The Diet Soda Delusion – The Epiphenomenon of Obesity V

Replacing a regular sugared drink with diet sodas seems like a good way to lose weight.  Diet drinks have zero calories and no sugar.  Since this will lower sugar intake, it seems like a good idea.  Both the American Diabetes Association and the American Heart Association in 2012 endorsed the use of diet drinks as a way of losing weight and improving health.  The evidence for benefit, though is surprisingly scarce.

If diet drinks substantially improved obesity of diabetes, then we would expect that as we increased use of diet drinks, obesity and diabetes would either stabilize or decrease.

From 1960-2000 there has been a 400% increase in the use of diet drinks.  The second most popular drink in the world after Coca Cola is Diet Coke, after all.  However, the obesity and diabetes epidemic has continued unabated.  The only logical conclusion is that diet drinks don’t really help.

Actually, there is substantial evidence that diet drinks may be quite harmful.  Dr. Fowler in “Fueling the Obesity Epidemic?” studied 5,158 adults in the San Antonio Heart Study.  The risk of becoming overweight in the 7-8 years of follow up was increased by 47% by the use of artificially sweetened drinks.  As Dr. Fowler writes

These findings raise the question whether AS (artificial sweetener) use might be fueling—rather than fighting—our escalating obesity epidemic.

The implication is that non caloric sweeteners are not good, they’re bad.  Other studies have some similar findings.  In “Diet soda drink consumption is associated with an increased risk of vascular events“, Dr. Gardner found a 43% increase in risk of vascular events (strokes and heart attacks) in people drinking diet sodas.

Rather than reducing risk of cardiovascular disease, diet sodas may actually increase the risk.  But why?  Reducing sugar intake should be a laudable goal.  Since sweeteners contain no calories or sugar, this should be beneficial.  Sweeteners also do not seem to raise insulin levels.

Let me put it this way.  Reducing dietary sugars is certainly good.  But it doesn’t mean that replacing sugar with completely artificial, manmade chemicals of dubious safety is a good idea.  I mean, pesticides and herbicides are also considered safe for human consumption.  That doesn’t mean we should be going out of our way to eat more of them.  (Anti-organic foods?  Extra pesticides for worm free apples!)

There are simply too many things that can go wrong with the ingestion of chemicals such as aspartame, sucralose, or acesulfam-K.  These are not foods.  There is nothing food like about them.  They are synthesized in a chemical vat and sold to you because they happen to be sweet and not kill you in the amounts used in foods.  Glue won’t kill you either.  That doesn’t mean we should be eating it.

Imagine if they advertised “Glue – tastes good and it won’t kill you, so you should eat more!” (at least one kid in every classroom seems to love the glue stick a little too much)

Imagine if they advertised “Aspartame – tastes good and it won’t kill you, so you should eat more!”

The bottom line is that these chemicals do not help weight loss.  They may actually cause weight gain.  These artificial chemicals may cause cravings that may induce over-eating of sweet foods.  By continually eating sweet foods, even if they have no calories, may lead us to crave other sweet foods that may contain sugar or starches.

The strongest proof of the failure of artificial sweeteners comes from 2 recently completed randomized trials.  In “A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight” 224 overweight adolescents were divided by random into two groups.  One group was given a year’s worth of water and diet drinks to consume.

At the end of 2 years, it is clear that the diet soda (experimental) group was consuming less sugar than the regular (control) group.  That’s good.  However, if you look at the weight gain, there is no significant difference between the two groups.

In the very same issue of the New England Journal of Medicine, there was another trial reported “A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children“.

A group of 641 normal weight children were randomly assigned to continue drinking as previously, or switched to diet sodas.

In this case, there was a statistically significant difference between the 2 groups.  However, the difference in weight gain is not as dramatic as many hoped.  The diet soda group weighed about 1 kg (2.2 lbs) less at the end of 18 months.

