A review of studies following 37,716 men and 80,647 women for 28 to 34 years shows that drinking a lot of soda or sports drinks is associated with a 28 percent increased risk of early death from any cause, a 31 percent increased risk of death from heart disease and a 16 percent increased risk of death from cancer (Circulation, March 18, 2019). The authors corrected their data for other known causes of premature death such as a pro-inflammatory diet, lack of exercise or obesity. Sodas are the highest source of added sugar in the North American diet, and it is sobering to learn that 50 percent of North American adults drink at least one sugared beverage each day. Sugared beverages are associated with taking in too many calories from other sources and with increased risk for high blood pressure, high sugar and high cholesterol. Fruit juices are also implicated; they raise total cholesterol, the bad LDL cholesterol, triglycerides, and blood pressure (American Journal of Clinical Nutrition, August 13, 2010), and increase risk for weight gain (Preventive Medicine, January 12, 2018) and diabetes (Arch Intern Med, 2008;168(14):1487-1492).
Evidence Against Artificial Sweeteners Two recent studies add to the evidence that artificially sweetened diet drinks increase risk for obesity, strokes, dementia, diabetes and pre-diabetes:
• Drinking two or more artificially sweetened drinks per day is associated with an increased risk of strokes, heart attacks, and early death, particularly in overweight women over 50 (Stroke, Feb 14, 2019). More than 80,000 healthy post-menopausal women were followed for almost 12 years. Those who consumed two or more 12-ounce artificially sweetened beverages each day were 31 percent more likely to have a clot-based stroke, 29 percent more likely to have heart disease and 16 percent more likely to die from any cause during the study period, compared to women who drank diet beverages less than once a week or not at all. Obese women were twice as likely to suffer clotting strokes, but non-obese women were not at increased risk.
• A review of 56 studies showed that adults and children gain weight on artificial sweeteners and gain even more on sugared drinks (BMJ, Jan 7, 2019).
Sugar and Artificial Sweeteners Both Change Colon Bacteria Both sugar and artificial sweeteners increase growth of harmful bacteria and decrease growth of healthful bacteria in your colon (PNAS, January 2, 2019;116(1):233-238; Nature, September 17 2014). Healthful bacteria in your colon convert the soluble fiber in fruits and vegetables into short chain fatty acids that lower high cholesterol and high blood pressure, make cells more responsive to insulin to help prevent diabetes, and reduce inflammation that causes cancer and heart attacks. Artificial sweeteners appear to block these healthful bacteria that produce short-chain fatty acids (Molecules, Feb 9, 2018;23(2):367). Researchers used genetically modified bioluminescent bacteria from E. coli to show that taking artificial sweeteners can cause toxic bacteria to overgrow in the colon and produce harmful chemicals (Molecules, Sept 25, 2018;23(10):2454). See Artificial Sweeteners Alter Gut Bacteria
My Recommendations Unless you are in the midst of a long, vigorous exercise session, I recommend that you drink only water or unsweetened coffee or tea. For my recommendations on use of sugared drinks during intense exercise, see Sugar for Prolonged Hard Exercise
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