Health & Fitness
rom soft drinks to white bread, almost
everything on the menu seems to
contain sugar. Although "diet " drinks
have been promoted as a healthful
alternative to sugar- sweetened beverages ,
researchers now argue this is not the case .
There are currently numerous campaigns trying
to raise awareness of the negative health effects
of sugar, particularly on weight gain and obesity .
Sugar is highly pervasive in our diet.
Approximately 75 percent of processed foods
and drinks contain added sugar.
Additionally, the consumption of sugar-
sweetened beverages (SSBs) has increased
fivefold since the 1950s.
Numerous studies have pointed to a link between
SSBs and cardiovascular disease, metabolic
syndrome, and diabetes .
The alternative to SSBs promoted by soft drink
companies is the sugar-free, "diet" drink. These
artificially sweetened beverages (ASBs) are said
to be healthful and prevent weight gain.
But researchers from Imperial College London in
the United Kingdom argue otherwise.
Full- sugar versus ' diet ' drinks
A new commentary on existing ASB research and
policy - published in the journal PLOS Medicine -
argues that ASBs are just as ineffective in
preventing weight loss as their full-sugar
counterparts.
The commentary is a collaborative effort
between Imperial College London, University of
Sao Paulo and the Federal University of Pelotas -
both in Brazil - and Washington University in St.
Louis, MO.
According to the authors, in the U.K., SSBs make
up a third of the total sugar intake among
teenagers. In Brazil, they are the second largest
source of dietary sugar, and in the United States,
SSBs account for almost half of the added sugar
in Americans' diet.
The researchers - led by Prof. Christopher Millett
- argue that although SSBs are very high in
calories , they contain almost no essential
nutrients. Additionally, "convincing
epidemiological evidence" has suggested that
consuming SSBs increases the risk of being
overweight or obese, as well as developing
diabetes.
ASBs are becoming more and more popular as an
alternative to harmful sugary drinks. By 2008, the
number of American children consuming ASBs
had doubled, compared with 1999.
Soft drinks, fruit juices, flavored water, and
ready-to-drink coffee and tea are all artificially
sweetened. Because they taste similar to their
full-sugar counterparts and have none of their
energy content, ASBs are perceived as healthful,
as it is believed they do not trigger any energy
compensation mechanisms.
Additionally, "taxes and regulation on SBS and
not ASBs will ultimately promote the
consumption of diet drinks rather than plain
water - the desirable source of hydration for
everyone," mentions Prof. Carlos Monteiro, one
of the authors of the review.
Diet drinks a ' potential risk factor for
chronic diseases '
However, researchers explain why the common
perception of diet drinks might be wrong.
ASBs can still cause a compensatory mechanism
by stimulating sweet taste receptors. This can, in
turn, increase appetite and stimulate the
secretion of gut hormones. Knowing that ASBs
are low in calories might amplify these effects
and lead to excessive consumption of other
foods.
This chain reaction could lead to weight gain,
obesity, and obesity-related complications.
In fact, Millett and team point out that several
observational studies and meta-analyses have
correlated ASBs with increased body mass index
( BMI) and a higher risk of cardiometabolic
diseases, such as type 2 diabetes and stroke.
However, observational studies are vulnerable to
so-called reverse causality - for example, people
with obesity might tend to consume more ASBs
because they are trying to control their weight,
rather than the ASBs causing the weight gain
themselves.
Even so, randomized controlled trials of ASBs
have shown either no effect at all on weight loss,
or only minor reductions in weight.
The authors warn against the dangers of biased
research and conflicting interests. They refer to
a systematic review that has shown studies
sponsored by beverage companies tend to report
positive effects of ASB on weight management.
"The lack of solid evidence on the health effects
of ASBs and the potential influence of bias from
industry-funded studies should be taken seriously
when discussing whether ASBs are adequate
alternatives to SSBs," says Dr. Maria Carolina
Borges, first author of the new review.
However, researchers explain why the common
perception of diet drinks might be wrong.
ASBs can still cause a compensatory mechanism
by stimulating sweet taste receptors. This can, in
turn, increase appetite and stimulate the
secretion of gut hormones. Knowing that ASBs
are low in calories might amplify these effects
and lead to excessive consumption of other
foods.
This chain reaction could lead to weight gain,
obesity, and obesity-related complications.
In fact, Millett and team point out that several
observational studies and meta-analyses have
correlated ASBs with increased body mass index
( BMI) and a higher risk of cardiometabolic
diseases, such as type 2 diabetes and stroke.
However, observational studies are vulnerable to
so-called reverse causality - for example, people
with obesity might tend to consume more ASBs
because they are trying to control their weight,
rather than the ASBs causing the weight gain
themselves.
Even so, randomized controlled trials of ASBs
have shown either no effect at all on weight loss,
or only minor reductions in weight.
The authors warn against the dangers of biased
research and conflicting interests. They refer to
a systematic review that has shown studies
sponsored by beverage companies tend to report
positive effects of ASB on weight management.
"The lack of solid evidence on the health effects
of ASBs and the potential influence of bias from
industry-funded studies should be taken seriously
when discussing whether ASBs are adequate
alternatives to SSBs," says Dr. Maria Carolina
Borges, first author of the new review.
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