The Downside to Diet Drinks: What to Tell Your Patients

Posted by Karina Erdelyi

By Nancy WurtzelThe case against diet soda is building. A growing body of evidence, including a new study published recently in the April 2017 issue of the medical journal Stroke is linking diet soda drinks to a widening range of medical issues.This latest research examined data from 4,000 adults over the age of 45. The data came from the Framingham Heart Study, a project of the National Heart, Lung, and Blood Institute and Boston University. Researchers looked for a correlation between diet soda and dementia and stroke. Their conclusions: Individuals who drank at least one diet soda daily were three times as likely to develop dementia or have a stroke as those who did not consume diet drinks.The reasons behind this link are unclear, and it is also important to point out that while the study determined there is a correlation, it did not establish cause and effect. However, other research has found brain changes when diet soda is consumed. The journal Alzheimer’s & Dementia found the intake of diet soda, one or more per day, was associated with smaller brain volume.The introduction of diet soft drinks goes back more than sixty years. Originally, diet sodas were marketed mainly to people who had diabetes, but that changed in 1963 when Coca-Cola launched Tab, which caught on fast with consumers and eventually helped revolutionize the soda industry. Coca-Cola selected the name “Tab” because the diet drink contained zero calories and therefore people could consume as much as they wanted and still keep tabs on their weight.Coca-Cola also marketed its diet soda products as a “healthy alternative” to regular soda, which was laden with sugar.With the success of Tab, other soft drink makers began jumping on the diet bandwagon. Diet soda drink sales soared for several decades, especially among women. However, the market peaked in 2005 when the industry reported sales of more than 3 billion cases of diet soda.A decade plus later, market demand for diet soda drinks has fallen and continues to decline.Fortune magazine sums up the state of the soda industry for the year 2015, “…the big losers were yet again the diet soda brands,” wrote journalist Jon Kell. “That’s because consumers have become increasingly skeptical of artificial sweeteners, most recently fretting about the health implications of consuming aspartame…” he added.While it is true that diet soda’s popularity has been waning with consumers, one in five Americans still reports they consume diet sodas regularly.What should you advise your patients about soda consumption? First, avoid demonizing diet soda as this may turn the patient off immediately.Instead, select a few examples from below to share with the patient:

• Artificially sweetened sodas and beverages were introduced to solve a problem – excessive sugar consumption.
• At the time, it was thought these alternatives were safe and healthy, but we now have more information, which shows diet drinks have some negative side effects.
• Diet sodas contain one or more artificial sweeteners such as saccharin, aspartame, and sucralose. These chemicals confuse the body, causing it to think it is actually getting a dose of glucose, but instead it is an artificial chemical.
• Studies have shown diet drinks can cause headaches and even migraine.
• The citric acid in diet sodas is very hard on teeth, weakening the tooth enamel. In 2013, CBS news reported that drinking diet sodas takes a huge toll on oral health. “Drinking diet soda for years takes a toll on the teeth that’s comparable to years of smoking crystal meth or crack cocaine,” Michelle Castillo reported for the network.
• The National Institutes of Health report diet sodas are linked to bone density loss in older adults.
• Instead of losing weight, diet sodas are now widely believed to cause weight gain.
• The British Journal of Nutrition, revealed people who drink diet sodas raise their risk of type 2 diabetes by about 13% for each 12-ounce can they drink daily.
• David DiSalvo wrote in Forbes magazine, “Diet sodas could imbalance the bacterial jungle in our guts—the microbiome—causing unpredictable results. Since there’s a bacterial superhighway from gut to brain, which we know interacts with key neurotransmitters, this theory may eventually tell us more of a much bigger brain story.”

Suggest the patient reduce and ultimately stop consuming diet soda drinks. Gauge their reaction. If the patient agrees, then offer support and encouragement.Tell your patient to drink more water to stay hydrated. Ask the patient to pay attention to how he or she feels when diet soda is eliminated. Most diet soda drinkers are taking in a lot of caffeine, so there might be side effects when stopping.

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