Long-Term Effects of Energy Drinks

By Gary Wickman | Recovery Addiction | Rating:

Within the past decade there has been a growing popularity of energy drinks of which
there are innumerable brands that you can find in literally every store in the country.
From corner curb stores to large supermarket chains you will see at least two or three
brands in the cooler behind those tempting glass doors. The problem with energy
drinks seems to be that no one really knows for sure what the long term effects are,
but based on the ingredients it is safe to assume that the most dangerous ingredient in
them seems to be caffeine, and its deceptive counterpart, guarana.
Unfortunately, there is a lot of misleading information floating around about guarana
which touts it as being a safer alternative to caffeine. Nonsense! The chemical in
guarana that gives us that boost is guarine which is, in fact, another name for
caffeine! It just comes from a different plant. And of course, a rose by any other name
is still a rose! While there is still a certain amount of controversy as to just what the
long term effects of caffeine are, there are four major areas that have been associated
(and well documented) with the long term effects of caffeine.
Caffeine Addiction
It is true that caffeine gives us that quick pulse of energy when called upon, but
drinking caffeinated drinks over time will lead to a caffeine addiction. You may notice
that I said will lead to a caffeine addiction and not may lead to one. You may not
realize it but caffeine is one of the most addictive substances on earth and if you
consume it every day over a period of years your body will become dependent on it in
more ways than one. Caffeine addiction is not only in the area of energy, but caffeine
addiction is also prevalent in other areas of the body as well.
Diuretic Dependence
Most of those OTC diet pills that claim to have a diuretic in them to help with water
retention simply have caffeine. The caffeine is meant to provide extra energy that
dieters arent getting from foods, but will also stimulate the production of urine which
is what any self respecting diuretic should do. However, the downside to that is that
over time, your body may become dependent on caffeine to stimulate kidney function
and should you suddenly deprive your body of it, there could be serious
consequences such as a loss of kidney function and a buildup of toxic urea.
Cardiovascular Disease
Because we know that caffeine speeds up the heart rate and also has been known to
elevate blood pressure, there is growing concern over the amount of people with
cardiovascular disease that have spent a lifetime drinking coffee, and other caffeinated
beverages such as those potent energy drinks that are loaded with it. There is
empirical data which substantiates that caffeine may lead to arteriosclerosis, or
hardening of the arteries. Not only does it put you at risk for heart disease, but you
may also be at an increased risk for strokes.
Osteoporosis
Of all the long term effects of energy drinks containing caffeine, osteoporosis is the
least publicized risk factor. There are growing bodies of evidence that indicate the
correlation between caffeine with the onset of and rate in which osteoporosis is
evidenced in the body. This is thought to be because of the way in which caffeine
promotes the loss of calcium in bones. While there is yet to be conclusive findings,
evidence is leaning in that direction.
Of course there are also other long term effects that we are well aware of. Disrupted
sleep patterns over a long period of time can cause permanent problems which have
even been associated with sleep apnea. The real problem however is the fact that
caffeine, and as a direct result of caffeine, energy drinks are addictive. A onetime
beverage isnt likely to cause any long term effects unless, of course, that rapid heart
rate or elevated blood pressure causes an immediate arrhythmia leading to a heart
attack. It is the long term effects we should be worried about, the greatest of which is
addiction that leads to all the others.






































A closer look at the health problems linked to soft drink consumption

Now, lets take a look at the various problems and health risks associated with diet
soft drinks. First, the most obvious: artificial chemical sweeteners:


Artificial chemical sweeteners
Factoid: One liter of most aspartame-sweetened soft drinks contains about 55 mg of
methanol.
- H.J. Roberts, M.D., Aspartame: Is It Safe?
Weve already covered artificial chemical sweeteners in some detail, so Ill limit my
comments in this section.

