Diet Soda Linked to Diabetes

Healthnotes Newswire (May 21, 2009)—People may choose diet soda over regular soft drinks to spare calories and avoid weight gain but new research suggests that people who drink diet soda on a daily basis should be aware that the habit has been linked to an increased risk of developing type 2 diabetes. However, whether the link stems directly from the diet soda or from other unhealthy lifestyle behaviors such as overeating or lack of exercise is not clear.

Uncovering unhealthy habits

This study looked at the association between diet soda and the risk of developing type 2 diabetes and the metabolic syndrome—a condition that increases a person’s risk for heart disease and diabetes and includes high blood sugar, high blood pressure, increased waist circumference, and elevated fats in the blood (lipids).

The study included 6,814 people between ages 45 and 85 enrolled in the Multi-Ethnic Study of Atherosclerosis. Participants had baseline and follow-up examinations between the years 2000 and 2007. At the study’s beginning, participants filled out a food questionnaire that included a combined item “diet soft drinks/unsweetened mineral water” and they reported how often they consumed this item. Waist circumference, fasting blood sugar, and blood pressure were measured at baseline and follow-up examinations. The results:

59% reported that they never drank diet soda/unsweetened mineral water.

14% of participants reported that they drank one or more servings of diet soda/unsweetened mineral water per day. This group had a 67% increased risk of developing type 2 diabetes during the study and had higher waist circumferences (one risk factor for the metabolic syndrome) compared with people who drank none.

Diet soda or lifestyle?

Jennifer Nettleton, PhD, and her colleagues from the University of Texas Health Science Center, Houston, Texas, do not claim a direct link between drinking diet soda and type 2 diabetes or the metabolic syndrome based on this study. They state, “We are cautious not to conclude causality between diet soda and the diabetic or prediabetic condition. The possibility of confounding by other dietary and lifestyle/behavioral factors cannot be excluded from these observational studies.”

In other words, it may not be diet soda that directly increases blood sugar or waist circumference but rather unhealthy lifestyle behaviors that may be common among people who drink diet soda such as overeating or lack of exercise, both of which may lead to being overweight which increases the risk of diabetes.

There were a number of limitations in this study and the link between diet soda and diabetes warrants further research. Experts in the artificial sweetener industry note that other studies have affirmed the use of artificial sweeteners as one helpful option in a weight management plan.

Choose healthy behaviors

To help prevent type 2 diabetes:

• Maintain a healthy weight.

• Lose weight if overweight.

• Exercise regularly.

• Eat a balanced diet.

• See a doctor to discuss your risk factors for type 2 diabetes and discuss recommendations to prevent this condition.

“Lifestyle changes must be moderate and sustainable and focus on all aspects of diet (not just single food or beverage entities) and include physical activity and stress management,” says Nettleton. “Too many marketing gimmicks exist that suggest there is a single ‘panacea’ to prevent obesity and its related morbidities. This simply isn’t the case.”

(Diabetes Care 2009:32:688–94.)

Jane Hart, MD, board-certified in internal medicine, serves in a variety of professional roles including consultant, journalist, and educator. Dr. Hart, a Clinical Instructor at Case Medical School in Cleveland, Ohio, writes extensively about health and wellness and a variety of other topics for nationally recognized organizations, Web sites, and print publications. Sought out for her expertise in the areas of integrative and preventive medicine, she is frequently quoted by national and local media. Dr. Hart is a professional lecturer for healthcare professionals, consumers, and youth and is a regular corporate speaker.

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