the diet soda “weight loss” super-post

STILL TRYING TO LOSE WEIGHT WITH DIET SODA IN 2018?
GET A FREAKING CLUE!

Diet Soda Weight Loss

“A rise in the percent of the population who are obese coincides with an increase in the widespread use of non-caloric artificial sweeteners, such as aspartame (e.g., Diet Coke) and sucralose (e.g., Pepsi One)…”   From the June 2010 issue of the Yale Journal of Biology and Medicine, Gain Weight by ‘Going Diet?’ Artificial Sweeteners and the Neurobiology of Sugar Cravings

“You never see skinny people drinking it.”  Actress Joan Collins’ answer after being asked why she doesn’t drink diet soda

Unless you are trumping for Big Sugar / Big Food / Big Ag like the medical community has been doing for decades (WebMD’s Diet Sodas Cause Weight Gain? Not so Fast is a prime example), it’s not news that SODA is bad news.  This is mostly because its massive amounts of sugar is a great way to screw up your METABOLISM / PHYSIOLOGY, as well as the fact it’s incredibly acidic.  If you can believe it, DIET SODA may be worse.  It fouls up various parts of the brain, which has led a significant number of scientists to declare that even though it contains zero calories, it actually causes more weight gain than sugary soda — the topic of today’s post.

Saccharin (300 times sweeter than sugar) was invented at Johns Hopkins University back in 1879 while working on, of all things, COAL TAR DERIVATIVES.  Cyclamate came next (1939), but was pulled off the US market in 1969 because it was shown to cause CANCER.  And although there was lots of talk about doing the same thing with Saccharin in the 1970’s (carcinogenic warning labels were added), it instead had the labels removed and is today readily available as Sweet’n Low.  While all of this was going on, a chemist for the drug company Searle was working on a medication for ulcers, which turned out to be a compound 200 times sweeter than sugar — aspartame.  If you want to read the sordid story of the way Donald Rumsfeld gained aspartame’s FDA approval after over a decade and a half of denials, HERE it is.

One of the questions I frequently ask patients is how much soda they drink.  Although I once had a person tell me (with others in the room nodding in confirmation) that she drank 30 cans of Diet Dr. Pepper a day, that’s extreme by anyone’s standard.  What’s fairly common is people consuming somewhere between 1 and 2 6-packs a day.  In a society that’s often defined by our addictions, science has clearly shown us that sugar is at the very least, AS ADDICTIVE AS HARD DRUGS, with many studies showing it’s actually more addictive — as great as 8x more addictive.  The truth is, if SUGAR / SODA were not addictive (even in its “diet” form) Americans would not be consuming a whopping 80 PLUS GALLONS per person, annually.  With such a large amount of non caloric beverages being consumed in the United States, we have to ask ourselves a simple question — is this stuff doing what it’s supposed to be doing?  Is it helping people lose weight?

“The second (and more complicated) theory has to do with how aspartame affects insulin production. ‘Aspartame binds to tastebuds in our stomach, which send signals to the pancreas telling it to release insulin,’ explains physician and biochemist Cate Shanahan, author of Deep Nutrition: Why Your Genes Need Traditional Food. ‘Insulin, in turn, shuts down our fat-burning enzymes and ramps up our fat-storing enzymes.’ In other words, artificial sugars trick our body into thinking we’re consuming regular sugar, causing it to go into energy-storage mode.”   Ian Lecklitner’s March 2017 article (What’s in This Diet Coke?) for Mel Magazine

“In addition, some studies indicate sugar substitutes like aspartame, sucralose and saccharin, which are commonly found in diet drinks, can throw off your body’s natural metabolic processes. Disrupting these processes could cause your body to store fat instead of burning it, and may increase your risks for diabetes and heart disease.”  October 2014 issue of the publication of MD Anderson Cancer Centers (Diet Soda and Cancer: What you Should Know)

“For example, three large studies published between 2007 and 2009 found that people who drank diet sodas regularly were more likely to develop type 2 diabetes and had between 30 and 55 percent higher risk of metabolic syndrome (a constellation of health problems that could increase the risk of type 2 diabetes, heart disease, and stroke) than those who didn’t. Two other studies from 2012 further bolstered these results: Researchers linked daily diet soda consumption to about a 45 percent higher risk of heart attack, stroke, and early death in one study of about 2,600 people; and about 30 percent increased risk of hemorrhagic stroke—a less common type of stroke where a ruptured blood vessel or burst aneurysm causes loss of blood flow to the brain—in the other study of 130,000 people. Past research has also found links between diet sodas and conditions such as depression or pre-term delivery. For example, one study of almost 320,000 people published in the journal PLoS One in 2014 found that those who drank four or more cans of diet soda each day were about 30 percent more likely to be diagnosed with depression than those who didn’t.”  From The Mounting Evidence Against Diet Sodas by Julia Calderone in the May 24, 2017 issue of Consumer Reports

It leads to more weight gain, it’s been linked to type-2 diabetes, it can cause heart problems and it can increase your risk of having a stroke by nearly 50%.  From Penn Medicine’s March 2017 article, Why Diet Soda is Bad for You

Knowing what we know about sugar, it’s easy to take for granted that sugary drinks like soda cause health problems (OBESITY, METABOLIC SYNDROME, DIABETES, ALZHEIMER’S, CANCER, etc).  And while one might assume that since “diet” beverages contain no calories, they cannot cause one to gain weight, this thought process is not only unfortunately incorrect, it’s really incorrect.   Today I want to show you this as I take you down memory lane, providing you a timeline of studies showing that diet soda is only not doing what’s been claimed of it for decades, but is doing the exact opposite — it’s causing consumers to gain weight instead.

