by Dr. Charles Mok
So let’s talk about dieting.
The American “diet” (noun) has led to a host of problems, not the least of which is the increase of obesity and obesity-related diseases such as hypertension, diabetes, cancer, heart disease…and a long list of modern epidemics in our country. The weight loss epidemic has motivated us to find diets (verb) that can help us get back on track and normalize our weight.
You will see on social media, hear from your peers, and watch on TV advice for diets that can off setpre-packaged foods, supplements, and even drugs to help you get the weight off.
You are probably skeptical if you have tried one of these “breakthroughs” that promised results if you spend money, make an effort, or adopt a belief, and they didn’t ultimately work out.
I am not going to say that you shouldn’t try various diets, supplements, or techniques. But, I would like to talk about the science of one of the most popular trends that has been a huge market for decades.
“Diet” beverages are sweetened beverages designed to replace our cravings for sugar with artificial sweeteners. I am going to avoid talking about all the scientific data that has made me advise my patients not to consume artificial sweeteners (there are numerous human and animal studies demonstrating why these don’t work).
A 6-month study in Mexico involving nursing students was elegantly performed to determine if diet drinks actually work. Mexico has a high incidence of obesity, similar to the United States, as well as a high consumption of sweetened beverages. These can include soda, juice, coffees, and other sweetened beverages containing sugar or sugar substitutes.
In this study, they divided the nursing students into three groups. They were about the same at baseline regards to average weight (tended to be overweight like 70% of the population), dietary patterns, and overall health. All three groups were over 18 (but as students, they were generally in their early 20s and contained more females than males) and consumed over 12 oz per day of sugar sweetened beverages.
No sweetened beverages.
Sweetened beverages that were “diet” (i.e. not containing sugar, but sugar substitutes).
Sweetened beverages, with either sugar or other natural sweeteners.
There were about 150 individuals who followed through with the study, here are the results:
“No sweetened beverages were permitted, only plain water, lemon and hibiscus flavored water, coffee and tea without sugar were permitted”
At 3 months, this group lost, on average, about 4 lbs at 3 months, and about 7 ½ lbs at 6 months. They also had better blood pressures, and their waistlines became thinner.
“Only allowing beverages with non-caloric sweeteners, plain water, lemon and hibiscus flavored water, coffee and tea without sugar were permitted”
They lost a little over a pound at 3 months and had slightly smaller waists, but at 6 months, they gained the weight back and then some.
“Had no modification in consumption of beverages, and only given general recommendations about beverages”.
They gained weight at 3 months and 6 months, pretty similar but slightly more than those who consumed “diet” drinks.
Diet sweetened drinks can be called “diet” because, in the very short term, they do lead to inconsequential weight loss. But long term they are pretty much the same as sugary beverages. They lead to weight gain. On the other hand, training yourself to drink unsweetened beverages leads to long, sustained weight benefits.
We can think of various reasons for this. This study was not designed to determine the “why didn’t it work,” but they did notice that the individuals who consumed artificially sweetened drinks tended to consume more food overall, particularly carbohydrates, while those who consumed no sugar or artificial sweeteners tended to consume less overall carbohydrates.
This corresponds to other literature which suggests that consuming more water leads to less hunger, and consuming either sugar or sugar substitute sweetened drinks lends to increase hunger for carbohydrates.
The bottom line: Diet beverages do not work. Kick the sweet tooth addiction and get your life back.
Thank you for reading, and I hope this can help impact your life and your health.
“A randomized control trial for reduction of caloric and non-caloric sweetened beverages in young adults: effects in weight, body composition and blood pressure”
Nutr Hosp. 2016; 33(6):1372-1378