It doesn't matter if it's sugary or dietary: a new study links all sodas to premature death

    Abdulaziz Sobh

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    Wait, diet soda drinkers. Regular consumption of soft drinks, both sweetened with sugar and artificially sweetened, was associated with an increased risk of all causes of death, according to research published this week in JAMA Internal Medicine.

    Participants who drank two or more soda glasses per day had a higher risk of mortality than those who consumed less than one glass per month.

    The study, one of the largest of its kind, tracked 451,743 men and women from 10 countries in Europe. He found that the consumption of two or more glasses of artificially sweetened soft drinks per day was positively associated with deaths from circulatory diseases. For sugar-sweetened soft drinks, one or more glasses a day were associated with deaths from digestive diseases, including diseases of the liver, appendix, pancreas, and intestines.

    The researchers recruited people from Britain, Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain and Sweden between 1992 and 2000, surveying them about their consumption of food and beverages. Participants were excluded if they reported incidents of cancer, heart disease, stroke or diabetes. The average age was 50.8 and 71.1 percent of the participants were women.

    Similar results have been shown in several recent studies, but the researchers cautioned that high soda consumption may be a marker for an overall unhealthy lifestyle.

    "In our study, consumers with high soda content had a higher body mass index (BMI) and were also more likely to be current tobacco smokers," said study lead researcher Neil Murphy of the International Agency for Cancer Research. "We made statistical adjustments in our analyzes for BMI, smoking habits and other mortality risk factors that may have biased our results, and positive associations remained."

    The researchers saw similar associations in smokers and non-smokers, as well as in thin and obese participants, indicating that the association between soft drinks and mortality is not strongly influenced by smoking habits and BMI.

    "The results of this study are significant," said Sarah Reinhardt, a leading food and health systems analyst at the Union of Concerned Scientists. "It reinforces a fact that will not surprise anyone in the field of nutrition: processed foods loaded with artificial ingredients will never be the magic bullet to improve health, no matter how low they are in sugar. Our bodies are smarter than that. ".

    While advocacy groups such as the Center for Science in the Public Interest greatly appreciate studies exploring the link between added sugars and human health, they warn that the results could be a "reverse causation" effect, where drinkers of diet soda as a population have other common qualities that could indicate a different explanation for the results.

    "This new European study is somewhat inconsistent with previous findings," said Bonnie Liebman, director of nutrition at CSPI. "In the new study, the risk of dying from any cause was more strongly related to people who drank more diet drinks than to people who drank more sugary drinks."

    Keri Peterson, a medical advisor to the Calorie Control Council, which represents low-calorie and calorie-free sweeteners, said numerous studies have shown that the sweeteners used in diet soda are some of the safest and most studied ingredients in the food supply.

    "The safety of low-calorie and calorie-free sweeteners has been reaffirmed time and again by major regulatory and government agencies around the world."

    Murphy said he can't rule out the possibility that artificially sweetened positive associations are influenced by unhealthy people who switch to artificially sweetened sodas.

    “We recognize that one possible explanation for the positive associations found for artificially sweetened soft drinks is that participants who already had a higher health risk (those who are overweight or obese; those with prediabetes) may have switched to artificially sweetened sodas to control their calorie and sugar intake, "he said in an email.

    The good news? The researchers found no link between soft drink consumption and general death from cancer or deaths from Alzheimer's disease.

    While the 50 international researchers who conducted the study did not present theories about the relationships observed, they encourage public health campaigns aimed at limiting the consumption of soft drinks.

    According to the American Heart Association, sweetened beverages are the largest source of added sugar in our diet. In the United States, the percentage of obese children and adolescents has more than tripled since the 1970s, according to the Centers for Disease Control and Prevention. About 40 percent of adults are obese, according to the American Medical Association.

    In the United States, four cities in California: Berkeley, San Francisco, Oakland, and Albany; Philadelphia; Boulder, Colo .; Portland, Oregon; and Cook County, Illinois, have moved to impose taxes on soft drinks, but more widespread efforts have met the resistance of the soft drink lobby. Even so, recent studies show that people drink less sugary drinks, opting for healthier options.

    William Dermody, the spokesman for the American Beverage Association, notes that today more than half of all purchased beverages do not contain sugar and that "no one should consume too much sugar, and we defend the safety and quality of our products."

    Seth Goldman, executive director of Honest Tea, owned by Coca-Cola, said the study should encourage large soda companies to introduce alternative drinks.

    "It is even more imperative to successfully market drinks with less sugar and less candy," he said. "There is a recognition that the consumer is also evolving. If [soda companies] do not change, that evolving consumer will be lost. We are seeing changes that are unlikely to be reversed."

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