Does Diet Soda Actually Make You Gain Weight?

Sweet taste without the calories sounds like a perfect example of no pain, all gain but unfortunately cumulative data suggests otherwise. A poster child for unintended consequences, diet soda ( Diet drink) typically contains a type of non-caloric artificial sweetenerSugar substitute called  Aspartame, for example NutraSweet or  Equal (sweetener). Unintended consequences in the form of not just weight gain but also increased risk of  Cardiovascular diseaseDiabetes mellitus type 2 Hypertension, Metabolic syndrome, all vigorously disputed of course (see some examples in references 1 2), which brings us to the glaring caveat we need to keep front and center when considering the science about artificial sweeteners. Historically the food and beverage industry has funded nutrition research so substantially, the ensuing entrenched conflict of interest renders the phrase ‘nutrition science’ an oxymoron ( 3).

North America currently leads in sales and consumption of diet beverages (see below from 4).

Artificial sweetener  consumption patterns tend to change rapidly in response to widespread perception of harm attendant to one type of artificial sweetener or another. US artificial sweetener consumption for example moved from cyclamate in the 1960s to  Saccharin, e.g.,  Sweet’n Low, to aspartame which reigned supreme for several decades until being upstaged in the 2010s by  Sucralose, e.g.,  Splenda, mainly because it’s highly stable in food (5) while  Acesulfame potassium (Ace-K), for example, Sunett, Sweet & Safe, Sweet One, is also increasing in use. Pepsi embodies such rapid change. In 2015 it changed its US Diet Pepsi formulation replacing aspartame with sucralose and Ace-K ( 6) but for reasons best known to itself announced in 2016 it was bringing aspartame back while also retaining the reformulated products ( 7). Meantime so-called natural sweeteners like  Stevia aka Truvia are also rapidly increasing in prevalence (4).

“If you can avoid taking in more food, does diet soda still somehow make you gain weight?’

Weight gain without increased food intake  is in fact a strikingly consistent observation in many animal model studies on artificial sweeteners ( 8 9 10). How does this happen? Problem with understanding how these artificial sweeteners affect human metabolism and health long-term is each artificial sweetener is different in chemistry, biology and pharmacokinetics (11, 12, 13, 14, see below from 4, 15). Obviously each will induce different metabolic and health effects.

For long, uncertainty dogged epidemiological studies on artificial sweeteners. Do they cause cancer or not? Do they increase risk of diabetes and/or obesity or not? Do they play a role in metabolic syndrome or not? And so on. Given the big bucks riding on ensuring people continued to guzzle at least diet soda even as the tide turned against sodas in general (16), unsurprising really that much of this data is conflicting, mostly due to avoidable study design flaws such as assessing artificial sweetener consumption in conditions far removed from how they’re consumed in real life, which is as part of a typical unhealthy “Western” diet replete in highly processed food and as part of a highly sedentary lifestyle. Few studies included children or elderly or minorities or low income, few examined long-term/chronic/habitual artificial sweetener consumption.

In other words, vast chasm between such studies and real life artificial sweetenerconsumption patterns. Most importantly, since different artificial sweeteners are used in different processed foods and drinks and since studies rarely address a single artificial sweetener specifically, we essentially don’t understand how each artificial sweetenerinfluences metabolism and health long-term.
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