Is Soda One of The Causes of Arthritis?

Written by Dr. Steve Chaney on . Posted in current health articles, Health Current Events, Healthy Lifestyle

is soda one of the causes of arthritis

Author: Dr. Stephen Chaney

 

Recently, I came across an article which claimed an association between soda and arthritis.  So, is soda one of the causes of arthritis?  In previous health tips from the professor I have shared that soda consumption can cause weight gain  and heart disease . As if that weren’t reason enough to avoid sodas, recent headlines suggest that sodas can also cause rheumatoid arthritis. That is a pretty strong claim, so let’s look at the study behind those headlines.

Do Sodas Cause Arthritis?

This study (Hu et al., American Journal of Clinical Nutrition, 100: 959-967, 2014) followed 79, 570 women enrolled in the first Nurse’s Health Study (NHS) and 107,330 women enrolled in the second Nurse’s Health Study (NHS II) – that’s a total of 186,900 women – for at least 20 years. The women were aged 25-55 at the beginning of the studies and 857 of them developed rheumatoid arthritis over the next 20+ years.

All of the participants in the study filled out a questionnaire covering medical history, lifestyle and chronic disease at entry into the study and every two years afterwards. Compliance to this protocol was >90%, which is excellent for this type of study. The results were pretty impressive:

· Women who consumed ≥ 1 serving of sugar sweetened soda/day had a 63% higher risk of developing rheumatoid arthritis compared to women who consumed no sugar sweetened soda or consumed < 1 serving/month.

· The association between sugar-sweetened soda consumption and rheumatoid arthritis was much stronger for late-onset rheumatoid arthritis than it was for early-onset rheumatoid arthritis. When the authors restricted their analysis to women who developed rheumatoid arthritis after age 50, consumption of sugar sweetened sodas was associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

· The type of sugar did not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup were equally likely to increase the risk of rheumatoid arthritis.

· There was no association between diet soda consumption and rheumatoid arthritis.

 

What Are The Strengths and Weaknesses Of The Study?

Strengths of The Study: The strengths of the study are fairly obvious.

This was a very large study and the effects (64%) and (264%) were also large. Those aren’t trivial differences. The size of the study and the magnitude of the effects bolster confidence in the outcome of the study.

Weaknesses of The Study:

This type of study measures associations. It doesn’t prove cause and effect. Therefore, the headlines saying “Soda Consumption is Associated With Arthritis” are more accurate than those saying “Sodas May Cause Arthritis”.

In studies of this kind we can never be sure whether the variable that was measured (soda consumption in this case) was responsible for the outcome or whether it was some other variable that wasn’t measured that was responsible for the outcome. In particular, the women who developed rheumatoid arthritis were also more likely to:

arthritis· Have lower incomes.
· Exercise less.
· Have higher energy (calorie) intake.
· Have poorer diets.
· Take fewer multivitamins and other supplements.

The authors tried their best to compensate for these differences statistically, and the fact that the very large effects of soda consumption on rheumatoid arthritis occurrence were not significantly affected when these differences were taken into account adds confidence to their conclusions. However, it is never possible to exclude the possibility that some other variable they did not measure was responsible for the increase in rheumatoid arthritis.

Are Diet Sodas Off the Hook?  Or,could They Be One of The Causes of Arthritis?

Could diet sodas be one of the causes of arthritis?  This study showed no association between diet soda consumption and rheumatoid arthritis. Previous studies have suggested that diet sodas don’t increase the risk of heart disease to the same extent as sugar-sweetened sodas. Does that mean that you should just start drinking diet sodas rather than sugar sweetened sodas?

diet sodas and arthritisThe answer is probably not. As I have pointed out in an earlier issue of “Health Tips From the Professor” , and has been confirmed by a recent meta-analysis of 24 clinical studies (Miller and Perez, American Journal of Clinical Nutrition, 100: 765-777, 2014), double blind studies in which all other caloric intake is carefully controlled generally show that people tend to gain slightly less weight when consuming diet sodas than when consuming sugar sweetened sodas.