DIET SODA CAUSES WEIGHT GAIN
1970’s, 1980’s, 1990’s

Back in the early 1970’s, Dr. Frank Speizer set up one of the biggest studies of it’s kind; THE NURSE’S HEALTH STUDY.  Among other things studied were the effects of diet soda on weight gain.  After looking at almost 32,000 female diet soda drinkers over the course of eight years it was determined that as a group they gained more weight than those who did not drink diet sodas.

Two big studies hit the libraries in 1986.  First, in March, Prevention Medicine (Artificial Sweetener Use and One-Year Weight Change Among Women) showed that out of the nearly 80,000 women studied, “Users were significantly more likely than nonusers to gain weight, regardless of initial weight.  These results were not explicable by differences in food consumption patterns. The data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain.”  Two short months later, Lancet published a study whose title told the entire story; Paradoxical Effects of an Intense Sweetener (Aspartame) on Appetite. Hint, the paradoxical effect was that even though it was being marketed as a diet aid, aspartame caused people to eat more. “The overall data indicate that aspartame, in some circumstances, has appetite-stimulating properties relative to the ingestion of water.”  Stick around and you’ll see the mechanism.

A 1988 study by the same author was published in the journal Dietary Phenylalanine and Brain Function (Effects of Aspartame on Appetite and Food Intake) which stated, “Aspartame—in addition to its role as an agent which disengages sweet taste and energy value—may influence eating via hormonal or neurochemical mechanisms.”  And even though it does not have anything to do with weight gain per se, be aware that even though aspartame had been linked to brain tumors for years, scientists at St. Louis’ Washington University raised a scary question via the title of the November 1996 issue of the Journal of Neuropathology and Experimental Neurology (Increasing Brain Tumor Rates: Is There a Link to Aspartame?).  “Compared to other environmental factors putatively linked to brain tumors, the artificial sweetener aspartame is a promising candidate to explain the recent increase in incidence and degree of malignancy of brain tumors.

As you can see, even though there were not an abundance of studies on this topic, experts were already saying over 3 decades ago that diet sodas were not a valid weight loss tool.  Follow along as the research picks up steam in the following decade.

DIET SODA CAUSES WEIGHT GAIN
2000 – 2010

Although there are innumerable studies during the first portion of the new millennium, the studies on diet soda don’t start ratcheting up until the 2007 issue of Circulation (the official journal of the American Heart Association).  In yet another installment of the famed Framingham Heart Study, Boston University’s School of Medicine compared outcomes of those who drink diet sodas as compared to those who drank regular sodas.  The news release from our government (Framingham Observational Study Notes Greater Incidence of Metabolic Syndrome Among Adults Consuming Soft Drinks) revealed that “Middle-aged adults who drank more than one soft drink daily, either diet or regular, have a more than 40 percent greater rate of either having or developing metabolic syndrome, a cluster of conditions that increase the risk for heart disease.”  In other words, there was no difference between drinking diet or regular — the authors could not tell the difference.  But how bad was it really?  Here is what BU’s website said.

“This study showed that association not only included drinking regular calorie-laden soft drinks, but artificially sweetened diet sodas as well…  individuals consuming one or more soft drinks a day had a 48 percent increased prevalence of the metabolic syndrome compared to those consuming less than one soft drink daily.  Consumption of one or more soft drinks a day was associated with a 44 percent higher risk of developing new-onset metabolic syndrome during a follow-up period of four years.  The researchers also observed that compared to participants who drank less than one soft drink daily, those who drank one or more soft drinks a day had a 31% greater risk of developing new-onset obesity; 30% increased risk of developing increased waist circumference; 25% increased risk of developing high blood triglycerides or high fasting blood glucose; and a 32% higher risk of having low HDL levels.”

Not sure what METABOLIC SYNDROME is?  Click the link and realize that all of its symptoms cluster around obesity (BELLY FAT, HIGH BLOOD PRESSURE, PRE-DIABETES, etc).  A year later in the  journal Obesity (Fueling the Obesity Epidemic? Artificially Sweetened Beverage Use and Long-Term Weight Gain), Dr. Sharon Fowler’s team did something similar by looking at the majority of the original 5,000 plus participants of the famed San Antonio Heart Study (1979-1988), determining that not only were artificially sweetened beverages associated with obesity, they essentially doubled your risk.  Furthermore, the more diet soda you drank, the greater your odds of becoming obese (it was “dose-dependent“).  The authors concluded that “artificial sweetener use might be fueling–rather than fighting–our escalating obesity epidemic.”  For the record, this increase in weight came without an increased intake in food.

