The Controversial Nature of Diet Soda
Is diet soda healthy or dangerous?
Despite having fewer calories, diet soda may be linked to numerous conditions that can worsen overall health. Diet soda replaces the sugar seen in the full-calorie beverage with an artificial sweetener like aspartame, saccharin, and sucralose. Diet soda began its marketing debut in the 1950s targeting people with diabetes and people trying to lose weight. Even though it is marketed to help people lose weight, diet soda’s health effects are debatable.
Weight gain and type 2 diabetes:
Despite being marketed to help people lose weight and reduce their risk of diabetes by being sugar-free or zero calories, studies suggest alternative outcomes to this. In one major study,
“At least daily consumption of diet soda was associated with a 36% greater relative risk of incident metabolic syndrome and a 67% greater relative risk of incident type 2 diabetes compared with nonconsumption”
Two more studies that were conducted as longitudinal cohorts demonstrated a positive link with the consumption of diet soda and metabolic syndrome regardless of baseline weight status. So if diet soda has few to no calories or sugar, why does it have an association with metabolic syndrome and type 2 diabetes? Well, it is speculated that this is the case for several reasons. Firstly, it is because they have few to no calories that it may cause cravings and changes in lifestyle habits which promote high-calorie foods. Another theory is that the sweet taste of the beverage triggers a dopamine and glutamate release in response resulting in an intense craving for sugary substances. In addition to the glutamate and dopamine, diet soda may also trigger the release of the hunger hormone ghrelin. Also, despite having no “real” sugar, artificial substances can negatively affect gut bacteria and damage your overall microbiome resulting in an unbalanced digestive system. In addition to this, these artificial sweeteners can trigger the same insulin response as normal sugar.
On the flip side, some debate that the weight gain and diabetes are due to the already poor dietary habits of the person and not related to their consumption of diet soda. In addition, two studies, featured in The American Journal of Clinical Nutrition, had findings that suggested diet soda could actually promote weight loss.
Cancer and diet soda
There have been many rumors flying around about diet soda, specifically the artificial sweetener aspartame, causing an increased risk for cancer. However, the studies which were conducted to test these rumors have been far from consistent. In summary, the evidence conducted thus far has not found a conclusive association between aspartame and cancer risk, according to the US Food and Drug Administration (FDA)and the American cancer society.
Other health concerns
Diet soda is not only linked to diabetes and metabolic syndrome, but it is also associated with an increased risk of chronic kidney disease (CKD). One theory suggests this is due to the high phosphorus load in diet soda, but it may also be due to other co-morbidities like hypertension and diabetes. In addition to CKD, diet soda was associated with a higher risk of all-cause dementia, ischemic stroke, and Alzheimer’s disease dementia. Another study associated both diet and regular cola beverages with a significantly lower bone mineral density in women. It is believed that this is due to lower calcium-to-phosphorus ratios. It is known that people with phenylketonuria (PKU), a rare genetic disorder, should avoid aspartame because it can result in seizures, brain damage, and intellectual disabilities.
Conclusion
The evidence so far has been stacked against diet soda having health benefits. While there is some conflicting evidence with some of the health concerns diet soda can cause, it may be beneficial to stay away from this beverage until more decisive data has been accumulated. Healthier alternatives that should be considered include water, sparkling water, unsweetened tea, and skim milk. Also, if you’re craving something sweet you could indulge in some sweeter fruits like mangoes and peaches.
Thank you for reading,
Shannon Muise, MCPHS University PharmD Candidate
