An article published in the May issue of Archives of Disease in Childhood advises that children with acute vomiting and diarrhea should not use ‘flat’ carbonated beverages as an alternative for oral rehydration solution.

Patients with gastroenteritis (inflammation of the gastrointestinal tract) who are losing fluids, salts, and sugars due to diarrhea and vomiting typically ingest an oral rehydration solution that contains a certain balance of salts and sugars that can prevent dehydration. People often think that ‘flat’ carbonated beverages can be effective substitutes for these solutions – an especially appealing notion for children who are put off by the taste.

Researchers from the Watford General Hospital’s emergency department for children combed through the literature to see if any published studies could support this alternative solution. After the search failed to find relevant studies, the researchers decided to compare the contents of different types of liquids. Ultimately they determined that carbonated beverages contain too much sugar and not enough salts.

Recommendations supplied by the World Health Organization specify that oral rehydration solutions should contain 75 mmol/l of both sodium (salt) and glucose (sugar). According to published biochemical analyses, carbonated drinks have sodium levels between 1.0 and 9.9 mmol/l and potassium levels between 0 and 0.3 mmol/l – much lower than recommended. Glucose levels in carbonated beverages were much higher than the recommended level, as branded cola has more than 7 times the recommended amount (about 550 mol/l).

The authors conclude that, “There is little direct clinical data to answer our question but many scientific analyses demonstrating the inappropriateness of non-physiological liquids for the treatment of acute gastroenteritis in children compared with physiologically based oral rehydration solutions. No study reported the degree of carbonation (ie, how ‘flat’ or ‘fizzy’ the carbonated drinks were) in relation to electrolyte content or osmolality. Therefore carbonated drinks, ‘flat’ or otherwise, including cola, provide inadequate fluid and electrolyte replacement and cannot be recommended.”

Does drinking “flat” cola prevent dehydration in children with acute gastroenteritis?
M Jacobs and A Reece
Archives of Disease in Childhood (2008)
doi:10.1136/adc.2008.142521
Click Here to View Journal Website

Written by: Peter M Crosta