In April of 2008, the European Journal of Clinical Nutrition (Direct and Indirect Cellular Effects of Aspartame on the Brain) described the metabolic mechanism whereby aspartame is converted into neurologically toxic substances (EXCITOTOXINS, MSG, and {gulp} formaldehyde aka embalming fluid).  “Aspartame is composed of phenylalanine (50%), aspartic acid (40%) and methanol (10%). Phenylalanine plays an important role in neurotransmitter regulation, whereas aspartic acid is also thought to play a role as an excitatory neurotransmitter in the central nervous system. Glutamate, asparagines and glutamine are formed from their precursor, aspartic acid. Methanol [rubbing alcohol], which forms 10% of the broken down product, is converted in the body to formate, which can either be excreted or can give rise to formaldehyde, diketopiperazine (a carcinogen) and a number of other highly toxic derivatives…. [which can cause] changes in regional brain concentrations of norepinephrine, epinephrine and dopamine. We propose that excessive aspartame ingestion might be involved in the pathogenesis of certain mental disorders and also in compromised learning and emotional functioning.”  The thing to remember here is how big a part brain chemicals play in both hunger and satiety (the feeling of fullness).

Just a couple months prior, the Journal of Toxicology and Environmental Health (Splenda Alters Gut Microflora and Increases Intestinal P-Glycoprotein and Cytochrome P-450 in Male Rats) showed a mechanism whereby diet soda is screwing up metabolism and causing weight gain — destruction of THE MICROBIOME.  In similar fashion to ANTIBIOTICS, it seems that diet soda is wreaking havoc on the microbiome (if you were not aware of the relationship between microbiome and obesity, HERE is one link of many).  Without going into detail here, the authors concluded that “Evidence indicates that a 12-wk administration of Splenda exerted numerous adverse effects…”  There have actually been a number of similar studies that I do not have time to cover today.

Shortly after, the January 2009 issue of the American Journal of Clinical Nutrition (Nonnutritive Sweetener Consumption in Humans: Effects on Appetite and Food Intake and their Putative Mechanisms) revealed that, “A critical review of the literature suggests that the addition of nonnutritive sweeteners (NNS) to non-energy-yielding [zero calorie diet-based] products may heighten appetite…. The addition of NNS to diets poses no benefit for weight loss or reduced weight gain….”  In April, the MESA study (Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis) from the journal, Diabetes Care, showed exactly what we’ve been seeing.  After following nearly 7,000 subjects from 2002 to 2007, researchers from numerous institutions including UT and Johns Hopkins, concluded that, “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.  Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident metabolic syndrome components and type 2 diabetes.”  Why are you still drinking diet soda?

By the beginning of the next decade, the heat was being turned up yet again on diet soda as a weight loss tool. Case in point was a study from the December issue of Acta Physiologica Hungarica, which concluded (Effects of Artificial Sweeteners on Body Weight, Food and Drink Intake) “Artificial sweeteners are widely used all over the world. Mice were given oral doses of water solutions of table top artificial sweeteners (saccharin, cyclamate, acesulfame-K based, and aspartame) the amount of maximum Acceptable Daily Intake (ADI) ad libitum [not forced, but as much as they cared to consume]. The controls received only tap water with the same drinking conditions as the treated groups. The mice were fed chow ad libitum.  Consumption of sweeteners resulted in significantly increased body weight; however, the food intake did not change. These results question the effect of non-caloric artificial sweeteners on weight-maintenance or body weight decrease.”  Are you starting to see a pattern here?

And for those parents providing this crap to their children, this study’s for you.  The August 2010 issue of the International Journal of Pediatric Obesity (Artificial Sweeteners: A Systematic Review of Metabolic Effects in Youth) provided these “CHERRY-PICKED” tidbits (I cherry pick everything for the sake of time and space).  Bear in mind that these authors analyzed the results of eighteen studies for this study.  Also bear in mind that a “positive correlation” means that those consuming the most diet soda are those who are gaining the most weight.

“Epidemiological data have demonstrated an association between artificial sweetener use and weight gain.  Since their FDA approval, artificial sweeteners and their benefits on metabolic health have been questioned. An association between artificial sweetener intake and weight gain was first observed in epidemiological studies with adults. Several largescale studies have shown a positive association between artificial sweetener use and increases in weight and/or BMI.  New data from both humans and animal models have provided convincing evidence that artificial sweeteners play an active role in the gastrointestinal tract, thus providing a mechanistic explanation for observed metabolic effects.  Currently, the FDA has approved five artificial sweeteners for consumption: acesulfame-K, aspartame, neotame, saccharin, and sucralose.  The majority of pediatric epidemiologic studies have found a positive correlation between weight gain and artificially-sweetened beverage intake.  Several cross-sectional studies in children have added to the association between artificially-sweetened beverage use and adverse health effects.  To date, only one observational study has shown an inverse association between artificial sweetener use and weight gain.”

