Mar 18 2019

Sugary Drinks Linked to Heart Disease

A new study adds confirmation to what we have already been seeing in the data – drinking a lot of sugar-sweetened drinks, like soda, is linked to an increased risk of heart disease and death in men and women. This may seem obvious, but it is worth repeating precisely because it is a pretty straightforward bit of health advice that tends to get lost in the noise of bad health advice.

For example, during my visit a few years ago to Google I noted that the company tries to offer a healthy environment for its workers, providing the space and time to exercise, and a freely available snack room filled with healthful snacks. However, their refrigerator was filled with drinks that were sweetened with “all natural cane sugar” and none with artificial sweetener. This is backwards, falling for recent health fads and the appeal-to-nature fallacy. It doesn’t matter if sugar comes from sugar canes, sugar beets, is raw, natural, non-GMO, organic, or whatever. In the end it is all crystalized sucrose. And it’s really no different than high fructose corn syrup.

What matters is how many calories you are consuming from concentrated simple sugars. We evolved to like the taste of sweetness because simple carbohydrates provide much needed calories and glucose. We evolved in a calorie-limited environment, and so seek out high-calorie food. But we then used technology to hack our love of sweet foods. It didn’t take modern technology either. Native Americans figured out how to get syrup from maple trees, and that innovation is linked to a spike in various diseases, such as tooth decay, obesity, diabetes, and heart disease. Honey is another low-tech source of concentrated sugar.

But nothing beats table sugar or similar sources of concentrated calories and sweetness. We have also become accustomed to certain foods being sweet, such as our beverages. Sugar-sweetened beverages are now a significant course of empty calories and excess carbohydrates. One 12 oz can of Coke or similar soda is 140 calories. If you drink 72 oz per day, which is a typical amount to drink, that’s 840 calories – every day. That’s massive. An average daily caloric need is about 2,000 calories, so you are already almost half way there. Even if you have just one can per day, that’s enough calories to equal 14.6 pounds in one year.

You could, of course, decrease your food consumption to compensate, but then you are decreasing food with actual nutritional benefit.

So, it’s no surprise that regular consumption of sugar-sweetened drinks is associated with increased risk of heart disease and death. It contributes to obesity and diabetes, which are huge risk factors. But the data shows it is an independent risk factor even if you control for things like obesity. I doubt this is due to a direct effect of the sugar, but is likely due to all the secondary metabolic and nutritional effects that come from consuming regular calories through concentrated sugar.

The new study is not actually new, in that it is taking an updated look at databases that have existed for years and already have produced studies with similar results. For example, here is a study from 2012 looking at the same data set in men, the┬áHealth Professionals Follow-Up Study. For women they used data from the┬áNurses’ Health Study. So the new study is confirming what we already new from the same data.

The data also shows that if you replace sugar-sweetened drinks with ones that use artificial sweeteners (are you paying attention, Google?) then the risk of heart disease and death is decreased. Of course it is. An yet people will prefer “all natural” sugar cane to artificial sweeteners because they have been confused by the heavily marketed health halo around anything arbitrarily labeled as “natural”.

Artificial sweeteners have also been demonized by the usual suspects pushing conspiracy theories and raging against anything establishment. I recently reviewed the published evidence regarding artificial sweeteners and the bottom line is that they are safe and a healthy option for weight management. So listen to the evidence, not the marketing hype.

In the current study, for men, there was an association with greater health and consumption of drinks with artificial sweeteners. In the women half of the study, having one drink per day with artificial sweeteners was associated with lower risk of heart disease, but more than one with a slightly increased risk. Although this correlation was very weak, and the authors say it needs to be confirmed with additional data. Such weak correlations are likely to be found in large data sets, and do not mean much by themselves – especially in the face of many other studies showing the opposite. Further, this is correlational only and even if you try to account for confounding factors, it’s very difficult to account for them all.

That’s why we have to look at all the scientific evidence – and when you do that, it’s pretty clear that there is a net health advantage to consuming drinks with artificial sweeteners because it helps people limit their sugar intake. But, if you have any lingering concerns, there is always straight water.

So yet again, it is better to listen to the consensus of scientific evidence, rather than marketing hype and fears. Avoid sugar-sweetened drinks. They are empty calories that overwhelms your body’s ability to safely metabolize the sugar-load. We did not evolve to consume large amounts of refined sugar. That is best left for an occasional treat. Meanwhile, low-calorie sweeteners are a perfectly safe alternative. They are among the most studied food ingredients in the world, and every country and health organization that has reviewed the mountain of evidence agrees that they are safe. Don’t listen to the conspiracy theories.

In this case, conspiracy theories might actually kill you.

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