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Diet Soda is Not A Free Ride

diet soda & weight gainThere is little doubt that obesity in America is on the upswing. Lots of people think that an artificially-sweetened beverage can offset the poor dietary decisions to which they have become accustomed. There has been established a relationship between non-sugar sweeteners and weight gain based on physiological responses to the message of satiety and the perceived need to consume more calories to achieve it. While the perception of sweet taste is supposed to satisfy appetite, the calculated deception to the body just might boomerang and call off all bets.

In the San Antonio Heart Study that ran from 1979 to 1988, researchers examined the association of artificially sweetened beverages with long-term weight gain, and found that, “A significant positive dose-response relationship emerged between baseline ASB (artificially sweetened beverage) consumption and all outcome measures…”  These outcome measures included overweight / obesity, weight gain, and changes in body mass index (BMI).  As with most nutrition research, considerations were made for demographics and behavioral characteristics.  Drinking more than twenty-one ASB’s a week had the most impact, with “…almost double risk of overweight / obesity among 1,250 baseline normal-weight individuals.”  For those with a body mass index already elevated, the changes were more pronounced.  This report concluded with, “These findings raise the question whether AS (artificial sweetener) use might be fueling—rather than fighting—our escalating obesity epidemic.”

That last sentence from the San Antonio Heart Study is quite the incrimination, would you say?
Diet soft drinks have long been thought to be healthier alternatives to their sugary counterparts, but reports like this one have linked increased incidence of weight gain, metabolic syndrome, and even diabetes to frequent intake of diet soft drinks.  Keep in mind, though, that all studies in all areas of health care are subject to scrutiny and critique.    Regardless of the topic, there are always two—or more—sides.  But here it may have been discovered that fooling the body is the instigator behind the concern.

When the body is told that something sweet has been ingested, it launches the production of insulin to carry the sweet to the cells to be burned for energy.  By the time the body finds out that there really is no sugar to be burned—in the form of glucose—the insulin has already been sent on its way to work.  Now the insulin has to find something to do, so it initiates a signal that says, “Feed me.  I need to carry glucose.”  That arouses hunger.  What do we grab for immediate satisfaction?  Carbohydrates, the simpler, the better.  Most of them spike glucose rapidly, which, if it fails to get burned for energy, is stored as fat.  It now appears that a lack of exercise becomes part of the equation.

There’s another tack to look at.  Some artificial sweeteners are alleged to block the brain’s production of serotonin, the neurotransmitter that controls mood, learning, sleep, and…appetite.  When the body experiences low levels of serotonin—and that can affect depressed mood—it seeks foods that can bring the levels back up.   Those foods happen to be the ones that will also bring the belt size up. Real sugar, of course, provides empty calories that can also cause weight gain as excessive energy intake.  But a weight conscious public does what it thinks is right.

Sweet taste enhances appetite.  Aspartame-sweetened water, for example, increased subjective hunger ratings when compared to glucose-sweetened water.  (Yang. 2010)  Other artificial sweeteners were associated with heightened motivation to eat, with more items selected on a food preference list. (Blundell. 1986)  This suggests that the calories in natural sweeteners trigger a response to keep overall energy intake constant, and that inconsistent coupling between sweet taste and actual caloric content can lead to compensatory overeating and consequential positive energy balance.  (This means that more energy came into the body than went out.)  People associate taste with calorie content.  You can tell that a crème brulee has more calories than the eggs from which it is made, but you’d probably eat more of it if made with artificial sweetener than with cane sugar.

Humans have a hedonic component.  We like those things that appeal to the senses and activate our food reward pathways.  That contributes to appetite increase.  But artificial sweeteners fail to provide completeness.  Unsweetening the American diet over the long haul, a little at a time, might just do the trick.  After all, it seems to work with salt.