DIET SODA CAUSES WEIGHT GAIN
2011 – 2020

As you will quickly notice, scientific studies linking diet soda (most particularly aspartame since it is the most common non-caloric sweetener) to obesity and weight gain were by this time starting to pick up some serious steam. In November of 2011, BMC Medicine published A Systematic Review on the Effect of Sweeteners on Glycemic Response and Clinically Relevant Outcomes, which concluded…

“In theory, substituting non-caloric and lower caloric sweeteners for simple sugars should reduce energy intake and thereby the risk of obesity and its consequences. However, there are a number of reasons why increasing use of non-caloric and lower caloric sweeteners might not lead to the expected improvements in energy regulation.  Use of hypocaloric sweeteners might not induce weight loss even in the short term.  Although our data suggest that non-caloric sweeteners may lead to clinically relevant weight loss through reduced energy consumption, this conclusion was driven by a single trial with a total of 41 participants. Unlike caloric sweeteners, non-caloric sweeteners are not known to suppress appetite, and therefore would not reduce the motivation to eat. Furthermore, it has been suggested that the psychobiological signals with non-caloric sweeteners may directly influence physiological regulatory mechanisms and thus further reduce their potential for reducing net energy intake.”

Two things stick out here.  Firstly, it’s not taking into account the absurd incidence of SUGAR / CARB / SWEET ADDICTION.  Secondly, it provides a great example of ideas that work 180 degrees differently in real life than they do in theory (SOCIALISM / COMMUNISM is another great example).  Which brings us to 2012.  In the May issue of Physiology & Behavior (Altered Processing of Sweet Taste in the Brain of Diet Soda Drinkers) researchers from San Diego State University concluded that this “altering” may be due to the way that zero-calorie chemical sweeteners foul certain parts of the brain, including those portions related to sweetness and satiety.  After looking at functional MRI’s of the brains of individuals shortly after consuming diet soda.  “These findings suggest that there are alterations in reward processing of sweet taste in individuals who regularly consume diet soda, and this is associated with the degree of consumption…. and may provide some insight into the link between diet soda consumption and obesity.”  In other words, people can become addicted to the sweet in diet drinks just like they become addicted to real sugar or HFCS.

In October the CDC published a paper (Consumption of Diet Drinks in the United States, 2009‒2010) that asked the question, “What percentage of the U.S. population consumed diet drinks?” and then turned around and answered it themselves.  “About 20% of the U.S. population aged 2 years and over consumed diet drinks on a given day during 2009‒2010. The percentage consuming diet drinks was similar for females and males at all ages except among adolescents aged 12‒19. The percentage consuming diet drinks increased with age for both males and females.”  By the way, as you may have expected, females were the larger consumer of diet beverages.  Later that month the journal Appetite published a study titled Saccharin and Aspartame, Compared with Sucrose, Induce Greater weight Gain in Adult Wistar Rats, at Similar Total Caloric Intake Levels.  Brace yourself for their shocking conclusions.  “Addition of either saccharin or aspartame to yogurt resulted in increased weight gain compared to addition of sucrose… Greater weight gain was promoted by the use of saccharin or aspartame, compared with sucrose [table sugar], and this weight gain was unrelated to caloric intake.”  Did you catch that?  Once again we see that the weight gain induced by diet sodas is directly related to the chemical sweeteners and not increased numbers of CALORIES CONSUMED

The final study of 2012 I want to discuss came from the December issue of the journal PLoS One (Crohn’s Disease-Associated Adherent-Invasive Escherichia coli Adhesion Is Enhanced by Exposure to the Ubiquitous Dietary Polysaccharide Maltodextrin).  Maltodextrin is a highly processed GRAIN-BASED thickener, filler and / or preservative for highly processed foods.  A simple Google search will tell you that maltodextrin is some nasty, high glycemic stuff, that is frequently associated with INSULIN RESISTANCE.  Just realize that in the case of E. Coli (AIEC), the DYSBIOSIS (bacterial overgrowth) is typically found in the form of a BIOFILM (in this case LF82).  Not surprising considering that while drugs, chemicals, or antibiotics typically cause dysbiosis, it’s simple carbohydrates and sugar that feed it (HERE).

“Crohn’s disease (CD) is associated with intestinal dysbiosis evidenced by an altered microbiome forming thick biofilms on the epithelium.  In the case of CD, pathogenic dysbiosis [is] characterized by an increase in total numbers of bacteria, a reduced diversity of bacterial species, and alterations in the spatial organization of the microbiome.   Adherent-invasive E. coli (AIEC) strains are frequently isolated from ileal lesions of CD patients indicating a potential role for these strains in disease pathogenesis.  MDX is included as a bulking agent in the no-calorie sweeteners Equal® (aspartame) and Splenda® (sucralose). Using these commercial sources of MDX, the growth and biofilm formation of LF82 was assessed. LF82 grew robustly in media supplemented with Equal® or Splenda® and specific biofilm formation was strikingly enhanced in medium containing Equal® or Splenda® relative to glucose-supplemented medium. The effect of replacing MDX with glucose as a filler component for aspartame or sucralose was also tested in specific biofilm formation assays. No increases in biofilm formation were observed in glucose-containing medium supplemented with aspartame or sucralose. Likewise, addition of the artificial sweeteners to MDX-containing medium did not further increase biofilm formation over the levels observed in medium supplemented only with MDX. These findings indicate that MDX found in commercial sources can stimulate LF82 biofilm formation.  MDX metabolism may promote colonization of multiple CD-associated bacteria.”