But allow me to summarize what weve learned so far:
Most diet soft drinks are sweetened with aspartame. It is well known that
aspartame breaks down into methanol (free methyl alcohol) which is a
chemical regulated by the EPA and considered an environmental pollutant.
This methanol, in turn, breaks down into formic acid and formaldehyde inside
the human body.
Formaldehyde is a potent nerve toxin, which may explain why so many users
of aspartame complain of nerve-related symptoms such as blindness,
dizziness, migraine headaches, and seizures. Aspartame alone is responsible
for 75 percent of the food and beverage-related health complaints to the FDA.
Aspartame remains legal solely due to the financial and political interests of
those who profit from its sales and consumption. The FDA does not protect
the public from aspartame because the FDA generally acts in collusion with
private industry, rather than in the interests of the general public.
It is my belief that when the truth about aspartame becomes publicly known, this
substance will join the artificial sweetener cyclamate on the list of highly toxic
chemicals permanently banned from use in the food supply.

When this ban is put in place, I predict the FDA will champion that ban, claiming they
are protecting the public!. Sure they are, but only after tens of millions have been
unnecessarily harmed.

As a reminder of the toxic nature of aspartame, heres a quote from the book
Aspartame: Is It Safe?
The unknowing consumption of aspartame, whether by ingestion or the chewing of
gum, predictably triggered subsequent grand mal seizures. The amount of aspartame
ingested in some patients was remarkably small.

This is illustrated by (1) an infant who developed convulsions when his nursing
mother drank an aspartame soft drink, and (2) a young woman believed to have
aspartame-related epilepsy who convulsed within minutes after chewing one piece of
sugar-free gum.
- H. J. Roberts, M.D., Aspartame: Is It Safe?

Soft drinks, phosphorus, meat and osteoporosis
In addition to the significant health risks posed by the artificial chemical sweeteners
found in diet soft drinks, another major health risk exists.

This one is rarely discussed, however, and because few people know about it. They
happily drink gallons and gallons of diet soft drinks each year, thinking they are
protecting themselves from the ravages of refined sugars and high-fructose corn
syrup.

What they dont realize is that while they may be avoiding the refined sugars, they are
not at all avoiding another problem thats perhaps worse: the dangerous mineral
imbalance.

To understand how this works, however, youll first need a fundamental
understanding of how minerals operate in the human body. Minerals like calcium and
magnesium must be present in a specific ratio (2 to 1, in this case) in order to support
healthy, balanced function in the human body. If this ratio is substantially altered,
imbalances begin to occur.

These mineral imbalances can create destructive health consequences.

One crucial mineral ratio in the human body is the calcium-to-phosphorus ratio. For
optimum balance and healthy function throughout the body, calcium and phosphorus
must exist in a ratio of around 1:1. In other words, for every 500mg of calcium you
consume, you should ideally get 500mg of phosphorus as well.

The standard American diet is way too high in phosphorus due to its heavy reliance
on foods and beverages with a high phosphorus content such as meats and dairy
products. All by itself, this dietary pattern presents possible imbalances in the
calcium-to-phosphorus ratio.

Many people are simply not getting enough calcium in their bodies, but they are
consuming an excess of phosphorus through meats and other high-protein foods
(protein, in general, contains a high phosphorus content). Remember: phosphorus
isnt a bad mineral, in fact it is essential to your health. Whats bad here is the ratio
of these minerals when phosphorus is consumed in excess.

Theres also the issue of the acidity of soft drinks.

When you consume these highly acidic beverages, your body must neutralize that
acid by buffering it with alkaline minerals such as calcium. And where do you think
your body might find stores of calcium? Your bones, of course, which are sort of like
calcium banks as far as your body is concerned.

In this way, eating or drinking soft drinks results in your body tapping your bones in
order to find the calcium needed to balance the phosphorus ratio in your body.

This calcium is stripped from your bones and then eliminated through your urine.


When you drink soft drinks, you are peeing away your bones
To put it simply, if you frequently drink soft drinks, you are initiating a series of
biochemical cause-and-effect events that result in you literally peeing your bones
away.

As explained in The Encyclopedia of Natural Medicine:
Soft drinks have long been suspected of leading to lower calcium levels and higher
phosphate levels in the blood. When phosphate levels are high and calcium levels are
low, calcium is pulled out of the bones. The phosphate content of soft drinks is very
high, and they contain virtually no calcium. It appears that increased soft-drink
consumption is a major factor that contributes to osteoporosis.

