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.

sugar.jpg

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

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