Can it get any scarier?  I guess it depends on how much chemical sweetener (overt or occult) you or your loved ones are consuming.  2013 saw the publication of Susan Swither’s study (Artificial Sweeteners Produce the Counterintuitive Effect of Inducing Metabolic Derangements) in the journal Trends in Endocrinology & Metabolism.  Similar to previous studies, Dr. Swithers’ team concluded, “The negative impact of consuming sugar-sweetened beverages on weight and other health outcomes has been increasingly recognized; therefore, many people have turned to high-intensity sweeteners like aspartame, sucralose, and saccharin as a way to reduce the risk of these consequences. However, accumulating evidence suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease.”  The Purdue Today (Prof: Diet Drinks Are Not the Sweet Solution to Fight Obesity, Health Problems) said of her study, “Research also shows that non-caloric or reduced-calorie food and beverages interfere with a body’s learned responses. The assumption is that fewer calories means less weight gain. Research, including studies from Swithers and colleagues, shows that frequent consumption of high-intensity sweeteners may have the opposite effect by confusing the body’s natural ability to manage calories based on tasting something sweet.”  As we have already seen, the resulting “metabolic derangements” are nothing less than devastating for both weight and overall health.

2014 saw the landslide continue with several studies, the first (and possibly most damning) found in October’s copy of Nature (Artificial Sweeteners Induce Glucose Intolerance by Altering the Gut Microbiota).  Pay close attention to the conclusions of this team of 17 Israeli researchers.  “Non-caloric artificial sweeteners (NAS) are among the most widely used food additives worldwide. Here we demonstrate that consumption of commonly used NAS formulations drives the development of glucose intolerance through induction of compositional and functional alterations to the intestinal microbiota. These NAS-mediated deleterious metabolic effects are abrogated by antibiotic treatment, and are fully transferrable to germ-free mice upon faecal transplantation of microbiota configurations from NAS-consuming mice.”  What does this mean in English?

It means that even though the single biggest cause of dysbiosis is antibiotics (HERE), in this study antibiotics were able to resolve soda-driven dysbiosis (after all, what is dysbiosis if not an infection?).  Furthermore, we can tell that the dysbiosis was driving the obesity (and not the other way around) because the authors took diet soda-induced dysbiotic feces from obese mice, transplant it into thin (germ free) mice, and made them fat (FMT).  “Collectively, our results link NAS consumption, dysbiosis and metabolic abnormalities, thereby calling for a reassessment of massive NAS usage.”  Just so you know, the soda / processed food industry crucified Dr. Swithers for her findings — not as severe as HERE, but not so much different nonetheless.

Several months prior, the European Journal of Nutrition once again compared the side effects of drinking diet soda to the side effects of drinking regular soda with a study titled Sugar-Sweetened Beverage and Diet Soda Consumption and the 7-Year Risk for Type 2 Diabetes Mellitus in Middle-Aged Japanese Men).  The team of 13 researchers from Kanazawa Medical University concluded that “Consumption of diet soda was significantly associated with an increased risk for diabetes in Japanese men. Diet soda is not always effective at preventing type 2 diabetes even though it is a zero-calorie drink.”  In March of 2014, the American Journal of Public Health (Diet-Beverage Consumption and Caloric Intake Among US Adults, Overall and by Body Weight) concluded that “Overweight and obese adults drink more diet beverages than healthy-weight adults and consume significantly more solid-food calories and a comparable total calories than overweight and obese adults who drink sugar-sweetened beverages.”  In other words, heavy people who drink diet soda are consuming more diet soda than heavy people who drink regular soda.  They are also eating more, although several studies have already shown us that the weight gain from diet soda is irrespective of caloric intake — a bad combination.

2014 also saw the publication of a couple of intriguing studies on the aspartame-affected brain; Biochemical Responses and Mitochondrial Mediated Activation of Apoptosis on Long-Term Effect of Aspartame in Rat Brain (from Redox Biology) and Neurobehavioral Effects of Aspartame Consumption (from Research & Health in Nursing).  Although these studies had significant amounts of freaky findings, one sentence should make the hair on the back of your neck stand on end.  “It is clear that long term aspartame exposure could alter the brain antioxidant status, and can induce apoptotic changes in the brain.”  In other words, aspartame fouled up GLUTATHIONE and similar antioxidant pathways (glutathione is the body’s most powerful antioxidant), MITOCHONDRIAL ACTIVITY, as well as bringing about premature apoptosis — pre-programmed cellular death.

If there is one thing we know for sure it’s that ABDOMINAL OBESITY is associated with about a jillion poor health factors and outcomes.  UT’s Sharon Fowler was back for the attack in 2015 with a study (Diet Soda Intake Is Associated with Long-Term Increases in Waist Circumference in a Biethnic Cohort of Older Adults: The San Antonio Longitudinal Study of Aging) published in Clinical Investigations.  The conclusions were rather simple and straightforward.  “In a striking dose-response relationship, increasing diet soda intake was associated with escalating abdominal obesity, a potential pathway for cardiometabolic risk…”  Once again, the more of this crap you put in your body, the fatter you are likely to be — especially belly fat; the most dangerous kind of obesity.

