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Diet soda - is it good for you?

Back in the 80s I remember a lot of stir about the brand "NutraSweet" that was first hyped as a brilliant way to loose weight, but was soon dismissed as rather problematic by various scientists appearing on TV and mentioning metabolic problems and changes in the brain as possible results of its consumption. The debate was furious but ended quite suddenly when the NutraSweet brand was dropped, and the "Light" concept was introduced with no mention of the active sweetening ingredient other than "aspartame" and such being listed in the list of ingredients. But now the debate seem to have flared up again, and this morning the newspaper refered to this report:

Diet Soft Drink Consumption is Associated with Increased Waist Circumference

Abstract No:0062-ORSaturday, June 25, 2011: 9:45 AM - 10:00 AM
Abstract Type:Oral
Author(s):Sharon P. Fowler, Ken Williams, Helen P. Hazuda
Location(s):San Antonio, TX

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.

17304 ada 2011 figure 1 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.

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