How To Avoid Sugared Soda

Transcription

1 Healthy Beverage Choices and Prevention of Obesity, Diabetes, and Cardiometabolic Diseases Frank B. Hu, MD, PhD Professor of Nutrition and Epidemiology Harvard School of Public Health Professor of Medicine Harvard Medical School

2 Harvard Public Health Review

3 What are Sugar-Sweetened Beverages? Examples Sodas Fruit Drinks Energy Drinks Coke Pepsi Mountain Dew Orange Soda Root Beer Sprite 7-Up Capri Sun Fruitopia Hawaiian Punch Hi-C Kool-Aid Minute Maid Snapple juices Adrenaline Rush Full Throttle MDX No Fear RockStar EnergyVault Sports Drinks Gatorade Powerade

4 Per capita calories from SSB in US children: Wang et al. Pediatrics. 2008

5 Soft drink ingredients Energy: kcal/ounce or ~ kcal/12 ounce can Sugars: g/ounce (~10 tsp/12 ounce can) Sweetened by high fructose corn syrups (55% fructose and 40% glucose)

6 US Per Capita High Fructose Corn Syrup Disappearance , Pounds / Year Year

7 SSB and Obesity Strong evidence points to a positive relationship between SSB and obesity Teens: For every can of sugared soda per day, increased risk of obesity by 60% In adults, regular consumption of SSB leads to greater weight gain Source: Ludwig et al., Lancet, 2001; Schulze et al., JAMA, 2004

8 SSB and Obesity: Why? Fluids are not be as satiating as solid foods. The body doesn't seem to "register" fluid calories as carefully as it does those from solid food. Sweet tasting soft drinks might stimulate the appetite for other sweet, high carbohydrate foods.

9 SSB and Risk of Type 2 Diabetes in the Nurses Health Study Relative Risk <1/mo 1-4/mo 2-6/wk >=1/d Sugar-sweetened soft drink consumption multivariate adjusted P<0.001 for trend multivariate + BMI

10 Emerging evidence on heart disease The Nurses' Health Study, which tracked the health of nearly 90,000 women over two decades, found that women who drank more than two servings of SSB each day had a 40 percent higher risk of heart attacks or death from heart disease than women who rarely drank SSB. Frequent consumption of SSB is also associated with high blood pressure and high triglycerides. Fung et al, AJCN, 2009

11 SSB and Risk of Gout Gout is inflammatory arthritis with uric acid building up in the joints Convincing evidence that regular consumption of SSB induces the production of uric acid and leads to high levels of blood uric acid. One serving per day of SSB is associated with 50% increased risk of developing gout.

12 Juice: A healthier option? Source:

13 Which has the most sugar? per 12 ounce serving Source:

14 per 12 ounce serving 150 calories 195 calories 255 calories 240 calories

15 100% fruit juice Fruit juice has vitamins and minerals, but it is high in calories, so stick to no more than a small glass (four to six ounces) a day.

16 Healthier beverage alternatives Water Coffee and tea Diet soda? Milk?

17 Beverage choices and weight gain Changes in beverage intake and changes in weight Weight change associated with each increased daily servings, per 4-y period (Ib) An Pan, 2011 (unpublished data)

18 Beverage substitutions and type 2 diabetes Fruit juice by tea Fruit juice by milk Fruit juice by coffee Fruit juice by water SSB by tea SSB by milk SSB by coffee SSB by water Substitution model for type 2 diabetes An Pan, 2011 (unpublished data)

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20 Diet Soda Some long term studies show that regular consumption of diet soda reduces calories and promotes weight loss or maintenance. Others show no effect, while some show weight gain. Diet drinks with artificial sweeteners may condition our taste buds to crave super sweet foods.

21 SSB vs. Diet Sodas and Diabetes Risk 1/day P for trend SSB Age adjusted 1.25 ( ) <0.001 Multivariate 1.24 ( ) <0.001 Diet soda Age adjusted 1.91 ( ) <0.001 Multivariate 1.09 ( ) 0.13 Adjusted for diabetes risk factors, high TG, HBP, previous weight change, dieting, baseline BMI De Konning et al. AJCN 2011

22 Harvard beverage guidelines Red: High sugar, drink sparingly Yellow: New beverage industry target No more than 1 gram sugar/oz 70% less sugar than a typical soft drink Cannot contain calorie free sweeteners (no Splenda, Nutrasweet, Stevia, etc.) Green: Best choice sugar free or nearly sugar free

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24 Healthy beverage recommendations Quit the sugar habit. The average can of sugarsweetened soda or fruit punch has 150 calories. If you were to drinks just one can of SSB every day, and not cut back on calories elsewhere, you could gain up to 15 pounds in a year. Cutting back on sugary drinks can help control your weight and lower risk of diabetes, heart disease, hypertension, and gout.

25 Healthy beverage recommendations Go calorie free naturally. Diet drinks with artificial sweeteners may condition our taste buds to crave super sweet foods. Plain water is the best calorie free beverage but if it s just too plain, try adding a squeeze of lemon or lime or a splash of 100% fruit juice. Un sweetened coffee and tea are also healthy caloriefree choices.

26 Focus on healthier drinks Beverage manufacturers Individuals Family food shoppers Food service (schools, worksites), restaurants Government

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28 Acknowledgement Lilian Chueng Sari Kalin An Pan Vasanti Malik Larry DeKoning Walter Willet