The perils of marketing sugar free beverages as ‘healthy’

Obesity is a worldwide pandemic. A quarter of all adults in the UK are currently considered obese, and terrifyingly one in five children between the ages of 10 and 11 are also in the obese category. But fear not. The soft drinks industry has the answer to one of the biggest health crises currently facing the Western world. The solution? Sugar free soft drinks. A low-calorie alternative to sugar, without the detrimental health problems attached, but crucially maintaining the same taste quality, the market for these drinks has grown year on year. And why wouldn’t it? These drinks have zero sugar, some zero calories. Surely, the only other drink this pure is water?

Well, no. Not exactly. You see what has actually happened is that in the last 10 years a large amount of scientific research has been released espousing the dangers of sugar, linking it to obesity and type II diabetes (Imamura et al., 2015). If fat was the obesity villain of the twentieth century, ever expanding our waistline, then sugar has taken over the mantel in the twenty first (Leslie, 2016). Figure 1 provides a good visualisation of added sugar in soft drinks. Sugar added to drinks provides the body with a huge number of calories but provides no additional nutritional benefits. For example, fruits such as oranges are naturally high in sugar, but in eating them a person also consumes large amounts of fibre and multivitamins. There is no such added nutrition in fizzy drinks. Research was also released in 2013 suggesting that sugar is more addictive to the body than drugs such as cocaine (Ahmed et al., 2013). In the last 15 years sugar has emerged as a dangerous contributor to the obesity epidemic.

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Figure 1: The amount of sugar in different Coca-Cola and Pepsi products. Taken from: http://www.diabetes.co.uk/sugary-soft-drinks.html

 

Research led to huge government initiatives to both increase taxation of sugary drinks and to also increase awareness of the dangers associated with their intake. This could have been catastrophic for the soft drinks industry. But they had a trump card. Sugar free alternatives. Figure 1 highlights their appeal when compared to sugar filled drinks. Intake of sugar provides a huge energy boost, that if not used is converted to fat for storage. Sugar free drinks work on the basis that these synthetic sweeteners provide little if any energy, but deliver the same sweet taste (Borges et al., 2017). The fizzy drink industry has taken full advantage of this and have branded these drinks as a healthy alternative that will help you lose weight (de Sá, 2014; Sylvetsky et al., 2012). Artificial sweeteners provide a way to benefit big business, and curb the obesity crisis. Apt that their benefits are being extolled just at the same time governments are clamping down on the soft drinks industry.

There are, however, issues with corporations branding sugar free drinks as ‘healthy’. There are long standing concerns that sugar free sweeteners trigger compensatory mechanisms within the body that prevent weight loss. Sweeteners are thought to stimulate taste receptors and increase appetite (Borges et al., 2017). It is also thought that because people are consuming fewer calories in their beverages they then subconsciously over consume other types of food (Blundell and Hill, 1986). Research into the effects of sugar free drinks on weight loss is limited and can be divided into one of two categories. That carried out by groups with interests in the fizzy drinks industry and research carried out by people without a conflict of interest. The majority of papers released state that there is no relationship between intake of sugar free drinks and weight loss. A small minority of papers found a small link between their intake and weight loss, but these papers were either poorly carried out, had links to big fizzy drinks corporations, or both (Borges et al. 2017). In terms of scientific research, this limits their validity. At this time claims by the soft drinks industry that sugar free alternatives to fizzy drinks will help aid weight loss, appear to be wholly unsubstantiated.

There are also concerns about the health effects of these chemical sweeteners on the body. Sweeteners such as aspartame and acesulfame K have only been consumed by humans in large quantities for the last 50 years, their long-term effects on the body are relatively unknown. It has been suggested that such chemicals can cause glucose intolerance by altering gut microbiota (Suez et al., 2014). Although meta-analyses have since found that such papers are subject to publication bias and confounding effects (Imamura et al., 2015). This basically means that because the paper produced contentious and headline grabbing results, it was more likely to be published and that if false positive results were found they wouldn’t be discarded as frequently as usual due to public interest. While properly conducted scientific research is lacking, a huge amount of unsubstantiated online content can be found on the negative effects of sugar free beverages. (For example: http://www.sweetpoison.com/aspartame-side-effects.html). These are often linked to the sweetener aspartame. The most contentious of the artificial sweeteners, it has been linked to brain tumours, leukaemia and allergic reactions. However, comprehensive studies into these claims have found it to be perfectly safe for human consumption. The body breaks the chemical down into harmless by-products such as aspartic acid. Headaches and migraines are also the biggest symptom exhibited in placebo trials (NHS, 2016). There appears to be numerous second hand accounts on the dangers of these sweeteners, but the science to back up these claims is lacking. The current scientific consensus is that artificial sweeteners are perfectly safe for human consumption.

