Is Diet Soda Bad For You?

Written by Dr. Steve Chaney on . Posted in Diet Soda and Health

Do Diet Sodas Increase Your Risk Of Stroke?

Author: Dr. Stephen Chaney

diet soda badIs diet soda bad for you?  With over two third of Americans overweight or obese, it is clear that we are in a midst of an obesity epidemic. Multiple studies have shown that over consumption of sugar-sweetened beverages (soft drinks, energy drinks, and “fruit” juices that aren’t made from real fruit) are major drivers of the obesity epidemic. Because of these trends, many experts recommend substituting artificially sweetened beverages for sugar-sweetened beverages in the American diet.

Is that advice sound? Do diet sodas help prevent weight gain? Are they safe? The answers to those questions are not as clear as you might expect.

Do Diet Sodas Prevent Weight Gain?

diet soda make you fatThe answer to that question would seem to be a no-brainer. Substituting beverages with no calories for beverages with calories should lead to less weight gain. However, as I summarized in a previous “Health Tips From the Professor” article Do Diet Sodas Make You Fat, the answer is not clear at all. Some studies suggest that diet sodas help people lose weight. Other studies suggest diet sodas cause just as much weight gain as sugar-sweetened sodas.

With so much confusion in the literature, what should we believe? More importantly, what do the experts say? This January an international consortium of experts reviewed all of the pertinent literature and published a position paper on whether artificially sweetened beverages were of value in responding to the global obesity crisis (Borges et al, PLOS Medicine, DOI: 10.1371/journal.pmed.1002195).

These authors concluded:

  • “In summary, the available evidence…does not consistently demonstrate that artificially-sweetened beverages are effective for weight loss or preventing metabolic abnormalities [pre-diabetes and diabetes]. Evidence on the impact of artificially-sweetened beverages on child health is even more limited and inconclusive than in adults.”
  • “The absence of evidence to support the role of artificially sweetened beverages in preventing weight gain and the lack of studies on their long-term effects on health strengthen the position that artificially-sweetened beverages should not be promoted as part of a healthy diet.”

Is Diet Soda Bad For You?

diet soda strokeAs if the lack of proven efficacy weren’t bad enough, other studies suggest that diet sodas may also be bad for your health. In previous issues of “Health Tips From the Professor,” I have discussed other studies showing that diet sodas are just as likely as regular sodas to increase risk of diabetes Artificial Sweeteners and Diabetes and heart disease Soft Drinks and Heart Disease.

Even worse, a study published earlier this month (Pase et al, Stroke, DOI: 10.1161/STROKE.AHA.116.016027 ) concluded that diet sodas may significantly increase the risk of stroke and Alzheimer’s disease.

This study looked at 2888 participants of the Framingham Heart Study. The participants evaluated for risk of stroke had a mean age of 62 on enrollment. Those evaluated for risk of dementia had a mean age of 69 on enrollment. All subjects were followed for 10 years. Three food frequency questionnaires were administered during that 10-year period to evaluate consumption of diet and sugar-sweetened sodas. The results of the study were:

  • People consuming at least one diet soda per day over a 10-year period were 3X more likely to have a stroke or develop dementia (primarily Alzheimer’s disease) than people consuming no diet sodas.
  • No increased risk of stroke or dementia was seen for people consuming sugar-sweetened beverages. However, that does not mean that sugar-sweetened beverages are good for you. Previous studies have shown they increase the risk of obesity and diabetes.
  • When the data were corrected for hypertension, cardiovascular disease, and obesity (waist to hip ratio), diet sodas still increased the risk of having a stroke by 2.6-fold.
  • This is not the only study to show a link between diet sodas and stroke. Two other studies have come to the same conclusion, and in both of those studies the increased risk was also seen only with diet soda consumption, not with sugar-sweetened soda consumption.

The author of the study concluded by saying: “As the consumption of artificially sweetened soft drinks is increasing in our community, along with the prevalence of stroke and dementia, future research is needed to replicate our findings and to investigate the mechanisms underlying the reported association.”

I agree. Current evidence does not definitively prove that diet sodas cause stroke and Alzheimer’s, but these are life-changing adverse health outcomes. Further research to test this association is desperately needed to know whether or not diet soda is bad for you.