The link between soft-drink consumption and bone loss is going to become even
more significant as children who were practically weaned on soft drinks reach
adulthood. Soft-drink consumption in children poses a significant risk factor for
impaired calcification of growing bones.

Since there is such a strong correlation between maximum bone-mineral density and
the risk of osteoporosis, the rate of osteoporosis may reach even greater epidemic
proportions.

The severe negative impact that soft drinks exert on bone formation in children was
clearly demonstrated in a study that compared fifty-seven children with low blood
calcium levels, aged eighteen months to fourteen years, to 171 matched controls
(children with normal calcium levels). The goal of the study was to assess whether
the intake of at least 1.5 quarts per week of phosphate-containing soft drinks is a risk
factor for the development of low blood calcium levels. Not surprisingly, a strong
association was found.

Of the fifty-seven children who had low blood calcium levels, thirty-eight (66.7 percent)
drank more than four bottles (12 to 16 ounces per bottle) of soft drinks per week, but
only forty-eight (28 percent) of the 171 children with normal serum calcium levels
consumed as much soft drink. For all 228 children, a significant correlation between
serum calcium level and the number of bottles of soft drink consumed each week was
found. The more soft drinks consumed, the lower the calcium level.

These results more than support the contention that soft-drink consumption leads to
lower calcium levels in children.

This situation that ultimately leads to poor bone mineralization, which explains the
greater risk of broken bones in children who consume soft drinks.
Although this study focused on children, the same is true for adults: the more soft
drinks you consume (diet or otherwise), the lower your levels of calcium. These soft
drinks literally leach calcium right out of your bones.

Loss of calcium and bone mass, not surprisingly, leads directly to osteoporosis and
other bone disorders:
The skeletal system suffers most from calcium deficiency. Teeth minerals are more
stable, though there is a possibility of poor dentition with insufficient calcium. Tooth
loss, periodontal disease, and gingivitis can be problems, especially with a high
phosphorus intake, particularly from soft drinks. All kinds of bone problems can
occur with prolonged calcium deficiency, which causes a decrease in bone mass.

Rickets in children, osteomalacia (decreased bone calcium) in adults, and
osteoporosis (porous and fragile bones) can occur when calcium is withdrawn from
bones faster than it is deposited. Fractures are more common with osteoporosis -
almost eight million yearly in the United States are related to this prevalent nutritional
deficiency disease

The typical American diet provides too much phosphorus and not enough calcium,
leading to reduced body storage of calcium; thus, many of the problems of calcium
deficiency discussed earlier may develop. Phosphorus and calcium can compete for
absorption in the intestines. High consumption of meats or soft drinks increases
phosphorus intake and may contribute to this imbalance. The ideal ratio of calcium to
phosphorus in the diet is 1:1.

In recent years, the increased consumption of soft drinks, which are buffered with
phosphates, has been a concern. There may be up to 500 mg. of phosphorus per
serving of a soft drink, with essentially no calcium.
- Elson Haas M.D., Staying Healthy With Nutrition

High phosphorus content combines with high meat consumption to spell disaster
As the statement above describes, most Americans diets are too high in phosphorus
to begin with. If you add diet soft drinks, your phosphorus consumption skyrockets.

This only accelerates the loss of calcium from bones and the subsequent bone
disorders that naturally result.
...one of the leading contributors to osteoporosis in the U.S. is carbonated soft drinks
containing phosphorus. Research has shown a direct link between too much
phosphorus and calcium loss. If youre guzzling down a couple of fizzy soft drinks a
day, youre most likely creating bone loss.

