Many "no-sugar" drinks contain sugar substitutes that contribute to health problems and drive up body weight regardless of sugar content.
This article explores the effects of diet sodas on diabetes and how to replace them with less harmful options.
Diet soda and diabetes
People with diabetes should avoid drinking soda due to the high sugar level.
The absence of sugar or calories does not necessarily make diet soda a better drink for people with diabetes.
A recent study in the American Journal of Clinical Nutrition followed 66,118 women for 14 years, keeping track of the drinks they consumed.
By its conclusion, the study linked both sugar-sweetened beverages and artificially sweetened beverages to a higher risk of type 2 diabetes.
The researchers stated that other factors might also be at play in the increased diabetes risk and therefore more studies need to be conducted to prove any causal links.
Other factors that have come to light regarding the health risks of diet sodas include weight gain and metabolic syndrome.
What is metabolic syndrome?
These factors include:
- low levels of "good" cholesterol, or HDL cholesterol
- high blood sugar levels
- belly fat
- high levels of triglycerides, a type of fat in the blood
- high blood pressure
One recent study posted in Diabetes Care found a strong association between diet sodas and diabetes factors. In the study, researchers found a significant link between diet soda and the development of high blood sugar levels and belly fat, two factors of metabolic syndrome.
The results of the study showed a 67-percent increase in the risk of type 2 diabetes in people who drank diet soda daily.
While these are observational results and do not prove a cause-and-effect relationship, diet soda is unlikely to be the best option for people looking to control or prevent type 2 diabetes.
Diet soda and weight gain
There is a long-term link between consuming diet soda and developing belly fat.
Obesity is a contributing factor in diabetes.
Controlling body weight is an important step in managing or avoiding type 2 diabetes.
A study posted in the Journal of the American Geriatrics Society looked at the long-term effects of diet soda on waist size, an indicator of visceral or belly fat.
This type of fat increases the risk of chronic disease more than fat located in other areas of the body. The study lasted for 9.4 years and included a total of 749 participants over 65 years of age.
The waist circumference of participants increased when they drank diet soda for a long period. Participants who drank diet soda on a daily basis showed nearly quadruple the waist gain than those who did not drink it.
This shows a long-term link between consuming diet soda and developing belly fat.
Alternative sweeteners and diabetes
With the rise in the popularity of diet soda comes a matching increase in the use of alternative sweeteners.
People with diabetes sometimes view these sweeteners as viable alternatives to provide sweet flavoring, as they do not contain sugar.
The artificial sweeteners used in diet sodas may still promote health risks, though many do not directly raise blood sugar. These risks include affecting the balance of healthy bacteria in the intestines which may indirectly affect insulin sensitivity and appetite hormones.
The most common alternative sweeteners, whether artificial or natural, in diet sodas are:
- Sucralose: One study showed this sweetener can raise blood sugar higher when carbohydrates are consumed later compared to those who did not consume any sucralose. Sucralose also causes peaks in insulin levels despite not containing sugar. The brand name is Splenda.
- Aspartame: This is a chemical sweetener found in everything from diet soda to chewing gum. Aspartame can increase body mass index (BMI). A study found people who drink diet sodas have consistently higher BMI.
- Acesulfame Potassium (Ace-K): This is a sweetener commonly used in combination with other sweeteners in beverages and snack foods. Ace-K has been linked to gut bacteria changes and weight gain in animal studies.
- Sorbitol: Sorbitol is a sugar alcohol common in diet foods and drinks. It has been linked to severe diarrhea in several studies.
- Stevia: A moderate amount of natural stevia leaf is a safe alternative to sugar.
- Erythritol: This is a corn-based type of sugar alcohol that has fewer calories than table sugar but retains a majority of the sweet flavor. This sweetener has fewer links to digestive upset than other sugar alcohols and has not demonstrated a negative influence on blood sugar, cholesterol, or insulin. Gut bacteria also do not ferment erythritol.
In fact, erythritol has shown protective effects for people with diabetes.
Sugary sodas and diabetes
High blood sugar is characteristic of diabetes.
If a person has diabetes, it is important to avoid drinks that contain excessive sugar, as they cause spikes in blood glucose.
One recent study posted in the BMJ found a link between drinking sugary drinks and the risk of type 2 diabetes.
Another study posted in Diabetes Care found that people who drink 1 or 2 sugar-sweetened drinks every day have a risk of developing type 2 diabetes that is 26 percent higher than those who do not.
Sodas can impact health in a range of harmful ways:
- Plaque loves soda: The bacteria that cause dental plaque need sugar to thrive. Soda washes the mouth in sugar with each gulp, making it a perfect breeding ground for plaque.
- Soda is acidic: Drinking soda regularly can make the mouth more acidic. This increases the risk of cavities, enamel decay, and gum disease.
- Soda provides empty calories: The average can of cola provides around 150 calories, while a 20 ounce (oz.) bottle contains significantly more, and has very little nutritional value.
Address soda cravings with the following options:
Carbonated water with a splash of fruit juice
People who drink soda for the refreshing fizz can choose carbonated water instead. Add a splash of fruit juice, such as lime, lemon, or grapefruit, for that sweet kick. The combination is rich in nutrients and rehydrates the body.
Drinking unsweetened black tea can provide a caffeinated alternative to soda.
Unsweetened black tea is a tasty alternative for people who drink soda for the caffeine boost.
Iced, unsweetened black tea is also available and provides the same level of refreshment as a soda.
Small amounts of caffeine can also help the body to process sugar and control weight. Many low or non-caffeinated herbal teas like citrus green tea, peppermint, hibiscus and others are readily available and are healthy alternative beverages.
People who crave the sweetness of soda might want to consider sweetening tea or carbonated water with whole stevia leaves. The leaves are a no-calorie sweetener with 30-40 times the sweetness of sugar.
They have less of the appetite-enhancing effects of most artificial sweeteners.
Both regular and diet soda are dietary waste. They have few nutrients and have a long list of harmful effects on the body.
Diet soda has links to weight gain and metabolic syndrome, which can make diabetes worse or increase the risk of it developing. Some sweeteners in diet soda even cause insulin spikes in the blood which worsens insulin sensitivity over time and can eventually raise blood sugar levels.
To stop soda cravings, add a splash of fruit juice to some carbonated water, or grab some unsweetened tea.
How do diet sodas link to diabetes if they do not contain sugar?
Diet sodas increases the risk of diabetes by negatively affecting gut bacteria, insulin secretion, and sensitivity. They also cause blood sugar levels to spike when a person eats carbohydrates, increasing waist circumference and body fat.
This can make insulin sensitivity and blood sugar management worse. Artificial sweeteners also alter brain function after meals, which can increase carbohydrate and sugar cravings later.Natalie Butler, RD, LD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.