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Study urges cutback in soda

Soft drinks a likely culprit in weight gain, analysis says

By JOHN FAUBER
Wisconsin Journal Sentinel,  Aug. 9, 2006

The role of soda in America's bulging waistline has been hotly debated, but a new analysis says that it has been an increasing source of calories for children and adults, a trend that likely has led to weight gain and obesity.

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While providing little nutrition, soda most likely has increased the risk of diabetes, fractures and cavities, according to a review article in the August issue of the American Journal of Clinical Nutrition.

The typical 12-ounce soda has 150 calories and the equivalent of 10 teaspoons of sugar, mostly in the form of high-fructose corn syrup, the article said.

Drinking one soda a day can lead to a one-year weight gain of 15 pounds.

"Consumption of sugar-sweetened beverages such as soda and fruit drinks should be discouraged and efforts to promote the consumption of other beverages such as water, low-fat milk and small quantities of fruit juice should be made a priority," the author wrote.

While the findings in the article might be viewed as common sense, it has been difficult to prove in individual studies that soft drinks are a major factor in obesity and weight gain, said Frank Hu, the review's senior author.

Other factors such as a reduction in physical activity over the years also are likely to play a role, said Hu, a professor of nutrition and epidemiology at Harvard School of Public Health.

"I think the controversy will continue, but I don't think we should wait for the perfect study," he said. "We have sufficient evidence to take action."

That action might include removing soda and other vending machines from schools, reducing soft drink consumption at home and limiting marketing and advertising of soft drinks to children, he said.

What about fruit juice?

Shailesh Patel, professor and chief of endocrinology at the Medical College of Wisconsin, would take it even one step further, telling people to avoid not just soda, but fruit drinks and juices as well.

"Eat fruit; never drink it," said Patel, who practices at Froedtert Memorial Lutheran Hospital in Wauwatosa. "There is no such thing as a healthy fruit juice, even orange juice. If you want vitamin C, eat the fruit."

Patel said the easily digestible liquid carbohydrates in juice provide calories without filling a person up and without activating the normal hormonal mechanisms that let him or her know when to stop eating.

"You are actually cheating physiology that has evolved," he said.

In addition, soft drinks and juices raise triglycerides, an unhealthy type of fat in the blood, which in turn lower HDL cholesterol (the good kind), he said. Low HDL cholesterol increases the risk of heart disease.

Many of Patel's patients with elevated triglycerides can get their numbers back to normal by cutting out soft drinks and juices, Patel said.

Dan McCarty, an epidemiologist at the Marshfield Clinic, said he would not tell people to eliminate fruit juice, but it is a good idea to limit consumption.

"It's better than soda if it's real 100 percent fruit juice because it does contain vitamins," he said.

On the other hand, eating fruit is better than drinking fruit juice because of the fiber and its ability to be more filling, he said.

McCarty said that for people who are trying to lose weight, one of the first and most effective measures they can take is to cut out soft drinks.

Article reviews years of studies

The article, by researchers at the Harvard School of Public Health, reviewed 30 studies published between 1966 and May 2005.

America's sweet tooth has gotten so voracious that nearly 16% of calories in the typical diet now come from added sugar, and about half of that comes in the form of soda and other sweetened soft drinks, according to the article.

Soda is especially fattening because the low satiety of liquid carbohydrates does not result in an equivalent reduction in eating at meals, the article said.

The review also questions the role of high-fructose corn syrup, which is used to sweeten soft drinks in the United States, while sucrose is used in Europe. It may increase the risk for diabetes.

Although the two sweeteners contain the same amount of calories, chemical differences have led some to theorize that fructose may cause greater weight gain and insulin resistance by elevating triglycerides.

In theory, fructose could cause a greater decrease in insulin production, as well as affect levels of the hormone leptin, which is involved in appetite suppression.

The authors say more study is needed to determine if high-fructose corn syrup causes more weight gain or a greater diabetes risk than other types of sugars.

The review was funded by the American Heart Association and the National Institutes of Health.

To read the report, go to www.ajcn.org/cgi/content/full/84/2/274.

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