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All Sweet Drinks May Harm You

Many studies associate artificially sweetened diet drinks with increased risk for obesity, strokes, dementia, diabetes and pre-diabetes. Two studies published this month give more evidence:
• 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).

Artificial Sweeteners Can Change Gut Bacteria
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

Artificial Sweeteners Can Make You Hungrier and Fatter
Artificially sweetened drinks may cause people to eat more food, which raises blood sugar levels and increases risk for gaining weight and becoming diabetic (Current Biology, August 11, 2017). In this study, which was partially funded by PepsiCo, researchers manipulated beverages so their subjects would not know what they were drinking. They changed the calorie content by adding tasteless maltodextrin, and made them more or less sweet with an artificial sweetener, sucralose. This study found that a sweeter-tasting, lower-calorie drink was more likely to make people hungrier than a less-sweet drink with more calories.

A review of 30 studies followed for up to 10 years showed that artificial sweeteners such as aspartame, sucralose and stevioside were associated with weight gain, increased waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and heart attacks (Canadian Medical Association Journal, Jul 17, 2017;189(28):E929-E939). People who took one diet drink per day were three times more likely than non-diet-soda drinkers to suffer a stroke (Stroke, April 20, 2017), and to have poorer memory, smaller brains, and markers of accelerated brain aging, and to become demented (Alzheimer's & Dementia, published online March 5, 2017).

Sugared Drinks Can Be Even Worse
One can of sugar-sweetened soda contains 25 to 50 grams of sugar, the recommended upper limit for an entire day for most people. Several research papers have associated all sugared drinks with weight gain and diabetes (BMJ, 2015;351:h3576), high blood pressure, high cholesterol, heart attacks and strokes (Circulation, 2012;125:1735–1741), some types of cancers (Annual Review of Nutrition, August 2018;38:17-39), dementia (Alzheimer's & Dementia, September 2017;13(9):955–964), and premature death (Am J Clin Nutr, 2009;89:1037-42).

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

February 24th, 2019
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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