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The skinny on diet drinks

Readers of my "Eat, Drink and Be Healthy" column and this blog will remember that I am not a fan of artificial sweeteners, which I think taste yucky and, in some instances, give me a headache.

So I was interested to read this roundup in the Journal of the American Medical Association of what we really know -- and what we don't yet know -- about the long-term effects of consuming artificially sweetened beverages.

David Ludwig of Children's Hospital Boston writes that while artificial sweeteners have been in use for a century and their safety studied extensively, there's not yet been a long-term human study of the relationship between diet-drink consumption and body weight. The few bits of research available suggest that drinking artificially-sweetened beverages is actually associated with being overweight, though it's not clear whether the excess pounds result from drinking diet beverages; it could be that people drink more diet beverages when they realize they've become overweight.

Ludwig argues that diet drinks pose tricky challenges for our bodies. Their lack of nutrients and intense sweet flavor might condition our minds and bodies not to be satisfied with naturally sweet, nutrient-rich foods such as fruit and non-sweet foods such as vegetables and legumes, leading us to make food choices that aren't conducive to weight control. And because they offer sweet taste without calories, over time, diet-drink consumers may cease to associate sweet taste with caloric intake.

Plus, he writes, "Calories displaced by artificial sweeteners may be replaced over time from other sources; the nature and completeness of this compensation would therefore determine the ultimate effects on body weight and other health outcomes."

Ludwig says science has pretty much shown that the five FDA-approved artificial sweeteners don't raise cancer risk. But that doesn't mean they're good for us. Our concern over the possible negative health effects of consuming sugar, he says,

has driven a marked increase in the consumption of artificial sweeteners, especially in liquid form. Per capita diet drink intake has increased from less than 1 oz. per day in the 1960s to about 4 oz. per day this decade. Among regular consumers of diet drinks, intake now totals more than three 8-oz. servings per day. If trends in consumption continue, the nation will, in effect, have embarked on a massive, uncontrolled, and inadvertent public health experiment.

That's an experiment I'd just as soon not be part of.

How about you? Where do artificially sweetened drinks fit in your diet and lifestyle? Do they help you control your weight?

By Jennifer LaRue Huget  |  December 10, 2009; 7:00 AM ET
Categories:  Nutrition and Fitness , Obesity  
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I drink 4-5 diet soda pop cans a week. That level of consumption is safe for nearly everyone. Twice that amount is probably just as safe. It has no impact on my weight except a tendency to keep it in check.


Posted by: SteveParkerMD | December 10, 2009 9:27 AM | Report abuse

I drank two cans of diet soda per day for 20+ years. During that time, I gained and lost and gained weight. But last year, I quit all diet drinks and am drinking green tea (unsweetened) instead. It was hard at first, but now I do not crave those drinks at all. I have lost close to 30 lbs., which I do attribute in part to this change. I am also saving money, which is a nice bonus.

Posted by: drl97 | December 10, 2009 10:12 AM | Report abuse

"Ludwig argues that diet drinks pose tricky challenges for our bodies. Their lack of nutrients and intense sweet flavor might condition our minds and bodies not to be satisfied with naturally sweet, nutrient-rich foods such as fruit and non-sweet foods such as vegetables and legumes, leading us to make food choices that aren't conducive to weight control. And because they offer sweet taste without calories, over time, diet-drink consumers may cease to associate sweet taste with caloric intake."

This quote makes it sound as if human beings are mindless slaves to their own worst impulses. It's not that difficult, these days, to find out how many calories are in most of the foods that we eat, and to actually think about what we're putting in our mouths instead of being "conditioned" to act in one way or another. If people choose to ignore simple common sense (or to believe in quack weight-loss nostrums, such as the acai berry supplements advertised on The Post's own website) I don't think it matters what they drink.

For myself, I do drink artificially sweetened soft drinks, including carbonated beverages, iced tea, and others (e.g., the "light" versions of the V8 fruit/vegetable drinks). I find they are useful in avoiding what would otherwise be "empty" calories, and they do aid in weight control.

