Soft Drinks and Nutrition: How Healthy Are the Light Ones?

Are Soft Drinks Healthy?

Soft drinks are a particularly beloved product among both young and old.

However, in recent decades, several studies have linked soft drink consumption to adverse health effects, including the development of tooth decay (especially in children), weight gain, and increased risk of chronic health conditions such as: (1)

• Diabetes Mellitus
• Cardiovascular Diseases
• Certain types of cancer
• Non-alcoholic fatty liver disease, etc.

The harmful impact of soft drink consumption on our health is associated with their high sugar content, primarily refined sugar. This is why soft drinks are classified as sugar-sweetened beverages (SSBs).

This led many health organizations to create guidelines for sugar intake for both adults and children, directly affecting the soft drink industry.

Also, many people turned to diet sodas (diet soda, light soda, zero soda), which seemed like an ideal alternative as they combine the taste and aroma of soft drinks with minimal or zero sugar and calories. However, we must not forget that the best way to hydrate is water.

What Are the Recommendations for Sugar?

The World Health Organization (WHO) guidelines recommend: (2)

“Reducing free sugar intake to less than 10% of total daily intake, for all stages of life”

Sugars or simple carbohydrates are considered to be monosaccharides: glucose, fructose, galactose, and disaccharides: sucrose (the name for common sugar), lactose, and maltose.

Sugars are found either naturally in foods (such as fruits, vegetables, and dairy products, honey, etc.) or are added to them during processing or preparation.

The World Health Organization recommendations use the term “free sugars” which refers to those added to foods as well as those naturally present in honey, syrup, and juices, implying that in these cases too, there should be a restriction on intake.

These recommendations are directly related to soft drink consumption as practically, sugar intake <10% of total daily energy intake in a 2000 calorie (Kcal)/day diet means <50 g of sugar/day .

If one considers that a 400 mL soft drink contains almost 10 teaspoons of sugar or 50 g of sugar , we realize that it’s difficult to stay within limits when soft drinks occupy a central place in our diet.

What Do Light Soft Drinks Contain?

Light soft drinks consist of a combination of carbonated water, natural or artificial sweeteners, coloring agents, natural or artificial flavors and aromas, and other food additives.

Additionally, light soft drinks usually provide fewer calories and do not contain added sugars such as sugar, high fructose corn syrup, etc.

For example, a cola-type soft drink with aspartame contains 7 calories (Kcal)/bottle (370 g) with no added sugars, while a corresponding classic soft drink contains 155 calories (Kcal)/bottle (370 g) with 37 g of added sugars . (3)(4)

Although there is no specific formula, some common ingredients among light soft drinks are: (5)

• Carbonated water. Water to which carbon dioxide has been added, resulting in the formation of carbonic acid that gives the characteristic bubbles to the drink.
• Sweeteners. These are substances that fully or partially replace sugar in foods and beverages.

  Sweeteners are divided into those that contain calories (such as glucose, fructose, and polyols) and those that have very low caloric value.

  In light soft drinks, non-caloric sweeteners are used, which are further divided into artificial sweeteners, such as aspartame (E951), acesulfame potassium (E950), saccharin (E954), cyclamate (E952), thaumatin (E957), neotame (E961) or natural sweeteners like steviol glycosides (stevia).

  These sweeteners provide minimal or zero calories and are 200-1000 times sweeter than common sugar.

  However, you should keep in mind that not all soft drinks with sweeteners are low in calories or low in sugar content. Some may contain sweeteners in combination with sugar. In any case, remember that careful reading of the nutrition label will give you information about the ingredients of the product you are about to consume.

• Acids. Acids such as phosphoric acid, malic acid, citric acid, etc. are often encountered.
• Coloring agents. Foods lose their original color during industrial processing. Natural and synthetic coloring agents make them attractive again. Some of the most important coloring agents found in soft drinks are caramel color (E150), tartrazine (E102), and beta-carotene (E160).
• Natural or artificial flavors.
• Preservatives. These are substances that prevent food spoilage, increase shelf life, and have antimicrobial properties.
• Caffeine. Some soft drinks may also contain caffeine. For example, a classic cola-type soft drink may contain 33 mg of caffeine.

5 Myths About Consuming Diet Soft Drinks

1. Diet soft drinks are more nutritious.

This is not true as both regular and diet soft drinks have no nutritional value, which is why their calories are often described as “empty” as they provide us with no nutrients.

2. Consuming diet soft drinks leads to weight loss.

In recent years, there has been significant debate in the scientific community regarding the effect of diet soft drinks on weight management.

Soft drinks, as a beverage rich in simple carbohydrates and mainly sugar, have been implicated in their negative impact on weight management. As mentioned above, a typical soft drink can provide 150-200 calories (Kcal). This can lead to an increase in total energy intake and consequently may lead to long-term weight gain.

Because of this, in recent years there has been a shift towards the use of diet soft drinks which are usually low in calories and contain sugar substitutes, with the prospect that they will solve the problem.