April of 2015 saw the publication of Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women’s Health Initiative in the Journal of General Internal Medicine by a group of ten physicians and researchers from institutions all over the Midwest and South.  They followed 60,000 women (average age 63) for an average of about five years, concluding that “After controlling for other cardiovascular disease (CVD) risk factors, women who consumed more than 2 drinks/day had a higher adjusted risk of CVD events, CVD mortality and overall mortality compared to the reference group.  This analysis demonstrates an association between high diet drink intake and CVD outcomes and mortality in post-menopausal women.”  There was more to come.

In July, the British Medical Journal (Consumption of Sugar Sweetened Beverages, Artificially Sweetened Beverages, and Fruit Juice and Incidence of Type 2 Diabetes….), while saying that diet soda studies contained “BIAS,” also revealed that “Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity.  Artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes. Both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.”  Bias or not, this should be getting downright scary for diet soda drinkers.

Two years ago in June, Purdue’s Susan Swithers published yet another study on the subject; Not-So-Healthy Sugar Substitutes in Current Opinion Behavioral Science.  As you might already suspect, her findings were not good for the beverage industry.  After essentially saying that all non-water beverages were problematic, she concluded with some factoids.  “Artificially-sweetened beverages are linked to increased risk for negative health outcomes in clinical cohorts. Little scientific evidence supports a role for diet soft drinks in reducing risk of overweight or obesity.  Multiple biologically plausible mechanisms have been supported by experimental models in pre-clinical studies.  Reduced intake of beverages sweetened with sugar or sugar-substitutes may improve public health outcomes.”  That same month, Current Diabetes Reports (What Does Diabetes “Taste” Like?) revealed this about type 1 and 2 taste receptors.

“The T1R2/T1R3 sweet taste receptor is expressed in taste buds on the tongue, where it allows the detection of energy-rich carbohydrates of food. This single receptor responds to all compounds perceived as sweet by humans, including natural sugars and natural and artificial sweeteners. Importantly, the T1R2/T1R3 sweet taste receptor is also expressed in extra-oral tissues, including the stomach, pancreas, gut, liver, and brain. Although its physiological role remains to be established in numerous organs, T1R2/T1R3 is suspected to be involved in the regulation of metabolic processes, such as sugar sensing, glucose homeostasis, and satiety hormone release.”

What does this mean?  Only that even though they have no calories whatsoever, diet drinks containing artificial chemical sweeteners act like sugar, having the capability of hijacking various metabolic pathways, as well as one’s ability to feel full (satiety).  While these scientists were excited about their discovery, it was openly evident that they were most excited about the money they could make if they found a “therapeutic target” for diabetes (i.e. a metabolite that a drug could attack). 

In August, the journal PLoS One published a study called Effects of the Non-Nutritive Sweeteners on Glucose Metabolism and Appetite Regulating Hormones: Systematic Review of Observational Prospective Studies and Clinical Trials.  Interestingly enough, after reviewing most of the same studies I’ve reviewed today, the authors of this study concluded that the “available evidence regarding the association between non-nutritive sweetener (NNS) consumption and metabolic diseases as well as the effects of NNS on glucose metabolism and appetite regulating hormones” was a wash.  Why?  They said that “adiposity” was thecommon identified confounding factor“.  This simply means that even though there is a boatload of evidence to the affirmative, the fact that 80% of our population is either obese, overweight, or MONW, left the authors unsure of whether to blame diet beverages. 

Interestingly enough, the very next month a dozen researcher from all over Europe published a study in the International Journal of Obesity (Does Low-Energy Sweetener Consumption Affect Energy Intake and Body Weight? A Systematic Review, Including Meta-Analyses, of the Evidence from Human and Animal Studies) coming to completely different conclusions than almost everyone before them had, even though they were looking at the same data (this was a meta-analysis, meaning they crunched everyone else’s studies in order to make sense of all of it as a whole unit).  The authors of this behemoth (205 sources in the biblography) stated….

“We found a considerable weight of evidence in favour of consumption of low energy sweeteners in place of sugar as helpful in reducing relative energy expenditure and body weight, with no evidence from the many acute and sustained intervention studies in humans that low energy sweeteners increase energy expenditure. Importantly, the effects of [artificially]-sweetened beverages on body weight also appear neutral relative to water, or even beneficial in some contexts.”

I must admit (I know you’ll be shocked at this) that I myself have some bias in this discussion.  And while bias was brought up by these authors yet again (they accused the anti-artificial sweetener scientists of bias), hang tight while I pull the rabbit out of the hat for you.  When you see a study that goes against all other studies, producing conclusions that don’t match anything you’ve seen thus far (even going as far to say that diet soda is in some cases superior to water), rest assured that the smell of filthy lucre is in the air. 

After seeing “ILSI Europe” mentioned (thanked) eight separate times in the ‘Acknowledgements‘ section at the end of the paper, I knew someone was pulling an “ARNOLD MONTO“.   I did a quick Google search and came up with a fascinating 34 page PDF titled A Spoonful of Sugar: How the Sugar Industry Fights Sugar Regulation in the European Union.  This must-read expose deals extensively with the organizations that funded the study above — the chief one being (surprise surprise surprise) the International Life Science Institute (ILSI Europe).  Besides talking about ANCEL KEYS, JOHN YURDKIN, and the numerous studies that for at least sixty years have were being secretly funded by Big Sugar to “prove” that dietary fat and not dietary sugar was the cause of all the health problems we have thus far discussed today (HERE & HERE), we learn the truth about ILSI Europe’s bought-and-paid for research.  ILSI Europe is….