Our other source of excessive phosphorus in the U.S. is eating too much meat. The
average American gets more than enough protein, so for most of us it can only help
to cut down on our meat consumption.
- Earl Mindell, Ph.D., Prescription Alternatives
Dr. James Balch, author of the A to Z Guide To Supplements, supports the same line
of thinking:
The average American diet of meats, refined grains, and soft drinks (which are high in
phosphorus) leads to increased excretion of calcium. Consuming alcoholic
beverages, coffee, junk foods, excess salt, and/or white flour also leads to the loss of
calcium by the body
- James F. Balch, M.D., A to Z Guide To Supplements
The meat connection to excess dietary phosphorus is also well explained in The
Doctors Complete Guide to Vitamins and Minerals:
Excess dietary phosphorus, found in meat, soft drinks, grains, and potatoes, may
promote bone loss by interfering with calcium balance. In theory, the higher your
phosphorus intake, the greater your tendency to leech calcium out of bones, which
could weaken the bony foundation beneath your gums. Recommendation: ...try not to
drink carbonated soft drinks, diet or otherwise.
As you can see, high-protein diets and soft drink consumption multiply each others
mineral imbalances.

While avoiding refined carbohydrates is a very healthy way to lose weight, if people
dont pay attention to their calcium / phosphorus ratios, some of their weight loss
may actually be due to their loss of bone mass!


Calcium supplements alone wont solve this problem
You might think you could solve this problem by simply taking calcium supplements.

But think again: the high consumption of phosphorus actually makes it difficult for
your body to absorb calcium. Phosphorus competes with calcium for absorption in
the intestines, meaning that the more phosphorus you have in your diet, the less
calcium you can actually absorb.

In this way, taking calcium supplements in order to balance the consumption of diet
soft drinks may not be nearly as effective as you hoped:
If your diet contains an excess of phosphorus, from too much animal protein or too
many carbonated soft drinks, you may fail to absorb calcium from your food as well
as lose more calcium from your urine. Americans tend to eat more phosphorus than
calcium, which looms large if you are at risk for bone thinning. ...Avoid carbonated
soft drinks and yeast products.
- Mary Dan Eades, M.D., The Doctors Complete Guide to Vitamins and Minerals
Eventually, with enough bone loss and depleted calcium stores, bone fractures start
to occur at an accelerated rate.

This has been well demonstrated in clinical studies of soft drink consumption, even
in young adults who typically have stronger bones than those who are older:
Significant calcium imbalance can come about as a result of high intakes of
phosphorus. Phosphorus is present in high quantities in protein-containing foods
and soft drinks. There is some evidence that due to the large increase in soft drinks in
the last decade that this factor alone may contribute to poor peak bone mass in
younger individuals.

Based on data from more than 4,000 children aged 2-17 years, soda consumption
among children and adolescents rose 41 percent in the time period of 1989-1991
compared to 1994-1995. A 1994 study of 127 children aged 8-16 found that 39 percent
of the girls and 41 percent of the boys had a history of bone fracture.

Girls who consumed greater amounts of cola beverages had a higher incidence of
fractures than those who consumed low amounts. A high calcium intake was found to
protect against fractures, particularly among girls who had high physical activity
(Ballew et al. 2000).
- Disease Prevention and Treatment by the Life Extension Foundation
(If you noticed, this study also showed that high physical activity helped protect
against bone fractures - something Ive advocated for years. The more physical you
get on a daily basis, the stronger your bones.)

This study showed that calcium supplementation helped prevent bone fractures. It
only makes sense: if you get more calcium, you will help balance out the ratios. But
as the earlier quotes mentioned, the absorption of that calcium may be seriously
impaired by the excessive phosphorus. This is why the best strategy is to reduce
phosphorus intake in order to balance the calcium / phosphorus ratio in your body.

And the easiest way to do that is to simply avoid soft drinks for life.



Milk is not the answer to calcium deficiency

Many people think they are getting plenty of calcium from all the milk they consume,
and therefore, they think they can drink diet soft drinks without worrying about the
imbalance.

The more milk they drink, they say, the more soft drinks they can safely consume.

This position is sadly misinformed. Milk doesnt have much calcium in it to begin with,
regardless of the hype and promotional efforts of the dairy industry (which will be
discussed in greater detail later). A cup of broccoli juice, for example, has more
calcium than a cup of milk. An ounce of spirulina (a micro-algae superfood) has far
more calcium than milk, along with magnesium and zinc as well.

Secondly, the calcium in milk isnt well utilized by the human body unless magnesium
and vitamin D are also present - and both of these are typically lacking in the
American diet.