But in the real world, people consuming diet sodas are just as likely to be overweight as people consuming sugar sweetened sodas. People seem to compensate for the calories saved with diet sodas by consuming more Big Macs, Mrs. Fields cookies and extra large Stabucks Lattes. In the real world, water is the only non-caloric beverage that is actually associated with lower weight.

Is It Enough To Just Stop Drinking Sodas?

I have often paraphrased that famous line from Western movies: “Just put down that soda and back away, and nobody gets hurt”. But is it that simple? Can you prevent rheumatoid arthritis just by drinking less soda?

Once again, the answer is probably no. There are a number of factors that can increase your risk of developing rheumatoid arthritis. Experts will tell you that the causes of rheumatoid arthritis are largely unknown, but that genetic predisposition, smoking and excessive alcohol use can increase your risk.

However, because rheumatoid arthritis is an inflammatory disease I would add overweight; diets high in animal protein, saturated fats, trans fats and sugar; food allergies; gut health issues; stress & exhaustion and chronic infections – and lack of fresh fruits and vegetables, omega-3 fatty acids and regular exercise.

The clinical study I described above found that soda consumption was much more strongly associated with late onset rheumatoid arthritis than early onset rheumatoid arthritis. Based on those data I would speculate that early onset rheumatoid arthritis may be more strongly influenced by genetics and other lifestyle factors, whereas late onset rheumatoid arthritis may be more strongly influenced by sugar sweetened sodas and other sugary foods. Only time will tell if my hypothesis is true.

Is soda one of the causes of arthritis?

The Bottom Line:

1) A recent study reported that women who consume ≥ 1 serving of sugar sweetened soda/day have a 63% higher risk of developing rheumatoid arthritis compared to women who consume no sugar sweetened soda or consume < 1 serving/month.

2) The association between sugar-sweetened soda consumption and rheumatoid arthritis is much stronger for late-onset rheumatoid arthritis than for early-onset rheumatoid arthritis. For women who first develop rheumatoid arthritis after the age of 50, consumption of sugar sweetened sodas is associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

3) The type of sugar does not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup are equally likely to increase the risk of rheumatoid arthritis.

4) There was no association between diet soda consumption and rheumatoid arthritis. However, this does not mean that diet sodas are a good thing. Consumption of diet sodas is just as likely to be associated with obesity as is consumption of sugar sweetened sodas, and some recent studies suggest that consumption of diet sodas is associated with high blood pressure.

5) This was a very large and well done study, but it only measures associations, not cause and effect. Further studies will be needed to confirm this observation. However, we already know that sodas are bad for us. This may be just one more reason to minimize our consumption of sodas.

6) We shouldn’t assume that we can prevent rheumatoid arthritis by simply cutting sodas out of our diet. Arthritis has multiple causes (see article above). We should aim for a healthier overall lifestyle if we wish to reduce our risk of developing rheumatoid arthritis and other diseases.

7) Osteoarthritis is much more common than rheumatoid arthritis. This study did not include women with osteoarthritis, so it is uncertain whether these results will apply to osteoarthritis as well.

8) Men are much less likely to develop rheumatoid arthritis than women, so it will be difficult to do a comparable study in men. However, it is likely that the same association between soda consumption and rheumatoid arthritis would be seen in men as well.

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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Comments (1)

  • Jame Thornburgh

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    Hi.
    Thought. this was an interesting. article science based. If one reads the doctor’s
    Credentials he appears to basse his articles in sceince nkot fads
    lovw you mom

    Reply

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Latest Article

Omega-3 Benefits: Lower High Blood Pressure

Posted July 16, 2019 by Dr. Steve Chaney

What Does the FDA Say About Omega-3 Benefit Claims?

Author: Dr. Stephen Chaney

 

 

Among omega-3 benefits is lower high blood pressure.  That claim can be made according to the FDA. 

lower high blood pressureHeart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing.  That is concerning because:

High blood pressure is a killer! It can kill you by causing heart attacks, strokes, congestive heart failure, kidney failure and much more.