“The European wing of a powerful industry-backed group originally founded by a veteran Coca-Cola executive with the help of Pepsi and other food industry players in 1978. It funds industry-friendly research and specializes in lobbying member states, European, and international agencies such as EFSA and the WHO. ILSI members span food as well as chemical, pharmaceutical, and biotech firms. Food industry members include Coca Cola, Pepsi, Nestlé, Red Bull, McDonald’s…. and many other large food corporations, including Südzucker/BENEO Group, the largest sugar producer in Germany.  Lobby spend: ILSI global income in 2014 is listed as €22 million [about 27million US].”

There was much more, but I simply don’t have time to cover it all.  This, my friends, is what happens way too often in the field of EVIDENCE-BASED MEDICINE. Unfortunately for industry, a single study by a group of people who are obviously biased has little effect on the bigger picture.  A study from the April 2016 issue of Nutrition and Metabolism (Hormonal Responses to Non-Nutritive Sweeteners in Water and Diet Soda) proved this by revealing that diet soda jacks insulin levels (can anyone say INSULIN RESISTANCE?). “Diet sodas… augmented GLP-1 (Glucagon-Like Peptide-1) responses to oral glucose. Our findings emphasize the need to test metabolic effects of non-nutritive sweeteners after chronic consumption”  Did 2017 get any better for industry?  I’ll give you three guesses and the first two don’t count.

The onslaught continued with January’s issue of PLoS One (Artificially Sweetened Beverages and the Response to the Global Obesity Crisis).  The gist of the paper was; yes, there is a global obesity crisis.  No, diet soda is not the solution.  The WHO (NO, NOT THE BAND) recently revised their guidelines on sugar intake, calling for nations to regulate sugar-sweetened beverages because industry has cranked  up their promotion of artificially sweetened beverages as a healthy alternative. “The absence of consistent evidence to support the role of ASBs in preventing weight gain and the lack of studies on other long-term effects on health strengthen the position that ASBs should not be promoted as part of a healthy diet.”  In February, Redox Biology carried a study very similar to one we discussed earlier, Chronic Aspartame Intake Causes Changes in the Trans-Sulphuration Pathway, Glutathione Depletion and Liver Damage in Mice.  For the record, in this study “chronic” meant 90 days.  There were a lot of technical findings in this study, but suffice it to say that aspartame screwed up metabolism in at least a dozen ways.

Although it’s not exactly soda, the February issue of Annals of Nutrition and Metabolism (Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study) looked at over 60,000 women, determining that those who used packets of artificial sweeteners had greater “type 2 diabetes risk, independently of major risk factors.  A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes.”  Then in April, Stroke published a study titled Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia that concluded “After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s disease dementia.”  This is not shocking considering what we’ve see thus far, as well as the fact that Alzheimer’s is increasingly being referred to as TYPE III DIABETES within the scientific medical community.

In June, PLoS One was back with a study by a team from the University of North Carolina (Chapel Hill) and University of Georgia (Athens).  It’s become increasingly clear that diet soda adversely affects GUT HEALTH.  This study (The Artificial Sweetener Acesulfame Potassium (K) Affects the Gut Microbiome and Body Weight Gain in CD-1 Mice) showed yet again that diet soda is messing up one’s microbiome.  “The observed body weight gain, shifts in the gut bacterial community composition, enrichment of functional bacterial genes related to energy metabolism, and fecal metabolomic changes were highly gender-specific, with differential effects observed for males and females. In particular, ace-K increased body weight gain of male but not female mice.”  Then in July, 14 researchers from institutions around the globe teamed up for a massive meta-analysis (Nonnutritive Sweeteners and Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies) in CMAJ-JACM that took the Academy of Nutrition and Dietetics to task for their ridiculous position.  After looking at 37 studies containing over 400,000 subjects…

“The position of the Academy of Nutrition and Dietetics is that nonnutritive sweeteners can help limit energy intake as a strategy to manage weight or blood glucose.  In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events.  Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk.”

Another one of those freaky diet soda / pregnancy studies was published in the October issue of the International Journal of Epidemiology (Maternal Consumption of Artificially Sweetened Beverages During Pregnancy, and Offspring Growth Through 7 Years of Age…).  “Our findings illustrated positive associations between intrauterine exposure to artificially-sweetened beverages and birth size and risk of overweight/obesity at 7 years.”  In other words, mom consumes diet soda while pregnant, and increases her odds of having an obese second grader.  The same month, Obesity Research and Clinical Practice (Carbon Dioxide in Carbonated Beverages Induces Ghrelin Release and Increased Food Consumption in Male Rats: Implications on the Onset of Obesity) showed that the CO2 “fizz” in soda fouls up ghrelin — the hormone that both regulates metabolism and tells you that you are hungry.  This means that carbonated drinks tell you that you are hungry even when you are not. And as you’ll see below, this research has already crossed over to humans.