Ultimately these drinks have been marketed on a global scale as a ‘healthier’ alternative to soft drinks containing sugar. To refer to them as healthy is an overstatement and an indictment of how global businesses will bend the truth to sell a product. Sugar free alternatives are probably less damaging than their sugar filled counterparts, but this does not make them healthy. More research needs to be carried out by scientists, specifically institutions that have no conflict of interest with the soft drink industry, to assess the effect of these drinks on weight and health. Government policy then needs to be implemented to increase awareness and ban unsubstantiated claims made by the soft drinks industry. This will better inform the general public on what they are consuming. If in doubt and trying to lead a healthier lifestyle/lose weight, the healthiest beverage will always be water.

References

Ahmed, S.H., Guillem, K., Vandaele, Y. (2013) Sugar addiction: pushing the drug sugar analogy to the limit. Current Opinion in Clinical Nutrition and Metabolic Care 16: 434-439

Blundell, J.E. and Hill, A.J. (1986) Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet 1, 1092-1093

Borges, M.C., Louzada, M.L., Hérick de Sá, T., Laverty, A.A., Parra, D.C., Garzillo, J.M.F., Monteiro, C.A., Millett, C. (2017) Artifically sweetened beverages and the response to the global obesity crisis. Public Library of Science Medicine 14: 1-9

de Sá, H. T., (2014) Can Coca Cola promote physical activity? Lancet 383, 2041

Hull, J.S. http://www.sweetpoison.com/aspartame-side-effects.html Last accessed: 13/03/17

Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S.N. et al. (2015) 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 fractions. The British Medical Journal 351: h3576

Leslie, I. (2016) The sugar conspiracy. The Guardian https://www.theguardian.com/society/2016/apr/07/the-sugar-conspiracy-robert-lustig-john-yudkin Last accessed: 5/3/17

NHS (2016) The truth about aspartame. http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-aspartame.aspx Last accessed: 5/3/17

Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C.A., Maza, O., et al. (2014) Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 514, 181-186

Sylvetsky, A.C., Welsh, J.A., Brown, R.J., Vos, M.B. (2012) Low-calrie sweetener consumption is increasing in the United States. The American Journal of Clinical Nutrition 96, 640-640

Picture; Diabetes UK http://www.diabetes.co.uk/sugary-soft-drinks.html Last accessed: 5/3/17

Using dragons blood to fight antibiotic resistance

Antibiotic resistance is one of the biggest threats facing the modern world. Frivolous prescriptions and largescale agricultural usage had led the world to the brink of a post antibiotic age. Such a world harks back to Victorian times, people dying from infected cuts, routine operations becoming a thing of the past and long forgotten diseases, such as tuberculosis, becoming commonplace. As you might imagine there has been a huge scientific response to try and establish new ways to kill bacteria before antibiotics become obsolete. This has ranged from the discovery of new antibiotics (Ling et al., 2015) to using other forms of bacteria to kill the pathogens (Tyson & Sockett, 2017). A new paper published in The Journal of Proteome Research by Bishop et al. (2017) suggests that they may have found another method, dragons blood. Not the mythical winged beasts with a penchant for dwarfish gold, but the closest real world equivalent, the Komodo dragon.

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Figure 1: A Komodo dragon (Varanus Komodoensis). Taken from: https://goo.gl/images/kPEqh0

 

It is a popular urban myth that Komodo dragons use bacteria in their mouths as a form of venom. The story goes that if an animal is bitten by a Komodo dragon but escapes, they will eventually die from the wound as bacteria within the dragons mouth will infect and kill the animal. Scientists have since discovered that the beasts have venom glands and surprisingly kill their victims with venom (who would have thought?) (Fry, et al., 2009). However, while the bacteria in the dragons mouths are not responsible for killing, a broad spectrum is present in saliva, the vast majority of which can be considered ‘potentially pathogenic’ (Bishop et al. 2017). So how do Komodo dragons quite happily live with these pathogenic bacteria in their saliva without any signs of infection? Especially as frequent fighting between dragons includes biting, but battle wounds hardly ever lead to infection. This led scientists to look at the immune system of the Komodo dragon.