Milk also contributes to the phosphorus mineral imbalance due to its own high
phosphorus and protein content:
Too much protein - milk again, as well as meat - increases calcium loss. Also,
phosphates (in processed foods and soft drinks, common in the average childs diet)
can cause calcium loss or excretion.
-Robyn Landis, Herbal Defense
Supplementing with magnesium would help your body absorb more supplementary
calcium, and increased exposure to healthy, natural sunlight would increase vitamin
D stores, but even then, there are far better places to get calcium. Namely: whole food
complexes and superfoods like chlorella and spirulina.

Plant sources of calcium are clearly your best choice:
Obtain as much calcium and magnesium and other trace minerals from your diet as
possible by ...eating dark green leafy vegetables, broccoli, nuts, and seeds; eliminate
or reduce the use of colas and other soft drinks in order to decrease phosphorus
intake.

Postmenopausal women should probably supplement with calcium/magnesium
capsules.

Calcium citrate is generally better absorbed and utilized than calcium carbonate.
Daily intakes should reach at least 1,000 mg of calcium and 500 mg of magnesium,
along with sufficient trace minerals including zinc, boron, and copper.
- Disease Prevention and Treatment


Soft drinks make you ugly by altering your facial bone structure

Consuming soft drinks can even alter your physical appearance by slowly destroying
the bone structure of your face and jaw.

Much of the calcium loss that impacts bones affects the dominant jawbone, which
makes a persons face look old, weak and sunken:
The differences between people who had eaten their ancestral diet from birth and
people who had feasted on sugar, white flour products, and soft drinks are
astonishing. The traditional wholesome diet produced wide faces with jaws wide
enough to accommodate all thirty-two teeth with proper spacing, high cheekbones,
few to no cavitations, and wide foreheads to house their brains.

The facial structures of the people who enjoyed a more civilized diet are not so
beautiful. Their jaws are narrow with so little room that the teeth crowd together in
two crooked rows. Cavities are common, and in cultures where dental care is
inadequate, the pain and suffering are intolerable.

Their foreheads are also narrow, or misshapen, with scarcely enough room for a
growing brain.
-Carol Simontacchi, The Crazy Makers
The solution to everything presented here is deceptively simple: drink water, not soft
drinks. Its the only liquid I consume: no soft drinks, no juices, no milk.

And yet so many people simply refuse to drink water:
Americans dont drink very much water. We drink coffee, a beverage that pulls even
more minerals out of the tissues and excretes them in the urine. Americans drink soft
drinks that are often loaded with more sodium and which further unbalance the
mineral stores. We drink V8, loaded with sodium. We drink everything but water,
which would pull the excess sodium out of the blood and out of the brain.

We defeat the bodys own mechanism of balancing the critical sodium-to-potassium
ratios by overindulging in these entrees and beverages that contain so much sodium,
and then by not drinking water to flush it out of the system.
-Carol Simontacchi, The Crazy Makers
So just how serious is this problem of calcium depletion and bone mass loss in the
first place? Its a hidden, destructive health consequence that comes from drinking
any kind of soft drinks, and very few people are aware of this.

Heres an extended collection of additional quotes from doctors and authors on this
subject:
Diets high in sugar alter calcium uptake; coffee, alcoholic beverages, and
phosphorous-rich soft drinks also promote increased calcium excretion.
- Disease Prevention and Treatment by The Life Extension Foundation


Many general dietary factors have been suggested as a cause of osteoporosis,
including: low calcium-high phosphorus intake, high-protein diet, high-acid-ash diet,
high salt intake, and trace mineral deficiencies. It appears that increased soft-drink
consumption is a major factor that contributes to osteoporosis.
- Michael T. Murray, N.D., The Encyclopedia of Natural Medicine


Avoid soft drinks. One study of 460 young, very active girls found that those who
drank colas were five times more likely to suffer fractures than girls of equal activity
who avoided soft drinks. It is suspected that because phosphorus draws calcium
from bone, it is the culprit in such cases. Cows milk is also high in phosphorus, as
well as protein. Avoid all soft drinks, especially those sweetened with aspartame.
Carbonated soft drinks deplete the bodys magnesium.
- Russell Blaylock, M.D., Health and Nutrition Secrets That Can Save Your Life