Posted by: oldguy2 | December 10, 2009 12:39 PM | Report abuse

I add splenda to my tea daily and drink an occasional diet soda. After removing sugar and other carbs: flour ,rice, and potatoes from my diet, I effortlessly loss 25 lbs! And have been able to maintain it with no problem. It also reduced my addiction to sweets and stabilized my insulin and blood sugar. My cholesterol and glucose levels are excellent as a result. Ironically, i do not count calories and eat as much as I want. Including good fats. Sugar/starches are the enemy, not fat!!!

Posted by: llerehs | December 10, 2009 12:45 PM | Report abuse

I have been drinking diet sodas pretty exclusively since I got out of college. I gained weight in college due to poor diet, which included too much regular sugary soda. The switch was a relatively painless way to enjoy soda without it negatively affecting my waistline. Like everything else, maintaining a healthy weight generally requires attention to calories in/out. Diet soda fills me up as well as water, with a more pleasing taste, and I feel like I've had a "treat" without consuming any unwanted calories. Diet soda alone won't make you lose weight if you still eat foods with too many calories. At best, diet soda may halt additional weight gain.
Basically, there is a trade-off for soda drinkers: consume only regular soda and either experience weight gain, or substantially decrease food intake, or take a chance on the unknowns of repeated consumption of artificial sweeteners. I prefer to keep my weight normal, and try to keep the diet soda intake at a reasonable level.

Posted by: dukebdc | December 10, 2009 12:46 PM | Report abuse

As a registered dietitian, I am often asked by my clients about the safety of artificially sweetened drinks. My response is that artificial sweeteners can fit into a healthy diet. Artificial sweeteners, also known as low- or no-calorie sweeteners, have more than 200 scientific studies confirming their safety as low-calorie sweeteners. For people who enjoy sodas, diet sodas allow them to enjoy a carbonated beverage without the calories. As I tell my clients, who also include the food and beverage company, data supported by the American Dietetic Association from the Journal of Clinical Nutrition and the European Journal of Clinical Nutrition, speak to their safety and actually show that low- and no-calorie sweeteners can help you manage your weight. And as stated in your blog, Dr. Ludwig brings up the question of whether drinking artificially sweetened beverages may actually increase hunger – From my knowledge, this is not the case. In fact, studies from the American Journal of Clinical Nutrition showed a person’s hunger reaction after drinking low-calorie beverages is not different than when he or she drinks water.

Posted by: janRD | December 10, 2009 12:51 PM | Report abuse

What this commentary may question is whether drinking diet beverages alone is enough to counter overeating. The simple answer is no. No- and low-calorie beverages can be a beneficial tool as part of a larger nutritional or weight loss plan, but they cannot solve the problem alone. The only way to maintain a healthy weight is by balancing calories consumed with calories burned.

Controlled studies in which diet beverages were substituted for regular soft drinks have shown weight loss, not weight gain. In fact, a study published this year in the International Journal of Obesity shows that that those who successfully maintain weight loss use a number of strategies to do so, including increased consumption of no- and low-calorie beverages.

Again, there is no magic cure for the complex problem of obesity. The only way to maintain a healthy weight is by balancing calories in with calories out. For more information on low and no-calorie beverages, please visit

 American Beverage Association

Posted by: jbadger1 | December 10, 2009 1:05 PM | Report abuse

Why post an article about this study, let alone DO a study that fails to address the basic question of causality? Of course a disproportionate number of obese people by diet beverages. That's common sense. Is this cause, effect, or a combination?

Like many others I use artificial sweeteners to help with weight maintenance. I haven't tried dropping them in favor of pure water. Even if I did it wouldn't prove much in isolation.


Posted by: bmcclinton | December 10, 2009 1:18 PM | Report abuse

what kind of scientific analysis uses might and may in every conclusion?

Posted by: pupupart | December 10, 2009 2:19 PM | Report abuse

Observational studies are useless. Unfortunately, most of the diet advice we receive is from observational studies. Studies that include lots of flaws!!! Not controlling for all variables and relying on self reported behavior. Also, many are funded by Food companies. No wonder many are fat and/or will die of heart disease and cancer. Look at obsesity research prior to 1970, both in the US and England.