So, yes, drinking diet soda will reduce sugar intake.  But no, it will not help reduce your weight very much.  This, of course, you already knew.  Consider all the people you see drinking diet sodas.  Do you know anybody at all who has said that drinking diet soda made them lose a lot of weight?

Undoubtedly, their sugar intake was reduced.  But their weight was not.  This is true for everybody.  This is common sense, which doesn’t seem so common in academic medicine or nutrition.  Weight aside, it is also possible that drinking diet soda may be associated with health problems.

At the March 2014 American College of Cardiology meeting, data was presented that showed an association between drinking diet soda and heart disease.  Following 59,614 women over 8.7 years in the Women’s Health Initiative Observational Study, there was a 30% increase risk of cardiovascular events (heart attacks and strokes) in those drinking 2 or more diet drinks daily.

This certainly does not prove that diet drinks cause heart disease.  This is an observational study and cannot be used to show causation.  You cannot prove that diet sodas are bad for you.  However, it is very strong evidence against the presumption that diet drinks are good for you.  So why would the ADA and AHA endorse something that is certainly not good for you?  I have a guess – it starts with M and rhymes with honey.  Also known as filthy lucre.

A large problem with most nutritional research is that there are often conflicting reports.  One study will show a benefit and another study will show the exact opposite.  Why is this?  Generally, the deciding factor is who has paid for the study.

Consider the case of sugar-sweetened beverages (SSB).  In this study, researchers looked at 17 different reviews of SSBs and weight gain.  83.3% of studies that were sponsored by food companies did not show a relationship between SSBs and weight gain.  But in studies that were independent, 83.3% of studies showed the exact opposite – a strong relationship between SSBs and weight gain.

Because research can be used to support whatever viewpoint you have, it is often important to look further into the funding for the study.  The final arbiter, though, is common sense.  Diet drinks do not make you lose weight.  That is common sense.  Believe it.

Am I saying that consuming entirely artificial chemicals of unknown toxicity into our bodies because they happen to be sweet is a really, really bad idea?  This question kind of answers itself…..

Continue to Hormonal Obesity Part XV here

Begin here with Calories I

See the entire lecture here – The Aetiology of Obesity 2/6 – The New Science of Diabesity

2018-05-26T12:16:39-04:0018 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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Heather
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Heather

What about stevia?

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[…] Dessert is not to be taken every day. But if your goal is weight loss, the first major step is to severely restrict sugar. Replacing sugar with artificial sweeteners is not a good idea either. Since sweeteners also raise insulin as much as sugar, they are equally prone to cause obesity. Sweeteners give the false promise of sweetness without consequence.  We reviewed artificial sweeteners in a previous post. […]

Robert
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Robert

First of all, Id like to say that since discovering this blog a few weeks ago, my entirely family has been reading all its entries and weve become a big fan of Dr. Fung. Now, with regards to this post, Id like to say that based on all the literature ive read on this, it seems that not everyone has the same reaction to artificial sweeteners. Some are very sensitive, and they may actually experience an insulin spike; there are others, on the contrary, who are not sensitive and experience no insulin response. If I were to bet money on… Read more »

hilda
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hilda

I also wonder about stevia. Does it have the same effect as synthetic sweeteners ?

anelli da donna
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Nel compilare la nostra lista di masserizie più costosi, ab orologio bulgari bulgari biamo cercato gli elementi c anelli da donna he sono comuni alla maggior parte delle case americane ognuno di noi ha un letto, e ci auguriamo che il proprietario di un aspirapolvere. Poi abbiamo cercato le versioni più caro, che sanno di spesa stile Dennis orologi bulgari K

Sally Shield
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Sally Shield

I too am interested if Stevia, which is derived from a plant, has the same effect on insulin levels and instantly puts an end to ketosis, like sugar and other sweetners?