Phase out soft drinks. Canned soda contains excess phosphorus, a mineral that
could lead to the leaching of calcium from your bones, a potential cause of
osteoporosis. Some researchers believe that calcium is first robbed not from your
hips or spine but from your jaw, leading to tooth loss, says Ken Wical, D.D.S.,
professor of restorative dentistry at Loma Linda University in California.
- Healing With Vitamins by Prevention Magazine
Action Item:
Avoid soft drinks for life.
Drink water or tea, but no acidic drinks like fruit juices
or nutritionally imbalanced drinks like cows milk.






Soft Drinks and Weight
Historians may someday call the period between the early 1980s
and 2009 the fattening of America. Between 1985 and now, the
proportion of Americans who are overweight or obese has
ballooned from 45 percent in the mid-1960s to 66 percent today.
(The Centers for Disease Control and Prevention has an online
slide show that shows the spread of obesity in the U.S.) There's no
single cause for this increase; instead, there are many contributors.
One of them is almost certainly our penchant for quenching our thirst with beverages
other than water.
Once upon a time, humans got almost all of their calories from what nature put into
food. That changed with the advent of cheap sugar, and then cheaper high-fructose
corn syrup. Sugar added to food now accounts for nearly 16 percent of the average
American's daily intake. Sweetened soft drinks make up nearly half of that. (3)

High-fructose corn syrup has been fingered as one of the villains in the obesity
epidemic. (2) But in fact, table sugar and corn sweeteners likely have the same
physiological impact on blood sugar, insulin, and metabolism. Read more about high
fructose corn syrup and health.
Dozens of studies have explored possible links between soft drinks and weight. It isn't
an easy task, for several reasons (read Sorting Out Studies on Soft Drinks and
Weight to learn why). Despite these research challenges, studies consistently show
that increased consumption of soft drinks is associated with increased energy intake.
In a meta-analysis of 30 studies in this area, 10 of 12 cross-sectional studies, five of
five longitudinal studies, and four of four long-term experimental studies showed this
positive association. (3) A different meta-analysis of 88 studies showed that the effect
appeared to be stronger in women, studies focusing on sugar-sweetened soft drinks,
and studies not funded by the food industry. (4) Studies in children and adults have
also shown that cutting back on sugary drinks can lead to weight loss. (5, 6)
On the surface, it makes sense that the more ounces of sugar-rich soft drink a person
has each day, the more calories he or she takes in. Yet that runs counter to what
happens with solid foods. People tend to compensate for a bigger than usual meal or
for a snack by taking in fewer calories later. That's how weight stays stable. This
compensation doesn't seem to happen with soft drinks. No one knows for sure why
this happens, but there are several possibilities:
Fluids may not be as satiating as solid foods. That means they don't provide the
same feeling of fullness or satisfaction that solid foods do, which might prompt you
to keep eating.
The body doesn't seem to "register" fluid calories as carefully as it does those from
solid food. This would mean they are added on top of calories from the rest of the
diet. (7)
It is possible that sweet-tasting soft drinksregardless of whether they are
sweetened with sugar or a calorie-free sugar substitutemight stimulate the
appetite for other sweet, high-carbohydrate foods.
Soft Drinks and Diabetes
Gulping the equivalent of 10 teaspoons of sugar over the course of a few minutes
gives the body's blood sugar controls a run for their money. Most people handle a
blast of blood sugar just fine. Over time, though, a diet rich in easily digested
carbohydrates may lead to type 2 diabetes (once called non-insulin-dependent
diabetes and adult-onset diabetes).

