Diet soda is a healthy alternative to full-sugar soda…right?
Companies have worked for years to convince consumers of this, and it worked. As of 2016, North America consumed 33.9% of the world’s diet soda (Popkin and Hawkes 2016). It has been known that full-sugar soda can cause a plethora of problems. It can cause weight gain, type-2 diabetes, and obesity, along with all the other health problems that come with such issues (Get the facts … 2022). Given that, it makes sense that consumers would seek out alternatives to try to avoid these serious health problems. Companies that produced the now scourged full-sugar sodas quickly presented diet soda to try to hold on to their customer base, and for a long time it was seen as the perfect alternative.
However, rumors and doubts began to grow at just how perfect this alternative could be. They ranged from diet soda causing an increase in waist circumference to it causing diabetes (Bellisle and Drewnowski 2007). This led to the 2016 experimental study published by the American Society of Nephrology that hypothesized a link between diet soda consumption and the risk of incident end stage renal disease (ESRD) (Rebholz et al. 2016). If this link was as hypothesized, diet soda would be just as harmful for your kidneys as regular full-sugar soda.
The study was conducted over twenty-three years, focusing on pulling participants from four regions in the US: Forsyth County, NC; Jackson, MS; the suburbs of Minneapolis, MN; and Washington County, MD. They ended up with 15,368 participants who they met with four times over the course of the study. At each meeting, they would analyze the participants’ diet, exercise habits, kidney health, along with other initial demographic characteristics (age, race, etc). They collected the data about the participants’ diet and exercise habits through self-reported surveys administered by professionals. Kidney health was measured by whether or not the participant needed a transplant or dialysis. Dialysis is clinically purifying one’s blood regularly (between multiple times a week and multiple times a day). It is needed once the kidneys have lost 85-90% of their function (Dialysis … 2022).
At the end of the study, the data on kidney health was compiled. After taking into account other participant risk factors (e.g. existing health problems), it was found that diet soda consumption was linked to an increased risk of ESRD in the participants of the study.
This study, like many others, has its flaws and limitations which is acknowledged by the authors throughout the article. They mention how one could take issue with the fact that diet and exercise data were self-reported by the participants, making it potentially misreported. Their attempt to counteract the possible effects of this was done by providing participants with visual aids to help them more accurately represent their daily lives, such as a physical glass so that they could more precisely report their diet soda consumption. Additionally, the authors noted that diet soda’s existing connection with poor nutrition, because of its frequent use as a weight loss tool, could additionally skew the data, as poor diets can also lead to ESRD. The participants in the study were also limited to being only black or white, so data is missing about people of other races. While the study may have limitations and flaws in other areas, it was largely ethical. There was informed consent by the participants to the point where researchers were afraid that it may disturb the data, as some participants were electing to drink less diet soda due to knowledge of the potential risks. Of course there is still some concern that this study was knowingly putting the participants at risk of ESRD. However, they chose participants who already consumed diet soda regularly. Participants were not asked to alter their consumption in any way to fit the study, so any consequences would have been present regardless.
An additional limitation to the study, that was also acknowledged by the authors, is that other studies that similarly investigate diet soda as a possible cause of health problems have found no correlation. Some of these studies claim that diet soda has no link to the health of the kidney; however, many of these studies were conducted differently than this study, were measuring for different things, and just overall had too many differences to be good comparisons to the findings of this study (Saldana et al. 2007; Shoham et al. 2008). More research in this field, specifically replicating this experiment, would be beneficial to finalizing the proposed connection between diet soda consumption and ESRD. The authors of the study push for more research on the topic and call for a replication of their experiment multiple times throughout the journal article.
Overall, this study is still applicable, as it was able to jumpstart a lot of long-term research that is sorely needed on this subject. The study had many participants across different areas of the US to allow for less bias and fewer extreme results. Additionally, it was conducted over a very long period of time to be able to see the long term impacts of diet soda on kidney health. Furthermore, the study was able to gather significant preliminary data that could be instrumental for future researchers looking into similar issues.
Once more research is conducted and if the final conclusion that diet soda can cause ESRD is reached, there could be major impacts on the diet soda industry. People may be eligible for some type of financial compensation, similar to those diagnosed with mesothelioma following exposure to asbestos, though it would be more complicated as ESRD is a much more common diagnosis with many and varied causes unlike mesothelioma.
As mentioned earlier, North Americans consume a lot of diet soda, more than anywhere else in the world. Diet soda has often been hailed as a perfect alternative to the unhealthy, full-sugar soda. Research such as this suggests it may have negative health impacts that would be concerning for regular consumers who have believed they were making a healthier choice. With the possibility of diet soda causing health concerns as serious as kidney failure, companies that have been selling diet soda could be at liability and possibly at fault for incidental deaths of people who have been consuming their products and suffering from negative health impacts. The impact that a possible class action suit could have on major companies such as Pepsi or Coca Cola could be disastrous and could lead to further legal action that may require the FDA to reclassify diet sodas or make them less accessible to the public. Overall, even if a class action suit never comes to pass, with this recent study people may reconsider their diet soda consumption and this may be the push some are looking for to ditch their diet soda habit completely.
References:
- Dialysis – procedure, types, risks, purpose. National Kidney Foundation; [accessed 2022 Sep 19]. https://www.kidney.org/atoz/content/dialysisinfo
- Get the facts: Sugar-sweetened beverages and consumption. [accessed 2022 Sep 19]. Center for Disease Control and Prevention. https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html#:~:text=Frequently%20drinking%20sugar%2Dsweetened%20beverages,gout%2C%20a%20type%20of%20arthritis
Bellisle F, Drewnowski A. 2007. Intense sweeteners, energy intake and the control of body weight. Eur J Clin Nutr. [accessed 2022 September 7]; 61:691–700. https://www.nature.com/articles/1602649#citeas
Popkin BM, Hawkes C. 2016. Sweetening of the global diet, particularly beverages: Patterns, trends, and policy responses. Lancet Diabetes Endocrinol. [accessed 2022 September 19];4(2):174–186. https://pubmed.ncbi.nlm.nih.gov/26654575/
Rebholz CM, Grams ME, Steffen LM, Crews DC, Anderson CAM, Bazzano LA, Coresh J, Appel LJ. 2017. Diet soda consumption and risk of incident end stage renal disease. CJASN. [Accessed 2022 September 6]; 12(1):79-86. https://cjasn.asnjournals.org/content/12/1/79
Saldana TM, Basso O, Darden R, Sandler DP. 2007. Carbonated beverages and chronic kidney disease. Epidemiology. [accessed 2022 September 8];18(4):501–506. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433753/
Shoham DA, Durazo-Arvizu R, Kramer H, Luke A, Vupputuri S, Kshirsagar A, Cooper RS. 2008. Sugary soda consumption and albuminuria: Results from the National Health and Nutrition Examination Survey, 1999-2004. PLoS One. [accessed 2022 September 8] 3(10):e3431. https://pubmed.ncbi.nlm.nih.gov/18927611/
Featured Image: pixabay.com, for free and fair reuse.