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Diet Soda Not so Sweet When it comes to Your Health

Attention all diet soda drinkers! Did you know that you may be at a greater risk for developing metabolic syndrome and/or type two diabetes if you continue to imbibe in this particular type of bubbly? Yes, say the authors of a study published in the January 16, 2009 on-line issue of Diabetes Care.

Metabolic syndrome, also known as insulin resistance or Syndrome X, is a serious condition characterized by elevated fasting blood sugar levels, elevated cholesterol and triglycerides, and high blood pressure. Insulin is a hormone that signals the cells to absorb glucose (energy from food) from the blood stream. Diets that are high in refined sugars cause the body to secrete more insulin and over time, the cells become resistant to its effects, resulting in high blood sugar. Women who are insulin-resistant are at a greater risk for developing heart disease, diabetes, breast cancer, polycystic ovarian syndrome, endometrial cancer, and possibly, Alzheimer’s disease.

Around the time of menopause, women often become less tolerant of carbohydrate and this leads to weight gain (especially around the tummy) and fatigue- two markers of metabolic syndrome. Peri-menopausal women who have metabolic syndrome generally report increased cravings for sugar, and afternoon dips in energy. So why would diet soda, which is calorie and carbohydrate-free, be a factor in insulin resistance which affects nearly one in four Americans?

First reported in two longitudinal cohort studies, The Framingham Offspring Study, and the Atherosclerosis Risk in Communities study (ARIC), individuals who consumed a can or more of diet soda a day had a 40 percent increased risk for metabolic syndrome and a 44 percent increased risk for type two diabetes. These studies only indicated an association and did not control for variables that could increase risk, such as lack of exercise and unhealthful dietary practices. However, the results of a recent large population-based study of over 6000 individuals, (the Multi-Ethnic Study of Atherosclerosis or MESA), revealed that participants who drank diet soda daily had a 36 percent greater relative risk for metabolic syndrome and a 67 percent greater relative risk for type two diabetes than individuals who did not drink diet soda. Of the individual components of metabolic syndrome, only high waist circumference (men ≥102 cm; women ≥88 cm) and high fasting blood glucose (≥ 100) were associated with diet soda consumption. Unlike earlier studies, demographic, lifestyle, and other dietary habits were adjusted for.

There are a couple of theories as to why soda drinking may be linked to metabolic syndrome. It is possible that artificial sweeteners “trick” the body’s satiety center causing an individual to overindulge in sugary, high-fat foods. Also implicated in insulin resistance is the caramel content of soft drinks. It is thought that caramel promotes metabolic changes and inflammation, which eventually lead to insulin resistance.

So, should you ditch your diet soda? While the jury is still out on whether artificial sweeteners are definitive cause of metabolic syndrome, it may be a good idea to limit your consumption. Individuals who are inactive, have excessive abdominal weight, and whose diets are rich in refined carbohydrates are at a greater risk for insulin resistance. It is possible that these factors combined with excessive diet soda consumption may lead to impaired glucose tolerance and eventual diabetes.

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