Some sources ofcarbohydrate are healthier than others, and sugar
added to foods and drinks falls into the less-healthy groupno matter
whether it's table sugar or brown sugar, honey orhigh-fructose corn
syrup, or any other type of added sugar. A good goal is keeping added
sugars from all sources to under 10 percent of your daily calories. But remember
your body doesn't need to get any carbohydrate from added sugar. That's why
theHealthy Eating Pyramid says sugary drinks and sweets should be used sparingly, if
at all. Learn how to find added sugar on a food label.
Strong evidence indicates that sugar-sweetened soft drinks contribute to the
development of this potentially disabling disease. The Nurses' Health Study explored
this connection by following the health of more than 90,000 women for eight years. The
nurses who said they had one or more servings a day of a sugar-sweetened soft drink
or fruit punch were twice as likely to have developed type 2 diabetes during the study
than those who rarely had these beverages. (8)
See a chart showing how sugary drinks contribute to the risk type 2 diabetes.
A similar increase in risk of diabetes with increasing soft drink and fruit drink
consumption was seen recently in the Black Women's Health Study, an ongoing long-
term study of nearly 60,000 African-American women from all parts of the United States.
(9) Interestingly, the increased risk with soft drinks was tightly linked to increased
weight.
In the Framingham Heart Study, men and women who had one or more soft drinks a
day were 25 percent more likely to have developed trouble managing blood sugar and
nearly 50 percent more likely to have developed metabolic syndrome. This is a
constellation of factorshigh blood pressure; high insulin levels; excess weight,
especially around the abdomen; high levels of triglycerides; and low levels of HDL
(good) cholesterolthat is one step short of full blown diabetes and boosts the odds
of developing heart disease. (10)
Soft Drinks and Heart Disease
Obesity and diabetes are both strong risk factors for heart disease, the number one
killer of men and women in the U.S. Given that drinking sugary beverages increases
the risk of both obesity and diabetes, it is a natural question to ask whether drinking
sugary beverages increases the risk of heart disease, too.

Q. What is the glycemic load?
The glycemic load is a way to classify foods that takes into account both the amount
and the quality of the carbohydrates that they contain. Foods that are high in rapidly
digested carbohydratea can of sugary soda pop, a handful of jelly beans, a plateful
of pastahave a high glycemic load. Eating a diet rich in high-glycemic-load foods
may, over time, lead to type 2 diabetes, heart disease, and other conditions.Learn more
about the glycemic load and health.
The answer from the first long-term study to ask that question is a resounding yes: The
Nurses' Health Study, which tracked the health of nearly 90,000 women over two
decades, found that women who drank more than two servings of sugary beverage
each day had a 40 percent higher risk of heart attacks or death from heart disease than
women who rarely drank sugary beverages. (11)
Of course, people who drink a lot of sugary drinks often tend to weigh moreand eat
less healthfullythan people who don't drink sugary drinks, and the volunteers in the
Nurses' Health Study were no exception. But researchers accounted for differences in
diet quality, energy intake, and weight among the study volunteers. They found that
having an otherwise healthy diet, or being at a healthy weight, only slightly diminished
the risk associated with drinking sugary beverages.
This suggests that weighing too much, or simply eating too many calories, may only
partly explain the relationship between sugary drinks and heart disease. The adverse
effects of the high glycemic load from these beverages on blood glucose, cholesterol
fractions, and inflammatory factors probably also contribute to the higher risk of heart
disease.
Soft Drinks and Bones
There's also some concern about the impact of soft drinks on building
bone and keeping it strong and healthy. There is an inverse pattern
between soft drinks and milkwhen one goes up, the other goes
down. (4) Trading milk for soft drinks isn't a good swap. Milk is a good
source of calcium and protein, and also provides vitamin D, vitamin
B6,vitamin B12, and other micronutrients (of course you can drink too
much milk, too; seeCalcium and Milk: What's Best for Your Bones and
Health, for more information). Soft drinks are generally devoid of
calcium and other healthful nutrients. And just adding vitamins and
minerals to sugar water does not make a healthy drink. Getting
enough calcium is extremely important during childhood and
adolescence, when bones are being built. Yet soft drinks are actively
marketed to these age groups, and they are key consumers of sugar-sweetened
beverages.
Cola-type beverages may pose a special challenge to healthy bones. Colas contain
high levels of phosphate. On the surface, this sounds like a good thing, because bone
needs both calcium and phosphate. But getting much more phosphate than calcium
can have a deleterious effect on bone. (3)
What About Diet Soft Drinks? Artificial Sweeteners and Weight Control
Using artificial sweeteners in soft drinks instead of sugar or high-fructose corn syrup
seems like it would sidestep any problems with weight or diabetes. Artificial
sweeteners deliver zero carbohydrates, fat, and protein, so they can't directly influence
calorie intake or blood sugar. Over the short term, switching from sugar-sweetened
soft drinks to diet drinks cuts calories and leads to weight loss. Long-term use, though,
may be a different story.