High blood pressure is a serial killer. It doesn’t just kill a few people. It kills lots of people. The American Heart Association estimates that high blood pressure directly or indirectly caused 410,000 deaths in 2014. That is almost 1 person every second and represents a 41% increase from 2000. It’s because high blood pressure is not a rare disease.

  • 32% of Americans have high blood pressure, also called hypertension, (defined as a systolic blood pressure of 140 mm Hg or more or a diastolic blood pressure of 90 mm Hg or more).
  • Another 33% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 65% of Americans with abnormal blood pressure!

High blood pressure is a silent killer. That’s because it is a very insidious disease that sneaks up on you when you least expect it. Systolic blood pressure increases 0.6 mm Hg/year for most adults over 50. By age 75 or above 76-80% of American adults will have high blood pressure.  Even worse, many people with high blood pressure have no symptoms, so they don’t even know that their blood pressure is elevated. For them the first symptom of high blood pressure is often sudden death.

Blood pressure medications can harm your quality of life. Blood pressure medications save lives. However, like most drugs, blood pressure medications have a plethora of side effects – including weakness, dizziness, fainting, shortness of breath, chest pain, nausea, diarrhea or constipation, heartburn, depression, heart palpitations, and even memory loss. The many side effects associated with blood pressure medications lead to poor compliance, which is probably why only 46% of patients with high blood pressure are adequately controlled.

You do have natural options. By now you are probably wondering whether there are natural approaches for controlling your blood pressure that are both effective and lack side effects. The answer is a resounding YES! I’ll outline a holistic natural approach for keeping your blood pressure under control in a minute but let me start with the FDAs recent approval of what they call “qualified claims” that omega-3s lower blood pressure.

 

What Does the FDA Say About Omega-3 Benefits?

omega-3 benefitsIn my book “Slaying The Supplement Myths” I talk about the “dark side” of the supplement industry. There are far too many companies who try to dupe the public by making outrageous and unsubstantiated claims about their products.

Only the FDA stands between us and those unscrupulous companies, and they take their role very seriously. That is why it is big news whenever the FDA allows companies to make health claims about their products.

Even then, the FDA is very cautious. They allow what they call “qualified” health claims. Basically, that means they are saying there is enough evidence that the health claim is probably true, but not enough evidence to say it is proven.

Of course, if you understand the scientific method, you realize there will always be some studies on both sides of every issue. That is why the only health claims the FDA allows are qualified health claims.

With that background in mind, let’s look at the qualified health claims the FDA allows for omega-3 benefits.

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added five qualified health claims about omega-3s and blood pressure. The 5 claims are very similar, so I will only list two below for the sake of brevity.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.
  • Of course, they add the usual wording about the evidence being inconsistent and inconclusive.

 

Omega-3 Benefits?

measure omega-3 benefits levelWe’ve known for some time that omega-3 fatty acids help lower blood pressure, but two recent studies were instrumental in convincing the FDA to allow these qualified health claims. These studies have highlighted just how strong the effect of omega-3s on lowering blood pressure is.

The first study was a meta-analysis of 70 randomized, placebo-controlled clinical trials of long chain omega-3 (EPA + DHA) supplementation and blood pressure (Miller et al, American Journal of Hypertension, 27: 885-896, 2014 ).

This study showed:

  • In the group with normal blood pressure at the beginning of the study EPA + DHA supplementation decreased systolic blood pressure by 1.25 mm Hg.
  • Given that systolic blood pressure rises an average of 0.6 mm Hg/year in adults over 50, the authors estimated that omega-3 supplementation alone would delay the onset of age-related high blood pressure by 2 years.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by an impressive 4.51 mm Hg and diastolic blood pressure by 3.05 mm Hg.
  • The authors noted that this decrease in systolic blood pressure could “prevent an individual from requiring medication [with all its side effects] to control their hypertension” or decrease the amount of medication required.