Are Diet Sodas Safe and Effective?

diet soda dangerousAs you might expect these studies have caused quite a bit of controversy. Some experts have embraced these studies and have concluded that health professionals should stop recommending diet sodas as a safe and effective alternative to sugar-sweetened sodas.
Others have been unwilling to change their recommendation of diet sodas for people who are obese and/or diabetic. Their rationale is 3-fold:

  • These studies merely show that diet soda consumption is associated with weight gain, diabetes, heart disease, stroke and Alzheimer’s. Association does not prove causation, so their viewpoint is that there is no conclusive proof that diet sodas cause weight gain and health risks.
  • The obesity epidemic is a major health crisis, and consumption of sugar-sweetened beverages plays an important role in weight gain.
  • They are convinced that most people are so addicted to the sweet taste of sugar that they would be unwilling to switch to calorie free options like water or herbal teas.

In short, they are desperately clinging to the hope that substituting diet sodas for sugar-sweetened sodas will put a dent in the obesity crises because they don’t believe there are any other viable options.

What Do These Studies Mean For You?

I side with those experts who have looked at the data from the opposite perspective and concluded there is no convincing evidence that diet sodas are either safe or effective.

If the conversation were just centered around weight gain, diabetes, and heart disease, this could be considered an academic discussion. One could argue that diet sodas might have some benefit, and, at the worst, would have the same health risks as the regular sodas they replaced.

However, the possibility that diet sodas may increase the risk of stroke and dementia is a game-changer in my mind. That’s because consumption of sugar-sweetened sodas does not appear to increase the risk of either stroke or dementia. If true, that means that substitution of diet sodas for sugar-sweetened sodas is not a neutral substitution. It could cause serious harm.

With no good evidence that diet sodas help people control weight and the possibility that they may have serious health risks, it is difficult to see how anyone in good conscience can continue to recommend diet sodas in place of regular sodas.

My recommendation is to substitute water and other unsweetened beverages for the sugar sweetened beverages you are currently consuming. If you crave the fizz of sodas, drink carbonated water. If you need more taste, try herbal teas or infuse water with slices of lemon, lime, or your favorite fruit. If you buy commercial brands of flavored water, check the labels carefully. They may contain sugars or artificial sweeteners. Those you want to avoid.

So, is diet soda bad for you?  Well, it’s not good for you.

The Bottom Line

  • This January an international consortium of experts reviewed all of the pertinent literature and concluded: “The available evidence…does not consistently demonstrate that artificially-sweetened beverages are effective for weight loss or preventing metabolic abnormalities. The absence of evidence to support the role of artificially sweetened beverages in preventing weight gain and the lack of studies on other long-term effects on health strengthen the position that artificially-sweetened beverages should not be promoted as part of a healthy diet.”
  • This April a study was published reporting that people consuming at least one diet soda per day over a 10-year period were 3X more likely to have a stroke or develop dementia (primarily Alzheimer’s disease) than people consuming no diet sodas. Two other studies on the effect of diet sodas on the risk of stroke have come to similar conclusions.
  • We cannot yet say definitively that diet sodas cause stroke and dementia. Further research is clearly needed to test these associations. However, at this point it is safe to say there is no convincing evidence that diet sodas are either safe or effective.
  • With no good evidence that diet sodas help people control weight and the possibility that they may have serious health risks, it is difficult to see how anyone in good conscience can continue to recommend diet sodas as a substitute for sugar-sweetened sodas.
  • My recommendation is to substitute water and other unsweetened beverages for the sugar sweetened beverages you are currently consuming. If you crave the fizz of sodas, drink carbonated water. If you need more taste, try herbal teas or infuse water with slices of lemon, lime, or your favorite fruit. If you buy commercial brands of flavored water, check the labels carefully. They may contain sugars or artificial sweeteners. Those you want to avoid.
  • For a more nuanced discussion of this issue, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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What Is The Planetary Diet?

Posted May 21, 2019 by Dr. Steve Chaney

Is Your Diet Destroying The Planet?

Author: Dr. Stephen Chaney

 

Earth Day has come and gone, but you are still committed to saving the planet. You save energy. You recycle. You drive an electric car. But is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor,” What Is The Flexitarian Diet , but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose diet.” It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

 

Is Your Diet Destroying The Planet?

When they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
  • Agriculture occupies 40% of global land (58% of that is for pasture use).
  • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
  • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
  • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
  • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

When they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
  • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
  • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

 

What Is The Planetary Diet?

In the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes.”
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

If you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time.”  If you have read my books “Slaying The Food Myths” or “Slaying the Supplement Myths,”  you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

 

Is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose diet.”  It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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