Soda-licious & Soda-ceptive: Why You Should Think Before You Drink
From a young age, we’re taught the importance of eating right... but what about drinking right? Added sugars have snuck their way into all kinds of foods, but surprisingly, almost 50% of added sugars consumed by the average American are from drinks! The popularity and accessibility of sugar-sweetened beverages (SSBs) has given them the title of “Public Enemy #1” in the fight against obesity and related diseases.
Figure 1: (A) SSB’s include vitamin water, sport drinks, energy drinks, soda, and fruit-flavoured drinks (B) Non-SSB’s include milk, 100% fruit juice, and water.
So what actually makes SSB’s the main villain in the obesity battle, as opposed to other sugary foods?
When you eat a meal, you consume calories but also obtain a variety of nutrients and achieve a feeling of fullness. When you drink pop, juice, or any other SSB, you’re still consuming calories and sugar, but these are empty calories. This means that you aren’t achieving the same full feeling, so you’ll consume more calories later on. It’s plain to see how these extra, hidden calories can add up and lead to weight gain. 1 in 4 Americans get at least 200 calories per day from SSBs. Based on a diet of 2000 calories per day, this accounts for 10% of daily calories. When this 10% is not accounted for in the rest of the daily diet, it leads to added calories each day and ultimately weight gain and increased risk of metabolic diseases.
Consuming liquid sugars also makes them more absorbable by the body, leading to harmful metabolic effects and more fat accumulation. Natural fructose in fruits and vegetables in absorbed more slowly by the body, since other nutrients (like the fibre in apples!) are being absorbed at the same time and regulating the digestive process. Similarly with milk, the sugar absorption is slowed down due to the presence of other proteins and fats. Consequently, when you consume a sugary drink composed primarily of carbonated water and HFCS, the liquid fructose is absorbed more quickly and increases the rate of hepatic extraction of fructose, de novo lipogenesis, and production of lipids. (See The F Word for more on HFCS metabolism)
Figure 2: Representation of SSB consumption in the USA. 50% of the US population consumes an SSB on any given day, 25% of the population consumes 200 cals/day from SSBs (approximately 2 cans of soda), and 5% of population consumes at least 567 cals/day from SSBs (approximately 4 cans of soda)
With long-term studies looking at overall diet and SSB consumption of both children and adults, we are able to see the effects directly rather than making conclusions about the harm of sugar based on mice or rat response. Even though there are a lot of variables involved in human trials, research behind the effects of SSBs is still proving to have an impact on how health and nutrition initiatives are tackling the problem of obesity.
It may sound obvious that replacing SSBs with alternative beverages would improve health, but there are actually extensive studies that have been done to support the idea. From children to adults, total energy intake as well as body composition and weight have been analyzed in long-term studies with regular 24hr diet recalls and regular food frequency questionnaires (FFQs). Studies looking at risk of type 2 diabetes, stroke, high blood pressure, and fatty liver disease have also been done, but only on adults. This review paper from last May looks at research going back as far as November 2013 to summarize the data and draw firm conclusions about the impact of SSBs on health over time.
But why so much research to support such a seemingly straightforward concept?
With the rising obesity rates in Canada and the US, there is more focus on changing regulations on food labeling and marketing to help limit consumption of unhealthy foods while promoting healthy alternatives. The updated Dietary Guidelines for Americans (2015-2020 Edition) has adjusted its recommendations for sugar consumption from “cutting back on calories from sugar” to “less than 10% of calories from added sugars per day.” Drinking 1 can of pop can be enough to surpass this limit! Some physicians are advocating for warning labels, limited SSB access, and even a “soda tax” with hopes of decreasing SSB consumption. (As strange as a “soda tax” may sound, it’s actually proven to be effective in lowering SSB consumption by an estimated 12% since being implemented a year ago in Mexico. Read more about the Soda tax here.)
Personally, rather than an increase costs of SSBs with a “soda tax”, I’d like to see healthier drink alternatives lower their prices instead. There’s definitely something wrong with the fact that you can buy a 32 oz pop for less than $1, but a bottle of water can cost around $2.
Accessible, less expensive alternatives and better education about the hidden health concerns behind SSBs makes more sense to me compared to limited access and added tax.
That brings me to why I’m so excited about all this SSB research... because it’s getting people talking! Once the Dietary Guidelines on sugar were updated in January, many major newspapers and broadcasting companies had something to say about it. This spread the word beyond the scientific community and out into the public in a way that everyone can understand.
In the end, as with most of the sugar research I’ve explored thus far, it’s important to take it all with a grain of salt. The key seems to be moderation and awareness. By being conscious of any extra sugar you’re putting in your body from SSBs and, as a result, cutting back on the extra sugar elsewhere, you should not have too much to worry about. Despite how unbiased the researchers try to be, everybody is different so there are always considerations when it comes to your dietary health and what works for you. Just be mindful, and think before you drink... because too many sugar-sweetened beverages may not be so sweet in the long run.
This study from last January followed 358 third graders for 6 years and examined the effects of substituting SSBs by tracking their diets and weight gain, while doing a great job accounting for variables like socioeconomic status, physical activity, pubertal status.
CNN article and NY Times Blog on the new added sugar recommendations.
Photo sources: http://www.mymacs.ca/polar-pop-1?language=en & http://www.mcdonaldsajax.com/2014/04/dollar-drink-days-are-back/
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