Vero
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Vero

Stevia is Derived from a plant but manipulated to such an extent that it has no advantage over any other artificial sweetener. Plus the fact that it tastes awful…

Danielle
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Danielle

Who drinks diet soda? Overweight people. Unsurprising then that diet soda is associated with coronary events. Correlation is not necessarily causality, as you say yourself in many places Dr Fung. It is also obvious that drinking diet soda will not help you lose weight. Why would it? Appetite controls the amount of food you eat. If you eat a sugary soda you will spontaneously reduce the amount of calories you eat if you appetite is working properly. They showed this on a BBC documentary in 2015. What I am curious about is does stevia really impact insulin levels? Like, really?… Read more »

Danielle
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Danielle

Quote:”Sweeteners also do not seem to raise insulin levels.” Why is the word seem in your sentence Dr Fung? What is the evidence? I get your objection to chemicals, but since stevia is natural and traditional (esp if you get the green powered whole leaf instead of the white extract) I am seeing it as a good thing if it does not raise insulin. It has to be better than eating a load of carbs, right? People are getting ill because they don’t have a longer fasting period to clear their glycogen out and lower insulin, not because they drink… Read more »

Jacqui Thornton
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Jacqui Thornton

I too would like to receive an answer to this question. I fully understand the theory that if you have obesity and diabetes then fasting has to be a better answer than bariatric surgery. What I find hard to resolve is the emotional attachment people have to food. Fasting is not easy when someone considers sweet food one of their only joys in life. If Stevia or Erythritol which was also mentioned on another site, could be used then those with emotional attachments might just have a higher chance of success. I think it is worth seriously looking into and… Read more »

Claudia
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Claudia

see study: Effects of stevioside on glucose transport activity in insulin-sensitive and insulin-resistant rat skeletal muscle☆ at https://www.metabolismjournal.com/article/S0026-0495(03)00388-3/abstract also the healthy advocate.com “So…stevia, which is a natural substance, may raise insulin levels (but not blood sugar levels). There are conflicting views on whether this is good or bad. Remember that constantly raising insulin can make the cells less receptive, meaning that when you actually eat carbohydrates, and those carbohydrates are broken down into sugar monomers (we’re concerned with glucose at the moment), the cells won’t be able to utilize them well. One study shows that stevia can enhance insulin sensitivity,… Read more »

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[…] still hot.  What I don’t finish while hot becomes iced coffee.  I have become accustomed to no sweetener.  This is consumed over several […]

Ron Colquitt, RN
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Ron Colquitt, RN

My question is: do artificial sweeteners cause you to leave the fasting state? In other words, do you lose the hormonal benefit that you’ve described while fasting? As a nurse, this question has come up in my head when I’ve shared your wealth of information, and I want to be correct in my sharing. They almost always ask with the assumption 0 calories=same as water, and I can’t see the fault in its logic either.

Connie Cason
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Connie Cason

I agree that artificial sweetener is bad for us overall. But I once drank regular sodas everyday and then switched to diet sodas. That is the only change I made in my diet. After 6 months, I lost 20 lbs. Just saying.

Bill Conley
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Bill Conley

Almost all of what Dr. Fung (and others supporting IF/Keto) preach is totally supported by science (which I love). But in the area of diet sodas for some reason, they seem to have an almost universal negative bias that is based on little real science. Aspartame (with which 90% of diet sodas are sweetened) is probably the most studied food additive in history (most funded by non-industry sources) and no ill effects have been noted. Also, Aspartame has been shown to not affect insulin levels at all (not true of all artificial sweeteners however). All the studies noted in the… Read more »

Casey
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Casey

Great explanation!! Thank you

Luis Villanueva
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Luis Villanueva

I just got my blood work results today and my sugar was through the roof funny thing is I dont eat anything with sugar. The one thing I do is drink diet coke like crazy. At least a 2 liter a day. I will be ending my love affair with the silver and red effective immediately.

jenn
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jenn

Luis, your sugar is also through the roof because of INSULIN Resistrance. Read more up on this topic on this website.