References

MAIN ABSTRACT
Obesity (2008) 16(8), 1894–1900.
Fueling the Obesity Epidemic? Artificially Sweetened Beverage Use and Long-term Weight Gain Sharon P. Fowler, Ken Williams, Roy G. Resendez, Kelly J. Hunt, Helen P. Hazuda and Michael P. Stern

SUPPORTING ABSTRACTS
Diabetes Care. 2009 Apr;32(4):688-94. Epub 2009 Jan 16.
Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr.
SourceDivision of Epidemiology, University of Texas Health Sciences Center, Houston, Texas, USA. [email protected]

Physiol Behav. 2010 Apr 26;100(1):55-62. Epub 2010 Jan 6.
High-intensity sweeteners and energy balance.
Swithers SE, Martin AA, Davidson TL.

SourceDepartment of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States. [email protected]

Yale J Biol Med. 2010 June; 83(2): 101–108.
Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings
Neuroscience 2010
Qing Yang

The Lancet, Volume 327, Issue 8489, 10 May 1986, Pages 1092-1093
PARADOXICAL EFFECTS OF AN INTENSE SWEETENER (ASPARTAME) ON APPETITE J. E. Blundell, A. J. Hill

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Fat Blocking Soda?

pepsi141112_insideNow we can eat all the fat we want in a meal and still lose weight. Forget that two cheeseburgers, fries and a soda, or fried onions rings/mushrooms and a juicy prime cut of beef with a gooey baked potato smothered in cheese sauce will render your blood as thick as petroleum jelly in a matter of minutes. The magic in this dining extravaganza is the soda, a new variety of cola that contains a fat blocker known as dextrin. But wait, first you have to travel to Japan to get this treat from Pepsi and its affiliate, Suntory, a company that distills booze “to bring happiness into the lives of our customers…in harmony with people and nature.” Yup, makes sense, eh?

Dextrin?
This is a group of carbohydrates that can be made by breaking down starch in the presence of water…hydrolysis. Dextrin also appears in the company of heat under acidic conditions, as happens to the crust on a loaf of bread, rendering flavor, color and crunch. Commercially, dextrins are used to make the glue on an envelope flap, the crispness enhancer in breaded frozen foods, and the cement that holds the pyrotechnics together in fireworks and sparklers. Because they are indigestible, dextrins are added to soluble fiber supplements, such as Benefiber. Whether they can help a person lose weight or not is another question; fiber’s claim to fame is increasing satiety and making you feel fuller faster. Fiber doesn’t actually push food through the system more quickly. Instead, it slows transit time through the stomach and small intestine, where digestion takes place. This is why fiber-rich foods keep you feeling full longer.  Once fiber gets to the large intestine, it keeps things in motion until they come out. It is true, though, that fiber can absorb some fat, but probably not enough to cause a significant weight loss in a short amount of time.

What About Fat?
Eliminating fat from the diet completely is not prudent. We need it to digest, absorb and transport vitamins A, D, E, and K, which are fat-soluble. The body demands the essential fatty acids, the omega-6’s and omega-3’s, to make substances that address inflammation, affect cell signaling, and add fluidity to the cell membrane. Furthermore, fat is an insulator and it provides a place for organs to attach while acting as a cushion, and it helps to keep the skin supple. If there is a problem with fat, it’s that one gram has 9 calories, contrasted to the 4 calories of carbohydrates and proteins. Fat gets broken down by enzymes, pancreatic lipase being the primary one. In the absence of this enzyme, fat molecules remain too large to be absorbed, so are excreted. The objective of the dextrins is to absorb some of this fat and usher it out the back door.

There are substances that do not absorb fats but prevent their breakdown, keeping their molecules too large to be metabolized so that they get eliminated quickly. One of the first of these was Orlistat, a prescription drug named Xenical that prevents the absorption of fat by inhibiting the enzymes that make the fat particles small enough to be metabolized.  But the side effects of drugs like this can be embarrassing, especially the urgent explosive diarrhea and gas, among a few other neat ones, like fainting or scratching yourself silly.  Alli is an over-the-counter version of Orlistat.

Does Dextrin Work?
According to the researchers at Japan’s NIH who studied this stuff, it works. The test animals were fed a high-cholesterol diet containing dextrin and a diglyceride, the latter molecule a fat used in foods to blend certain ingredients together, such as oil and water, which otherwise would not mix. Upon examination of the animals, the group found that serum triglycerides decreased and, strikingly, that the length of intestinal villi increased (Nagata, 2006).  Basically, less of the fat was absorbed. You can buy dextrin, either as Benefiber or Nutriose, and make your own soda or other high-fiber beverage (even one from Suntory).

