• Sugar cut in fizzy drinks can prevent diabetes

    Obesity is an epidemic among adults and children in developed countries. It has spread fast in developing countries too. Sugar-sweetened beverages are a major contributor to the problem of obesity. Beverages account for more than 20% of the average daily caloric intake of US adults, according to a study.

    Researchers found that a reduction of one serving of sugar-sweetened beverages per day was associated with a mean weight loss from baseline of 0.49 kg at 6 months, and this mean reduction had grown to 0.65 kg by 18 months. Reducing liquid calorie intake by 100 kcal/day had a more mild effect on weight loss. But overall, reducing caloric consumption from beverages was associated with improved weight loss compared with caloric restriction from solid foods.   

    Two fizzy drinks a day could double the risk of diabetes - even if they are diet versions - a Swedish study has found.Research by the Karolinska Institute on 2,800 adults found that those who consumed at least two 200ml servings of soft drinks daily were 2.4 times as likely to suffer from a form of type- 2 diabetes.Many fizzy drinks are sold in 330ml cans, meaning that one and a half cans would be enough to double the risk. Those who drank a litre of such drinks saw a 10-fold rise in their chance of suffering from the condition.

    The increased risks were the same regardless of whether the drinks were sugary or artificially sweetened, the research published in the European Journal of Endocrinology found.

    Researchers said the sugary drinks may have induced insulin resistance, triggering the cases of diabetes.

    The artificial sweeteners in the diet drinks may stimulate and distort appetite, they said, increasing food intake, and encouraging a sweet tooth. Such sweeteners might also affect microbes in the gut leading to glucose intolerance.

    Josefin Edwall Löfvenborg, lead author, said soft drinks might influence glucose metabolism and insulin sensitivity, leading to the increased risk of latent auto-immune diabetes, a form of type- 2 diabetes.

    It was also possible that those consuming low calorie drinks may have switched to them after a long history of drinking sugary versions, which could explain the link with diabetes, he added.

    Consumers of soft drinks were likely to have a lifestyle which was less healthy overall. 

    A most interesting finding was that the higher risk was the same for both sweetened and artificially sweetened beverages, suggesting that greater risk of diabetes was not directly related to higher calorie intake, or adverse metabolic effects of sugar (in the form of sucrose) from the sweetened drinks.

    Last year, a study by Harvard University suggested that two cans of fizzy pop could increase the risk of heart attacks and strokes.

    The study found the drinks raised the risk of heart attacks by one third and the risk of strokes by one sixth.

    Other studies have linked sugary drinks to a raised risk of prostate cancer. A 15-year study found those drinking 300ml of fizzy drinks daily had a 40 per cent higher chance of the disease.

    Reducing beverage consumption is easy to recommend to individual patients and the public at large, but implementing real change in sugar-sweetened beverage consumption is not straightforward.

    Another report shows that one year after a 10% sugar tax was introduced on sugar-sweetened beverages in Mexico, there was a moderate reduction in sales, by as much as 12% per month in some cases, and a 4% increase in purchases of untaxed beverages.

    Any public-health measures that can reduce the prevalence of obesity, and especially reduce the likelihood of transitioning from healthy weight to obesity, must be worth exploring, especially if the measure is likely to have the greatest effect on population groups most at risk. And better still if the measure can be introduced without a substantial effect on commercial activity.

    Reducing the amount of sugar in soft drinks and fruit juices by 40% over five years could prevent 300,000 cases of diabetes in the UK and stop 1.5 million people from being overweight or obese, according to a study.

    The report is based on efforts to reduce salt content in many foods, which has already seen the amount used cut by a similar amount over the same time period.

    Published in the journal Lancet Diabetes and Endocrinology, the study used data from both the government’s national diet and nutrition survey and the British Soft Drinks Association (BSDA) to calculate the consumption of so-called sugar-sweetened beverages, and how much they contribute to UK-wide sugar and energy intakes.

