in the morning, but not for the caffeine in diet soda. It is a your diabetes may vary sort of thing.

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