Posted by: llerehs | December 10, 2009 3:31 PM | Report abuse

If they would just ask King Obama, he can tell them everything they want to know about anything... Just ask him!

He is so smart.. he even knows how to avoid working for a living...

Posted by: ProveMeWrong | December 10, 2009 3:37 PM | Report abuse

I don't think it matters very much. I weigh about 15 lbs. than I did before I started drinking diet soda, but I don't think that proves causation in either direction!

Posted by: lewyn | December 10, 2009 3:50 PM | Report abuse

I drank 1-2 cans diet soda for years. A few years ago I gave it up and lost 5 lbs within the first month with no other changes in my diet. Always wondered if there was a connection.

Posted by: LDRT | December 10, 2009 4:17 PM | Report abuse

I think the effects of artificial sweeteners vary with the person who's using them.

If your body has a bichemical set-up for addiction (and that includes addiction to sugars), then artificial sweeteners will prime your brain to want more of the taste of sweet. Doesn't matter if that sweet taste comes from sugar, agave nectar, or low/no-calorie sweeteners. In this case, the brain doesn't really make a distinction. What this does is to create/maintain cravings for the taste of sweet.

This effect is not, to my knowledge, dependent upon the type of insulin response provoked by the sweet substance -- i.e., low/no-calorie sweeteners are no better for you in this regard than caloric sweeteners.

And aspartame can be highly addictive for some people.

After a lifetime of daily sugar intake, I no longer use any sweeteners (including non/low-calorie). Among other benefits, I no longer have *any* cravings at all.

Posted by: domystic8 | December 10, 2009 4:45 PM | Report abuse

We have been drinking diet soft drinks for years, a couple of time a week, ever since my husband was diagnosed with diabetes. My weight has been stable, on the slim side. I am not disputing or trying to dispel the article. But, from the standpoint of a diabetic, artificially sweetened anything has been a good thing.

Posted by: jmardiwelch | December 10, 2009 6:34 PM | Report abuse

For years I drank 8-10 cans of diet coke a day. I gave it up in January and have noticed a remarkable drop in my desire to consume candy and other sweet foods.

I've lost 70 lbs.

Posted by: Marimom | December 10, 2009 7:24 PM | Report abuse

ProveMeWrong, shut up, fatso

Posted by: bendan2000 | December 11, 2009 12:31 AM | Report abuse

I average about 6 cans of diet soda a day. Although I'm in law school and it's exam time so I'm at around 9 or 10 a day.

I switched from regular soda to diet after I graduated from college (where I was a varsity athlete and exercised regularly) and entered the workforce (where I rarely exercised). My pant size is 2 inches bigger after 8.5 years of that.

I've never been a "foodie," but a lot of food does seem bland to me. I don't know whether that's because of the decades of soda or because my sense of smell is slightly below average. The upside to that is that portion control is easy for me. So if I just try to avoid buying too much junk food at the grocery store, I'm fine. Still need to exercise more though.

Posted by: Booyah5000 | December 11, 2009 12:42 AM | Report abuse

ProveMeWrong, shut up, fatso

Posted by: bendan2000

Out of curiosity... How old are you? Do your parents know you are blogging again in their basement?

Posted by: ProveMeWrong | December 11, 2009 8:32 AM | Report abuse

How about having the occasional diet soda because you don't want all that sugar on your teeth? One more factor to throw in there.

Posted by: di89 | December 11, 2009 7:42 PM | Report abuse

My mom drinks lots of diet cokes throughout the day and I am always trying to get her to stop since they have absolutely no nutritional value to her. She would be much better off with a glass of water or tea! I keep telling her too that if she wants to maintain a healthy weight that she could incorporate a good probiotic into her diet to help! Our family loves our Vidazorb and we take it for all the other benefits they have for us too! "thumbs down" on diet pops!

Posted by: smilinggreenmom | December 14, 2009 8:33 AM | Report abuse

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