What About The Vitamins?
Vitamin A, retinol, helps with night vision, bone growth, tooth development, reproduction, cell division and gene expression. It’s great for the skin and mucous membranes. It’s even recommended to treat acne. Vitamin D is needed to help the body to use calcium and phosphorus in the structure of bones. It supports the immune system and may help to prevent hypertension and common cancers. Vitamin E is an anti-oxidant that protects vitamins A and C, red blood cells and essential fatty acids from destruction via oxidative stress. Vitamin K is naturally produced by gut bacteria, but is also found in foods and as a supplement. It not only helps blood to clot normally, but also escorts calcium to bones where it can’t contribute to arterial plaque. There‘s more, but we don’t have the room for that right now. None of these can be utilized without fat in the diet, so if you choose to use dextrin to absorb fat from a meal, be deliberate, keep things in balance, and supplement.

References

Carter R, Mouralidarane A, Ray S, Soeda J, Oben J.
Recent advancements in drug treatment of obesity.
Clin Med. 2012 Oct;12(5):456-60.

Carvalho MA, Zecchin KG, Seguin F, Bastos DC, Agostini M, Rangel AL, Veiga SS, Raposo HF, Oliveira HC, Loda M, Coletta RD, Graner E.
Fatty acid synthase inhibition with Orlistat promotes apoptosis and reduces cell growth and lymph node metastasis in a mouse melanoma model.
Int J Cancer. 2008 Dec 1;123(11):2557-65.

Kimura Y, Nagata Y, Buddington RK.
Some dietary fibers increase elimination of orally administered polychlorinated biphenyls but not that of retinol in mice.
J Nutr. 2004 Jan;134(1):135-42.

Lefranc-Millot C, Guérin-Deremaux L, Wils D, Neut C, Miller LE, Saniez-Degrave MH.
Impact of a resistant dextrin on intestinal ecology: how altering the digestive ecosystem with NUTRIOSE®, a soluble fibre with prebiotic properties, may be beneficial for health.
J Int Med Res. 2012;40(1):211-24.

Nagata J, Saito M.
Effects of simultaneous intakes of indigestible dextrin and diacylglycerol on lipid profiles in rats fed cholesterol diets.
Nutrition. 2006 Apr;22(4):395-400. Epub 2006 Feb 2.

Sheikh-Taha M, Ghosn S, Zeitoun A.
Oral aphthous ulcers associated with orlistat.
Am J Health Syst Pharm. 2012 Sep 1;69(17):1462, 1464. doi: 10.2146/ajhp120073.

Seguin F, Carvalho MA, Bastos DC, Agostini M, Zecchin KG, Alvarez-Flores MP, Chudzinski-Tavassi AM, Coletta RD, Graner E.
The fatty acid synthase inhibitor orlistat reduces experimental metastases and angiogenesis in B16-F10 melanomas.
Br J Cancer. 2012 Sep 4;107(6):977-87. doi: 10.1038/bjc.2012.355. Epub 2012 Aug 14.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Sweet And Large

sweetnersA corned beef special with extra Russian dressing, a side of cole slaw, and a hunk of New York cheese cake for dessert, chased with a Diet Coke. This was pretty common lunchtime fare for a raft of patrons at a local eatery. Were they looking to cut calories? Or was diet soda merely the rage? If these folks were trying to fight the Battle of the Bulge, they chose the losing faction. If marketing diet soft drinks, they joined the pack.