    The authors, Prof Graham MacGregor and fellow academics at Queen Mary University of London, then estimated how much a person’s energy intake would fall through the hypothetical drop in sugar content, and the resultant reduction in body weight.

    The report said  that the 40% drop in sugar over five years would, by the end of the final year, see an average drop in adult body weight of 1.2kg, meaning about 500,000 adults would no longer be overweight and a million would not be obese.

    If fruit juices were excluded from the scheme, the study said, it could still prevent up to 250,000 cases of diabetes over the same period, with an average weight loss per person of just under 1kg. This would make 300,000 fewer people overweight and 800,000 fewer obese.

    A gradual change in sugar content would be unlikely to change people’s buying habits, the authors argued, while other research showed the calories lost would be unlikely to be replaced from elsewhere.

    While encouraging people to drink fewer sweet drinks should still happen, “the advertising power of industry” made this difficult, the report said. “Our proposed strategy provides an innovative and practical way to gradually reduce energy intake from sugar-sweetened beverages and its combination with other strategies, including a tax on sugar-sweetened beverages, would produce a more powerful effect.”

    Sugary drinks are the biggest source of sugar in young people’s diets. A programme to reduce the sugar from the sweetest drinks – alongside other measures like controls on advertising and marketing – would lead to a significant drop in the amount of calories consumed. A soft drinks tax should also be considered.

    Establishment of a policy whereby manufacturers slowly and imperceptibly reduce the amount of sugar in sweetened beverages during a 5-year period -- without the addition of artificial sweeteners -- could dramatically cut the prevalence of overweight, obesity, and type- 2 diabetes in the population.

    Overall, a 40% reduction in free sugar added to sugar-sweetened beverages at 5 years would lead to an average reduction in intake of 38.4 kcal per day, resulting in an average 1.2-kg reduction in bodyweight in adults by year 5. This would cut the adult prevalence of overweight by 1.0 percentage point (from 35.5% to 34.5%) and obesity by 2.1 percentage points (from 27.8% to 25.7%).

    This would amount to approximately 0.5 million fewer cases of overweight and 1.0 million fewer cases of obesity in the United Kingdom.

    The resulting 1.5% reduction in body mass index (BMI) would in turn prevent between 274,000 and 309,000 new cases of type- 2 diabetes for the next 2 decades, or roughly 15,000 cases per year.

    On the basis of the salt reduction experience, the authors point to several reasons to believe that incremental sugar reduction would work on a large scale. First, as has been seen with salt, human taste preference adapts to small, gradual reductions and is unlikely to lead to increased consumption of sugar from other sources.

    "After 5 years, people have gotten used to the reduction because the taste receptors' appreciation of salt or sugar is reduced. That's been demonstrated time and time again. Once you get used to it, you prefer foods with less salt and sugar," Dr MacGregor said.

    In addition, because the reduction of added sugar to sugar-sweetened beverages will have little effect on the cost and price of the product, it is unlikely to affect sales and profits for the soft-drink industry, which could help politically.

    A successful obesity-prevention policy will need to include several elements beyond sugar reduction, not least to restrict the inducements to consume unhealthy food. These are beamed at children through much of the media they use -- as well as the implementation of a soft-drinks tax.

    In combination, such measures could have a substantially greater effect on sugar consumption than in isolation, bringing even greater relief to the overstretched budgets of the health services across the globe.

    Since reformulation of fruit juices might present a greater challenge, Ma and colleagues performed the same calculations with fruit juices excluded from the category of sugar-sweetened beverages.

    Here, there would be a 31.0-kcal intake reduction per day, leading to a 0.96-kg body-weight reduction and reductions in overweight and obesity of 0.7 and 1.7 percentage points, respectively.

    And, even with fruit juices remaining unchanged, the 40% decrease in sugars in other beverages would prevent between 221,000 and 250,000 new diabetes cases after the predicted body-weight reduction is achieved, the investigators esti