The diet soda challenge

The quick answer:  America’s love affair with diet drinks was a big mistake.  Our recipe for better health: water, on the rocks, with a slice of lime.

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Heard of the Ornery Rule?  My invention, I confess, but it says you can count on someone finding the stuff you like the most . . . to be unhealthy.  Like sugar.  We’ve taken on America’s love for sugar—excess sugar is our single biggest health problem—with these Healthy Changes:

#1   If you consume sodas or other sugared drinks, limit yourself to one (12 oz.) serving per week. 

#3   Cereal products must be made of whole grains, and have more grams of natural fiber than grams of sugar.

#6  Drink lots of water; make it your main drink.

#8   Buy candy a piece at a time; never bring a box or bag of candy into the home.

#12 Enjoy a healthy mix of snacks by making a daily snack plate.  (Because sugary snacks are often impulsive, this adds the virtue of premeditation to snacking.)  

#25 Don’t skip breakfast.  Start your day with a healthy breakfast rich in antioxidants with more fiber than sugar.

Non-sugar sugar?

A little history?  In the beginning there was no sugar, just natural sweeteners like honey,  By and by, someone discovered how to make sugar from cane and in the 1600s, colonies were established in the New World to meet the growing demand.  Fortunes were built on the sugar trade.  Even before the cotton plantations of the South, slaves were taken from Africa to the Caribbean to work the cane fields.  In Europe, because sugar was so precious at first, it was usually sold in drugstores (apothecaries).  As the effects of eating sugar became apparent, doctors began to warn of its dangers.

During this time there arose in France a lawyer turned food writer named Brillat-Savarin.  In 1825 he composed the first important book on food, The Physiology of Taste.  It became a classic and nearly two centuries later is still a good read.  Brillat-Savarin observes how health concerns about sugar were met with the mindless rejoinder, “sugar hurts nothing but the purse.”   A learned man even promised that, “if sugar should ever again be thirty sous a pound, I will drink nothing but eau sucree.”  He wasn’t alone, which brings us to America’s love affair with sugar alternatives.

In 1890 it was discovered that saccharine gave the taste of sugar without the calories.  Prescribed first for diabetics, it was approved for general use in 1958.  Some remember it for launching Diet Rite and then Tab, the first big diet drink.  With saccharine, it seemed, you really could have your cake and eat it too, if you didn’t mind the bitter aftertaste.  Other artificial sweeteners followed: including cyclamates (no longer approved in the US); and aspartame (NutraSweet, or Equal), the most controversial of the sweeteners.

Coca-Cola, building on the popularity of Tab, introduced Diet Coke, which used aspartame.  Launched in New York City in 1982 with a $100 million advertising campaign, Diet Coke was an immediate success and is now the #2 soft drink, after Coke.  Not to be outdone, Pepsi, Dr Pepper, and Mountain Dew brought out diet versions.  Again, as with sugar, a few doctors spoke out against the danger of artificial sugars but the temptation of both sweetness and slimness was irresistible.

Are diet drinks really healthier than sugar drinks? 

This brings us to the big question:  Are diet drinks healthier than sugary drinks?  Long story short, diet drinks really are unhealthy, but in different ways.  For example:

• Preterm delivery risk:  A 2010 Danish study found pregnant women who consumed one diet drink daily at 38% higher risk for preterm delivery.   There was also a dose response: women who drank four per day had a 78% greater risk.  No such risk was found for sugar drinks.
• Metabolic syndrome:  A nine-year study of 9714 people, age 45 to 64 years, reported in 2007, looked for dietary causes of metabolic syndrome (which we discussed here).  High meat intake was found to be a significant risk but the big surprise was that diet drinks increased the risk 34%. 
• Osteoporosis: There is a longtime link between diet drinks and osteoporosis, but the exact cause remains unknown.  Is calcium leached from the bones to buffer the phosphoric acid?  Or, do soda drinkers just get less calcium from sources like milk?  We haven’t figured it out yet, but perhaps it shouldn’t surprise us that research against highly profitable products doesn’t get funded.
• Kidney stones:  Where does the calcium lost from the bones go?  Some winds up as kidney stones.  An NIH study of kidney stones found two or more cola drinks each day double the risk for stones.  As the most popular drinks, sugar or diet, are colas, urologists will be busy treating those painful stones. The calcium in your diet isn’t the problem—a 1993 study found calcium from food protects against kidney stones. 
• Stroke and heart attack: A U. of Miami study of 2500 Manhattan residents followed over 9 years found a 61% higher risk of vascular events (heart attack, stroke, or vascular death) for daily diet soda drinkers vs those who abstained.  Even after controlling for known risk factors, a 48% greater risk remained.   
• Weight gain:  There’s a bag-full of studies showing diet sodas add rather than reduce weight but this shouldn’t be news.  Back in 1986 a study of 78K women ages 50-69 found nearly 2 pounds per year greater weight gain for women consuming artificial sweeteners vs. women who didn’t.  A pound or two isn’t much, but multiply it by 28 years (since Diet Coke was introduced) and you’re looking at a big gain.

The problem of weight gain for diet soda drinkers was addressed in a Yale review of prior studies.  The conclusion was that artificial sweeteners reinforce the sugar desire, without satisfying it as regular sugar does.  No surprise then that the national weight gain of recent decades parallels the growing use of artificial sweeteners—the more we eat, the more we want. Good for business, but bad for health.

There’s true irony here:  Diet drinks—despite the marketing—don’t make us slimmer, what’s worse they introduce new health risks.  We’ve been through the sugar binge, high fructose corn syrup, saccharine, and aspartame, and the bottom line seems to be that we must return to olden ways and recover our taste for flavors other than sugar, whether real or artificial. A little sugar is okay, but we've gone way past a little.

Healthy Change #31 reads much like our first Healthy Change: 

Budget Wisdom:  Americans spend about $12 billion yearly on soft drinks, I’m told.  Drinking less bottled drinks, way less, and more good old water from your tap (well, after it runs through the charcoal filter) will save you money that can be better used to buy whole foods, as well as your health.  Water on the rocks with a twist of lime—you can't beat it for value, convenience, or healthfulness.

Please comment:  This is a challenge because diet drinks are tempting, especially for moms who want something to pick them up on busy days, which can be everyday.  For this reason I’ve saved it until our 31^st week—after you’ve gained strength from the dietary improvements and extra exercise.  If you’ve successfully cut back on diet sodas, please share your experience.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Comments

[Sarah]

Just wanted to note that some of your soda history is off. TAB was Coca-cola's diet drink response to Diet Rite, the very first diet coke. I love TAB.

[Skip Hellewell]

Sarah, thanks for the correction. Can you still buy TAB?