Bishop et al. specifically looked at cationic antimicrobial peptides (CAMPs) in the dragons blood plasma. These peptides are an essential part of the immune system and are found in nearly all living organisms. They function as part of the innate immune system (that which is present from birth). They appear to work by directly interacting with pathogens as the body’s first line of defence. They target the lipopolysaccharide (LPS) layer of bacterial cell membranes. Some have even been found to enhance the effect of antibiotics (Bahar and Ren, 2013). CAMPs have displayed effectivity against bacteria, viruses and fungi. These molecules are conserved across evolution but hardly any bacterial resistance has been observed. For these reasons scientists have increased research into CAMPs in recent years. Bishop et al. designed a new method for extraction and identification of CAMPs from the Komodo dragon plasma, deemed ‘bioprospecting’, that is faster and more efficient than previous methods.

Firstly, CAMPs were harvested from blood plasma. Plasma was used that had been stimulated by incubating it with LPS, as the presence of bacterial cell markers has been shown to increase the production of CAMPs in blood plasma. Unstimulated blood plasma was also used. The process by which this occurred is illustrated in Figure 2. The particles were then analysed using complex mass spectrometry. Peptides that had no match to databases were looked at further to see if they contained DNA sequences and chemical properties related to CAMPs with known antimicrobial properties (i.e. similar pH, hydrophobicity, size). To do this a computer script was created using the coding programme PYTHON, it was this step that reduced analysis of potential target molecules from weeks to a matter of minutes.

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Figure 2: How CAMPs were separated from blood plasma. A) Hydrogel particles were added to the plasma. B) The particles attract all the small cationic peptides in the plasma but exclude larger proteins. C) The particles are purified from the sample D) and eluted to remove the hydrogel particles. E) the peptides are sequenced. Taken from Bishop et al., 2015

 

Bishop et al. found 48 potential new CAMPs using this method. All but one were histone derived proteins. Histones are proteins that are involved with condensing chromatin so that chromosomes fit within a cells nucleus, they also play a role in gene activation. Research has been published showing that histones might also have antimicrobial properties (Hirsch, 1958). Findings align with previous publications and suggests that further research is needed into the antimicrobial properties of histones and their derivatives. The antimicrobial properties of 8 out of the 48 potential CAMPs were tested against two different types of potentially pathogenic bacteria, Pseudomonas aeruginosa, which is gram negative, and Staphylococcus aureus, which is gram positive.  Seven of the peptides were effective antimicrobials against both bacteria, the 8th CAMP was only effective against P. aeruginosa.  

These results open the door to further study into the antimicrobial properties of CAMPs. Such research is especially promising as plasma from other species of animal may be host to a whole different range of CAMPs. This would mean that if resistance were to develop, a new drug with a different CAMP could be used to treat infections. This is no panacea but, as scientists have started to realise, bacteria will always develop resistance to antimicrobials. The trick is to keep developing compounds to combat them and stay one step ahead. While this research is still a long way from creating drugs based on these CAMPs, it is not impossible that one day we may be taking pills with extract of dragon blood to help fight infections.

References

Bahar, A.A. and Ren, D. (2013) Antimicrobial Peptides. Pharmaceuticals 6, 1543-1575

Bishop, B.M., Juba, M.L., Devine, M.C., Barksdale, S.M., Rodriguez, C.A., Chung, M.C. et al. (2015) Bioprospecting the American alligator (Alligator mississippiensis) host defense peptidome. Public Library of Science One 10, 1-17

Bishop, B.M., Juba, M.L., Russo, P.S., Devine, M., Barksdale, S.M., Scott, S. et al. (2017) Discovery of novel antimicrobial peptides from Varanus komodoensis (Komodo Dragon) by large-scale analyses and De-Novo-Assisted sequencing using electron-transfer dissociation mass spectrometry. Journal of Proteome Research

Fry, B.G., Wroe, S., Teeuwisse, W., Van Osch, M.J.P., Moreno, K., Ingle, J. (2009) A central role for venom in predation by Veranus komodensis (Komodo Dragon) and the extinct giant Varanus (Megalania) priscus. Proceedings of the National Academy of Sciences 106, 8969-8974

Hirsch, J.G. (1958) Bactericidal action of histones. The Journal of Experimental Medicine 108, 925-944

Ling, L.L., Schneider, T., Peoples, A.J., Spoering, A.L., Engles, I., Conlon, B.P. et al. (2015) A new antibiotic kills pathogens without detectable resistance. Nature 517, 455-459

Tyson, J. and Sockett, E.R. (2017) Nature knows best: employing whole microbial strategies to tackle antibiotic resistant pathogens. Environmental Microbiology Reports 9, 47-49

https://goo.gl/images/kPEqh0 Last accessed: 5/3/17