“Here, we show that rats consuming gaseous beverages over a period of around 1 year gain weight at a faster rate than controls on regular degassed carbonated beverage or tap water. This is due to elevated levels of the hunger hormone ghrelin and thus greater food intake in rats drinking carbonated drinks compared to control rats. Moreover, an increase in liver lipid accumulation of rats treated with gaseous drinks is shown opposed to control rats treated with degassed beverage or tap water. In a parallel study, the levels of ghrelin hormone were increased in 20 healthy human males upon drinking carbonated beverages compared to controls.  These results implicate a major role for carbon dioxide gas in soft drinks in inducing weight gain and the onset of obesity via ghrelin release and stimulation of the hunger response in male mammals.”

One of the things I’ve repeatedly shown my readers is just how potent / strong stomach acid not only should be, but must be (HERE).  I’ve also shown you that there is typically an inverse relationship between the acidity / alkalinity of the stomach and the acidity / alkalinity of the body (HERE).  In other words, the stomach should be highly acidic, while most of the rest of the body is slightly alkaline.  Last January’s issue of Applied Physiology, Nutrition & Metabolism (Inhibition of the Gut Enzyme Intestinal Alkaline Phosphatase May Explain how Aspartame Promotes Glucose Intolerance and Obesity in Mice) helped show why one’s body’s acid / base balance is such a big deal as far as one’s weight is concerned.  Last February’s Mediators of Inflammation (The Role of Intestinal Alkaline Phosphatase in Inflammatory Disorders of Gastrointestinal Tract) said this of Alkaline Phosphatase…..

“Over the past few years, the role of intestinal alkaline phosphatase (IAP) as a crucial mucosal defence factor essential for maintaining gut homeostasis has been established. IAP is an important apical brush border enzyme expressed throughout the gastrointestinal tract and secreted both into the intestinal lumen and into the bloodstream. IAP exerts its effects through dephosphorylation of proinflammatory molecules including lipopolysaccharide (LPS), flagellin, and adenosine triphosphate (ATP) released from cells during stressful events. Diminished activity of IAP could increase the risk of disease through changes in the microbiome, intestinal inflammation, and intestinal permeability.”

Mess with alkaline phosphotase and you’ll likely end up with a LEAKY GUT (intestinal permeability), INFLAMMATION, and the “changes in the microbiome” scientists refer to as DYSBIOSIS.  Oh, and lets not forget lipopolysaccharides (HERE — aka endotoxins).  The mice that were given aspartame in their drinking water showed that “IAP activity was reduced by 50% compared with controls.”  And not too surprising, the aspartame group gained significantly more weight than the water group did.  Finally (whew!), we make it to 2018, where researchers from the Medical University of Wisconsin and Marquette’s Medical School published a study in Experimental Biology called The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes.  The authors concluded….. (I left out the crazy technical stuff).

“As diabetes and obesity become a rising worldwide heath concern there has been an increased awareness of environmental factors, such as diet, that are contributing to the problem. The negative implications of consuming high amounts of dietary sugar on overall health have long been linked to diabetes, obesity, cardiovascular disease, and other systemic health problems.  However, it was not until recently that the negative impact of consuming non-caloric artificial sweeteners in the place of sugar had been increasingly recognized as a potential contributor to the dramatic increase in diabetes and obesity, along with the associated complications. Overall, results of this study suggests that exposure to high glucose and artificial sweetener administration lead to unique mechanisms of vascular impairment and homeostatic alterations that may be important during the onset and progression of diabetes and obesity.”

Do you know what “vascular impairment” is folks?  It means that your blood vessels are screwed up and weakened.  Impair your vascular system and an increasingly likely consequence is having a stroke.  My suggestion is that you do what it takes so that you don’t have your life forever altered by a stroke.  And for Pete’s sake, give up the diet sodas and start drinking WATER.

THE DIET SODA LAW SUIT

If you wish to read about these lawsuits from an industry point of view, Elaine Watson’s article on Food Navigator (Does Diet Soda Promote Weight Gain? Debate Rages in the Courts as Coca-Cola, PepsiCo, Challenge ‘Outlandish’ Lawsuits) is a great place to start.  Bottom line; plaintiffs have been arguing that the term diet is misleading because it implies people could actually lose weight by drinking sodas laced with chemical sweeteners.  Industry has fought back saying that the word “diet” in beverage names (Diet Coke, Diet Pepsi, Diet Dew, Diet Crapola, etc) merely indicates a lower calorie (or no calorie) offering. 

As far as the “correlation is not causation” argument, while this is certainly true, the preponderance of the evidence is not only overwhelming, but continues to mount.  However, there is too much money at stake for Big Soda to stop selling gullible people on the so-called weight loss benefits of “diet” products.  Even though the second of these lawsuits was dismissed just last week (S.D.N.Y Dismisses Complaint Alleging “Diet” Soda Did Not Assist In Weight Loss), best guess is that the evidence will be there in another two or three years.  Just remember that if you are going to take on the soda industry, you had better have deep pockets because I promise you that theirs are deeper!

If you are looking to break free of your food addictions and get healthier in the process (and maybe even lose weight while you are at it), I created a post that will help the majority of you (that would be over 50% of you) do just that.  Take a look at it (HERE), and then show us some love on FACEBOOK if you like what you are seeing.  Honestly, it’s one of the simplest ways to reach the people you love and care about most with pertinent health-related information.

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