However, the solution to the problem doesn’t seem to be that simple, as the data from various studies are often conflicting and don’t allow us to draw safe conclusions.

A meta-analysis that included 17 randomized clinical trials involving overweight and obese individuals showed that the replacement of sugar-rich beverages with diet drinks may help in weight reduction. (6)

On the other hand, there are several studies that have shown a tendency towards weight gain when diet soft drinks are consistently chosen. (7) This may be attributed to the various sugar substitutes contained in them, which seem to increase the individual’s desire for sugar intake and energy-dense foods.

So although they may seemingly be an ideal solution to reduce the intake of calorie-rich soft drinks, on second glance, their increased consumption may lead to an increase in the consumption of other calorie-dense foods throughout the day, leading to a positive energy balance and weight gain.

In conclusion, diet soft drinks may contribute to weight management, under certain conditions:

• When they replace calorie and sugar-rich soft drinks
• When they are not accompanied by increased consumption of other calorie-rich options.

3. Consumption of diet soft drinks is not associated with the development of diabetes.

There are studies in the literature showing that systematic consumption of soft drinks with sugar substitutes may not be an ideal solution for the prevention of diabetes.

A meta-analysis, which included 17 prospective studies, showed that increased consumption of diet beverages led to an increased risk of developing diabetes. Specifically, for each increase in their intake by one serving (250 mL)/day, the risk increased by 8%. (8)

4. They don’t harm dental health.

One of the main ingredients in diet soft drinks, as is the case with regular soft drinks, is acids.

Although many people know that reducing sugar consumption reduces the risk of cavities, they don’t know that tooth erosion also occurs when certain acids dissolve the hard tissues of the tooth.

During the early stages of erosion, the surface layers of tooth enamel are eliminated. And in advanced stages, the soft pulp inside the tooth may be exposed.

Therefore, replacing regular soft drinks with their diet versions doesn’t seem to help much in maintaining good dental health.

5. People with diabetes can consume them without worry.

Regulating blood glucose levels is a key goal in managing individuals with diabetes in order to prevent complications of the disease.

The low-calorie sweeteners added to diet soft drinks do not seem to affect blood glucose and insulin levels, which is why their use is considered free for people with diabetes.

Replacing regular soft drinks with their diet versions may even improve glycemic control in these individuals.

However, the recommendations of the American Diabetes Association state that the use of low-calorie sweeteners should be prudent and always within the context of a healthy and balanced diet and should not exceed the maximum tolerable intake set by the U.S. Food and Drug Administration. (9)

In conclusion

In recent decades, soft drink consumption has been associated with a plethora of negative health effects. Their negative effects are primarily associated with the sugar they contain.

These revelations led the soft drink industry to promote diet soft drinks using sugar substitutes, with the prospect of limiting simple sugar intake while allowing soft drink lovers to enjoy their favorite beverage.

Although this would seemingly provide a solution to the problem, such a thing does not appear to be happening.

There are several myths surrounding the consumption of diet sodas, and it seems their consumption is not as innocent as we believe.

Although the data from the literature is conflicting regarding the impact of diet sodas on our health, the only certain thing is that they have no nutritional value for our body.

Bibliography

1. Malik V, Hucorrer F. The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat Rev Endocrinol. 2022, 18(4): 205–218. doi: 10.1038/s41574-021-00627-6.
2. WHO. Guideline: sugars intake for adults and children. Available at: https://www.who.int/publications/i/item/9789241549028. (Accessed at February 2023).
3. USDA. Beverages, carbonated, low calorie, cola or pepper-type, with aspartame, contains caffeine. Available at: https://fdc.nal.usda.gov/fdc-app.html#/food-details/175099/nutrients. (Accessed at February 2023).
4. USDA. Beverages, carbonated, cola, regular. Available at: https://fdc.nal.usda.gov/fdc-app.html#/food-details/174852/nutrients. (Accessed at February 2023).
5. British Soft drinks association. Ingredient Definitions Available at: https://www.britishsoftdrinks.com/ingredients-old. (Accessed at February 2023).
6. McGlynn Ν, Khan Τ, Wang L et al. Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk A Systematic Review and Meta-analysis. JAMA Netw Open. 2022, 5(3):e222092. doi:10.1001/jamanetworkopen.2022.2092.
7. Azad Μ, Abou-Setta Α, Chauhan Β, Rabbani R, Lys J, Copstein L, Mann A, Jeyarama M. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ. 2017 Jul 17; 189(28): E929–E939.doi: 10.1503/cmaj.161390.
8. Imamura F, O’Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju S,Forouhi Ν.Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ. 2015 Jul 21;351:h3576.doi: 10.1136/bmj.h3576.
9. Shwide-Slavin C, Swift C,Ross T. Nonnutritive Sweeteners: Where Are We Today?. Diabetes Spectr 2012;25(2):104–110. https://doi.org/10.2337/diaspect.25.2.104.