Diet pop and more bulging waists

[Mayabird]

You may have seen the articles saying "Diet soda makes you fat" or whatever. I decided to go straight to the abstract.

Diet Soft Drink Consumption Is Associated with Increased Waist Circumference in the San Antonio Longitudinal Study of Aging

Presented During Session: Obesity — Human
Saturday, June 25, 2011: 9:45 AM - 10:00 AM

Abstract No:
0062-OR
Abstract Type:
Oral
Author(s):
SHARON P. FOWLER, KEN WILLIAMS, HELEN P. HAZUDA
Location(s):
San Antonio, TX

Abstract Body:
Consumption of diet soft drinks (DSDs) has been linked to increased incidence of obesity, metabolic syndrome, and diabetes. We examined the relationship between DSD consumption and long-term change in waist circumference (ΔWC) in 474 participants, aged 65-74 yrs at baseline, in the San Antonio Longitudinal Study of Aging (SALSA). Measures of height, weight, waist circumference (WC), and DSD intake were recorded at baseline and at each of 3 follow-up exams, for an average follow-up interval of 3.6 yrs (9.5 yrs total). Using repeated-measures ANCOVA, we compared mean ΔWC for DSD users vs. non-users in all follow-up periods, adjusted for sex; baseline WC, age, ethnicity, education, neighborhood, leisure physical activity, diabetes and smoking status; and length of follow-up.[figure1]Overall, DSD users experienced 70% greater increases in WC compared with non-users: +2.11 +0.33 cm vs. +0.78 +0.24 cm, respectively (p < 0.01). A positive relationship emerged between DSD use and subsequent ΔWC (p<0.001 for trend). Point estimates for ΔWC were 63% higher in daily DSD users than in non-users, but this difference was not significant (p=0.146 for 1 to < 2 DSDs/day vs. none). Among frequent users (>=2 DSDs/day), however, mean increases in WC were 5 times greater than those in non-users (p<0.001).

WC is widely used as a proxy measure of visceral adiposity, a major risk factor for diabetes, cardiovascular disease, cancer, and other chronic conditions. These results suggest that – amidst the national drive to reduce consumption of sugar-sweetened drinks – policies which would promote the consumption of DSDs may have unintended deleterious effects. Data from this and other prospective studies suggest that the promotion of diet sodas as healthy alternatives may be ill-advised: they may be free of calories, but not of consequences.

The most commonly noted hypotheses as to the relationship have to do with the brain. We all know of those types who'll scarf down five Big Macs and then a diet Coke, possibly out of some delusional thinking that the lack of the 200 calories in the Coke will counterbalance the almost 600 calories per Big Mac. For the other, there have been studies with rats showing that various types of low-fat and sugar substitutes during their weaning leads to greater weight gains because their brains cannot form a correct relationship between the taste and the nutritional and caloric value. "This flavor also means that there's not enough stuff in it, so I must eat MORE!" It wouldn't be surprising if we end up retraining our brains the same way, leading to eating more or eating other unhealthy things (see: five Big Macs). Or heck, it could be both and wouldn't that explain a lot?

Of course, this is only mentioning diet pops and not regular consumption of any other sugar substitutes which could very well play a similar role.


Also diet sodas taste like nasty chemicals and I don't know how you people can drink it.

[Simon_Jester]

I just dilute the soda; it works better for me, reduces the calories to almost the same extent, and you quickly get used to the flavor- most non-diet soft drinks are overconcentrated and oversugared.

[Mr Bean]

I just don't drink soda, sad to say my heath demands it as I was enough of a caffeine addict drinking three sodas in two days is enough to get my body hooked again and give me 2-5 days of intense migraine style headaches. When I quit cold for a two week camping trip after six months of living on caffeine and 12 hour on off watches I was hating life itself and would have taken myself out of my misery if not able to keep so busy as physically possible. As it was I still had the shake, raging headaches that had me drinking galleons of water a day and taking the max dosage of Ibuprofen while those with me did their best to sell me on the placebo affects of that drug.

That little story aside I tell you that only to say I tried to drink Diet Soda and hated every minute of it. First off Diet Coke and Diet Pepsi taste nothing like those two drinks but like harsh medicine so I never could drink them to begin with. But I think this study is on to something in that people who are healthy and fit would not order a Diet coke as it tastes like chemical run-off but if your overweight your much more likely to drink a Diet Coke instead. Kind of like wheelchairs being a great indicator for not having working legs but not the thing that breaks your legs to begin with.

[Spectre_nz]

Well, apparently different things happen in our brains when we taste 'real sweet' compared to 'artificial sweet'
There's another article I'm trying to find but can't; the gist of which was your body can actually assess the calorie value of a meal before you swallow. They basically got participants to do a little exercise then gave them taste but not swallow a little snack. The bodies participants who tasted a sugary snack then released, I think, additional glucose, into the bloodstream compared to the other participants who got artificially sweet tastes, although the effect only lasted about 2 minutes. The theory goes that your tastebuds can judge the calorie value of the sugars and send a message down the line that more energy is on the way, no need to be so frugal with the energy stores.
Same thing didn’t happen with artificial sweeteners, so the “not enough calories, eat more” reaction seems logical. But then, I’d expect if they were eating fatty burgers as well, they’d cue the system that actual calories were on the way.