Q. What is stevia?
Stevia is a non-caloric sweetener made from the leaves of a shrub that
grows in South and Central America. Its manufacturers say that it is safe;
while the FDA has not done its own safety evaluation, it has not objected
to these safety findings, (13) paving the way for stevia's incorporation
into foods and drinks. Stevia is about 300 times sweeter than sugar.
Early reports that stevia might cause cancer had made the FDA demand more
information from manufacturers about its safety. A number of major soft drink
companies have begun launching stevia-sweetened beverages, sometimes combining
stevia with erythritol, a sugar alcohol. There are no long-term studies of the health
effects of stevia, however, so drinkers beware.
To date, the FDA has approved the use of five artificial sweeteners. Gram for gram,
each one is far sweeter than sugar. (12) They include:
aspartame (Equal

, NutraSweet

, others), 180 times sweeter than sugar

acesulfame-K (Sunett

, Sweet One

), 200 times sweeter than sugar

saccharin (Sweet'N Low

, Necta Sweet

, others), 300 times sweeter than sugar

sucralose (Splenda

), 600 times sweeter than sugar

neotame (no brand names), 7,000 to 13,000 times sweeter than sugar
Some long-term studies show that regular consumption of artificially sweetened
beverages reduces the intake of calories and promotes weight loss or maintenance.
Others show no effect, while some show weight gain. (12)
One worry about artificial sweeteners is that they uncouple sweetness and energy.
Until recently, sweet taste meant sugar, and thus energy. The human brain responds to
sweetness with signals to, at first, eat more and then with signals to slow down and
stop eating. By providing a sweet taste without any calories, artificial sweeteners could
confuse these intricate feedback loops that involve the brain, stomach, nerves, and
hormones. If this happens, it could throw off the body's ability to accurately gauge how
many calories are being taken in.
Studies in rats support this idea. Purdue University researchers have shown that rats
eating food sweetened with saccharin took in more calories and gained more weight
than rats fed sugar-sweetened food. (14) A long-term study of nearly 3,700 residents of
San Antonio, Texas, showed that those who averaged three or more artificially
sweetened beverages a day were more likely to have gained weight over an eight-year
period than those who didn't drink artificially sweetened beverages. (15) Although this
finding is suggestive, keep in mind that it doesn't prove that artificially sweetened soft
drinks caused the weight gain.

Q. Are sweeteners like erythritol and xylitol good alternatives to sugar?
Erythritol and xylitol are sugar alcohols, a class of compounds that have been used for
decades to sweeten chewing gum, candy, fruit spreads, toothpaste, cough syrup, and
other products. Newer, cheaper ways to make sugar alcohols from corn, wood, and
other plant materials, along with their sugar-like taste, are fueling their use in a
growing array of foods. Read more about sugar alcohols.
Imaging studies support the idea that sugar and artificial sweeteners affect the brain in
different ways. Some parts of the brain become activated when we experience a "food
reward." At the University of California-San Diego, researchers performed functional
MRI scans as volunteers took small sips of water sweetened with sugar or sucralose.
Sugar activated regions of the brain involved in food rewards, while sucralose didn't.
(16) So it is possible, the authors say, that sucralose "may not fully satisfy a desire for
natural caloric sweet ingestion." More research is needed to tease out the implications
of these findings for weight control.
Although the scientific findings are mixed and not conclusive, there is worrisome
evidence that regular use of artificial sweeteners may promote weight gain. Because of
these mixed findings about artificial sweeteners, drinking diet soda may not be the
best replacement for drinking sugary soda.