Not too long ago scientists re-examined the effects of artificial sweeteners on human physiology, prompted, it seems, by the obesity epidemic that is sweeping the country and a considerable part of the Western World. It is presumed that eliminating the cause will also eliminate the effect. The cause in this case has multiple personalities, starting with saccharin, the oldest fake sugar, discovered at Johns Hopkins in the late 1870’s…from coal tar. Sounds yummy, right? Yep, a little waterproofing/shampoo in your coffee gets the day off to a running start, and it’ll even treat dandruff and kill lice. In its infancy, saccharin was featured on drug store shelves as a sugar replacement for people with diabetes. It was put into soda in the 1940’s for those who wanted to limit sugar intake, which was ironic because sugar was limited during World War II anyway. Saccharin is 300 times sweeter than table sugar and has a bitter aftertaste. Cyclamate came out in the 30’s, and was blended with saccharin to improve the flavor. Both were GRAS—generally recognized as safe—at first, in the late 50’s. In the late 60’s, however, cyclamate was abandoned by the U.S. as a carcinogen, and saccharin was viewed with suspicion. Other countries allow cyclamates to this day. Saccharin had received a warning label, but that was removed in 2000 by the Sweetness Act. How adorable! In 2010, the EPA took saccharin off its hazardous chemical list. Did you know this stuff is made from toluene, which has limited carcinogenic potential but still is paint thinner?

Aspartame was stumbled upon when Big Pharma was looking to make a new ulcer drug in the mid 1960’s. A combination of the amino acids phenylalanine and aspartic acid linked to a methanol backbone, aspartame is supposed to be avoided by those with phenylketonuria, a rare inherited metabolic disorder that fails to process phenylalanine, leading to mental retardation and other serious problems. Popular reports cite aspartame as causative of seizures and mood changes, an allegation that is still hotly debated (Magnuson, 2007) (Pediatrics, 1997). Its sweetness parallels that of saccharin.

Neotame, a product of Monsanto’s NutraSweet, is 7,000 times sweeter than sugar. That was approved in 2002. It’s the sweetest child on the block. Acesulfame potassium (K) hit the streets in dry foods in the 80’s and as a general sweetener in ’03. But the hot one these days is sucralose–Splenda®. It’s the most popular artificial sweetener, used mostly in soft drinks, but also in some baby foods (Why?).

What’s this got to do with obesity? For starters, the brain doesn’t appreciate being fooled. As soon as it gets the message that something sweet is eaten it initiates the secretion of insulin by the pancreas to start metabolizing glucose. When there is no nutritive entity to provide glucose, the brain makes you hungry enough to get some. You then eat.

Dr. Yanina Pepino and her team of researchers at Washington University School of Medicine found that sucralose is not an inert ingredient, but one that has a definite effect on blood sugar peaks. When subjects drank a sucralose beverage prior to drinking a glucose beverage, their sugar levels rose 20 percent higher than when they drank plain water before the glucose drink. The analysts related this to enhanced insulin and glucose responses caused by the artificial sweetener (Pepino, 2013), possibly leading to insulin resistance. True sweet taste cues serve to regulate energy balance, while non-nutritive sweeteners may promote increased food intake and consequent weight gain (Swithers, 2010).

Sucralose has chlorine groups replacing hydroxide groups in a glucose molecule, making it an organochloride that is related to some pesticides and plastics. It has the capability of lowering intestinal pH, making it acidic and hostile to beneficent colonic bacteria. Even after stopping sucralose, the changed pH may persist (Abou-Donia, 2008). Isn’t chlorine used in swimming pool and bathroom cleaners to kill bacteria?

Before sucralose hit the market, similar investigations focused on then-current artificial sweeteners, aspartame paramount among them. Where a 1986 project found ambiguity concerning appetite signals (Blundell, 1986), later study found that aspartame-sweetened carbonated water increased appetite in the short term (Black, 1993), implying a subsequent intake of excess energy. While the cheesecake crowd was enjoying its low-cal sodas, scientists were already looking at weight management in a highly homogeneous group of middle-aged women, learning that heavier gals were more likely to use non-nutritive sweeteners than their normal weight counterparts, but that, in the long term, artificial sweeteners were not able to prevent weight gain or help weight loss (Stellman, 1986). As with much of what we ingest, dose makes the difference. Those imbibing up to three artificially-sweetened drinks a day appear more likely to risk overweight and obesity than those who consume none (Fowler, 2008). For those who exercise, the difference is insignificant.

