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.