On the subject of softdrinks; I can't stand diet.
I don't drink coke all that often, but when I do, I go with the old fashioned sugar loaded stuff.
I also eat a fairly high fat, high calorie diet. My only saving grace is I walk 50km in an average week...
I put on about 25% of my total body weight in the 4 years after I left high school, going from underweight to normal. Alas in the last few years my metabolism has slowed down and I’m starting to develop a spare tire.

[JointStrikeFighter]

Yeah! Fuckem! Just drink fullstrength instead! Why would anyone want to make something bad less bad by comparison?


Anyone who says "wwaaaah diet coke yuck" is a baby with no self-control or ability to retrain their mind; drink diet for 6 months = full strength now tastes like shit. Turns out the taste is only associative to the addiction?

[Napoleon the Clown]

Zero calorie sweeteners have a very noticeable and unpleasant aftertaste. If you want to talk willpower, stop fucking drinking sweet stuff entirely. Go for teas instead. Very low calories and you can get them in varieties that are quite palatable without adding sweeteners of some sort.


Anyway, I'm interested in what the exact mechanics behind this are. Whether it be because the person more than replaces the calories lost by going from sugar to artificial, or the body reacts to the artificial sweetener in a manner that exacerbates weight gain. I'd love to see studies that go further in-depth with this subject.

One particular thing to think on: Diabetes sufferers are more likely to drink diet than those without diabetes. Is there much info on diabetes increasing the likelihood of becoming obese? If so, that could well cause a difference in the study, too.

[ThomasP]

The abstract doesn't mention it, but I wonder if there were any controls for overall fluid or even calorie intake. I'd be hesitant to assign causality to the diet soda intake alone without knowing more about tendencies to consume in general; are diet sodas really the causing weight-gain, or is a large diet soda intake only correlated with bad eating practices?

[cosmicalstorm]

I generally stopped drinking soda about three years ago. I recall spending a few weeks reading up on the health effects of soda in general and I have to say I find it reasonable to refer to it as liquid poison. I'll drink perhaps two to four liters of Coca-cola per year. With all the great stuff coming out concerning the positive health effects of black coffee and tea; which seem to have an inverse relationship with a number of problems such as diabetes, cancer, Alzheimer's, Parkinson. I've just switched over to those instead.

[Marcus Aurelius]

The abstract doesn't mention it, but I wonder if there were any controls for overall fluid or even calorie intake. I'd be hesitant to assign causality to the diet soda intake alone without knowing more about tendencies to consume in general; are diet sodas really the causing weight-gain, or is a large diet soda intake only correlated with bad eating practices?

Yes. This type of epidemiological studies have to be taken with a huge banner of "CORRELATION DOES NOT IMPLY CAUSATION" in mind. You would need a real experiment with stricter controls to show causal relationships, but they are much more difficult to arrange. Also, even if there is causality, it may be culture-dependent. There were fat people long before diet sodas or even carbonated soft drinks in general become common.

The whole diet soft drinks business is the soft drink industry's answer to the worsening obesity problem in the US and increasingly in Western Europe as well. This would indicate that there can't be any primary causality, but there might be a secondary sociopsychological effect, which enables people with bad eating habits to continue while using the diet sodas as an excuse that they are trying to change their habits (the five Big Macs with diet Coke syndrome Mayabird referred to). In other words, it appears likely that people whose calorific intake is already too large have often transitioned to diet soft drinks, but they either compensate by eating more or the relative amount of energy from soft drinks was already fairly insignificant in their diets.

[GrandMasterTerwynn]

Zero calorie sweeteners have a very noticeable and unpleasant aftertaste. If you want to talk willpower, stop fucking drinking sweet stuff entirely. Go for teas instead. Very low calories and you can get them in varieties that are quite palatable without adding sweeteners of some sort.


Anyway, I'm interested in what the exact mechanics behind this are. Whether it be because the person more than replaces the calories lost by going from sugar to artificial, or the body reacts to the artificial sweetener in a manner that exacerbates weight gain. I'd love to see studies that go further in-depth with this subject.

The leading theory is that the base parts of the brain equate sweetness with caloric value. So when you drink a diet soda, you're temporarily tricking the brain into thinking you're taking in calories. And not just regular calories, but quickly-processed calories. So when your regulatory systems don't see the sudden boost in blood sugar that they're expecting, the brain turns back on the "hungry" signal, and cranks up the gain so you hear it as "HUNGRY NOW!!11" So, the end result is that drinking a lot of diet sodas makes you want to eat more than you would've if you'd just consumed the regular stuff (which will make you eat more than if you'd eaten fruits instead, since all your feedback systems are calibrated to getting sugar from fruits, which actually have much more to digest than just plain sugar.)

It's wiring that's been in the brain for about as long as there have been primates and primate-like primitive mammals, so it's not easy to short-circuit. The basic advice is to simply avoid sweet foods as much as possible.