So, now, what’s the worry, insulin resistance or weight gain? Being a little overweight doesn’t automatically translate to type 2 diabetes, but it is one of the risk factors. Daily consumption of diet soda was associated with a 36% greater relative risk of metabolic syndrome and a 67% greater risk of incident type 2 diabetes, compared to non-consumption, in a 2009 report from the U of TX (Nettleton, 2009). Whatever the concern might be, fake sugars stir the soup and promote insulin release (Malaisse, 1998). One of the mechanisms involves faking out the brain, not only with renegade appetite signals, but also with altered reward processing of the sweet sensation that rightfully belongs outside the sphere of artificial sweeteners (Green, 2012). As with all heath topics, the debate goes on because some people remain completely unaffected. And we thought that only Superman was bulletproof. The bottom line is that artificial sweeteners do not activate the food reward pathways in the same fashion as natural ones (Smeets, 2005).

References

[No authors listed]
“Inactive” ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs.
Pediatrics. 1997 Feb;99(2):268-78.

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS.
Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.
J Toxicol Environ Health A. 2008;71(21):1415-29.

Stephen D. Anton, Corby K. Martin, Hongmei Han, Sandra Coulon, William T. Cefalu, Paula Geiselman, Donald A. Williamson
Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels
Appetite 55(1); Aug 2010: 37-43

Black RM, Leiter LA, Anderson GH.
Consuming aspartame with and without taste: differential effects on appetite and food intake of young adult males.
Physiol Behav. 1993 Mar;53(3):459-66.

Blundell JE, Hill AJ.
Paradoxical effects of an intense sweetener (aspartame) on appetite.
Lancet. 1986 May 10;1(8489):1092-3.

Brown RJ, de Banate MA, Rother KI.
Artificial sweeteners: a systematic review of metabolic effects in youth.
Int J Pediatr Obes. 2010 Aug;5(4):305-12.

Brusick D, Borzelleca JF, Gallo M, Williams G, Kille J, Wallace Hayes A, Xavier Pi-Sunyer F, Williams C, Burks W.
Expert panel report on a study of Splenda in male rats.
Regul Toxicol Pharmacol. 2009 Oct;55(1):6-12.

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP.
Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.
Obesity (Silver Spring). 2008 Aug;16(8):1894-900.

Green E, Murphy C.
Altered processing of sweet taste in the brain of diet soda drinkers.
Physiol Behav. 2012 Nov 5;107(4):560-7.

Magnuson BA, Burdock GA, Doull J, Kroes RM, Marsh GM, Pariza MW, Spencer PS, Waddell WJ, Walker R, Williams GM.
Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies.
Crit Rev Toxicol. 2007;37(8):629-727.

Malaisse WJ, Vanonderbergen A, Louchami K, Jijakli H, Malaisse-Lagae F.
Effects of artificial sweeteners on insulin release and cationic fluxes in rat pancreatic islets.
Cell Signal. 1998 Nov;10(10):727-33.

Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr.
Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).
Diabetes Care. 2009 Apr;32(4):688-94

Pepino MY, Tiemann CD, Patterson BW, Wice BM, Klein S.
Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load.
Diabetes Care. 2013 Apr 30.

Rogers PJ, Carlyle JA, Hill AJ, Blundell JE.
Uncoupling sweet taste and calories: comparison of the effects of glucose and three intense sweeteners on hunger and food intake.
Physiol Behav. 1988;43(5):547-52.

Rudenga KJ, Small DM.
Amygdala response to sucrose consumption is inversely related to artificial sweetener use.
Appetite. 2012 Apr;58(2):504-7.

Smeets PA, de Graaf C, Stafleu A, van Osch MJ, van der Grond J.
Functional magnetic resonance imaging of human hypothalamic responses to sweet taste and calories.
Am J Clin Nutr. 2005 Nov;82(5):1011-6.

Stellman SD, Garfinkel L.
Artificial sweetener use and one-year weight change among women.
Prev Med. 1986 Mar;15(2):195-202.

Swithers SE, Martin AA, Davidson TL.
High-intensity sweeteners and energy balance.
Physiol Behav. 2010 Apr 26;100(1):55-62. Epub 2010 Jan 6.

Qing Yang
Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings:Neuroscience 2010
Yale J Biol Med. 2010 June; 83(2): 101–108.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.