However, the doses of omega-3s used in these studies ranged from 1 to over 4 grams/day (mean dose = 3.8 grams/day). That sparked a second study (Minihane et al, Journal of Nutrition, 146: 516-523, 2016) to see whether lower levels of omega-3s might be equally effective. This study was an 8-week double-blind, placebo-controlled study comparing the effects of 0.7 or 1.8 grams of EPA + DHA per day (versus an 8:2 ratio of palm and soybean oil as a placebo) on blood pressure.

This study showed:

  • In the group with normal blood pressure at the beginning of the study, EPA + DHA supplementation caused no significant decrease in blood pressure. This could be due to the smaller number of subjects or the lower doses of EPA + DHA used in this study.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by 5 mm Hg and, the effect was essentially identical at 0.7 grams/day and 1.8 grams/day.
  • The authors concluded “Our data suggest that increased EPA + DHA intakes of only 0.7 grams/day may be an effective strategy for blood pressure control.”

 

A Holistic Approach to Lower High Blood Pressure

holistic approach to lower high blood pressureThe FDA’s allowed claims about omega-3s are good news indeed, but that’s not the only natural approach that lowers blood pressure. You have lots of other arrows in your quiver. For example:

  • The DASH diet (A diet that has lots of fresh fruits and vegetables; includes whole grains, low fat dairy, poultry, fish, beans, nuts and oils; and is low in sugar and red meats) reduces systolic blood pressure by 5-6 mm Hg. [Low fat, low carb and Mediterranean diets also lower blood pressure, but not by as much as the DASH diet].
  • Reducing sodium by about 1,150 mg/day reduces systolic blood pressure by 3-4 mm Hg.
  • Reducing excess weight by 5% reduces systolic blood pressure by 3 points.
  • Doing at least 40 minutes of aerobic exercise 3-4 times/week reduces systolic blood pressure by 2-5 mm Hg.
  • Nitrates, whether derived from fresh fruits and vegetables or from supplements probably also reduce blood pressure, but we don’t yet know by how much.

If you’ve been keeping track, you’ve probably figured out that a holistic lifestyle that included at least 0.7 grams/day of long chain omega-3s (EPA + DHA) plus the other omega-3 benefits in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.  What

That’s significant because, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could reduce your risk of:

  • Stroke by 37%.
  • Coronary heart disease by 21%.
  • Death from cardiovascular disease by 25%.
  • Death from all causes by 13%.

 

A Word of Caution

While holistic approaches have the potential to keep your blood pressure under control without the side effects of medications, it is important not to blindly rely on holistic approaches alone. There are also genetic and environmental risk factors involved in determining blood pressure. You could be doing everything right and still have high blood pressure. Plus, you need to remember that high blood pressure is a silent killer that often doesn’t have any detectable symptoms prior to that first heart attack or stroke.

My recommendations are:

  • Monitor your blood pressure on a regular basis.
  • If your blood pressure starts to become elevated, consult with your doctor about starting with natural approaches to bring your blood pressure back under control. Doctors are fully aware of the side effects of blood pressure medications, and most doctors are happy to encourage you to try natural approaches first.
  • Continue to monitor blood pressure as directed by your doctor. If natural approaches are insufficient to bring your blood pressure under control, they will prescribe the lowest dose of blood pressure medication possible to get your blood pressure where it needs to be.
  • Don’t stop making holistic lifestyle choices to reduce blood pressure just because you are on medication. The more you do to keep your blood pressure under control with a healthy diet and lifestyle, the less medication your doctor will need to use (That means fewer side effects).

 

The Bottom Line

Heart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing. That is why anything we can do lower blood pressure naturally is important. What does the FDA say about omega-3s and blood pressure?

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added qualified health claims about omega-3s and blood pressure. For example, they now allow the following claims.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.

For more information on the studies that convinced the FDA to allow claims about omega-3s and blood pressure and for a discussion of holistic natural approaches for lowering blood pressure, 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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