Tuesday, February 14, 2012

Diet Soda

Ludwig (2009) has an interesting short article on why we may need to be concerned about diet soda consumption.

Diabetes and Metabolic Syndrome

A recent study by Nettleton and colleagues finds an increased risk of metabolic syndrome in people who drink diet soda.

RESULTS At least daily consumption of diet soda was associated with a 36% greater relative risk of incident metabolic syndrome and a 67% greater relative risk of incident type 2 diabetes compared with nonconsumption (HR 1.36 [95% CI 1.11–1.66] for metabolic syndrome and 1.67 [1.27–2.20] for type 2 diabetes). Of metabolic syndrome components, only high waist circumference (men ≥102 cm and women ≥88 cm) and high fasting glucose (≥100 mg/dl) were prospectively associated with diet soda consumption. Associations between diet soda consumption and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures, whereas associations between diet soda and metabolic syndrome were not independent of these factors.

Another study by de Koning and colleagues (2011) found no effect of diet soda consumption on Type 2 diabetes but found an inverse effect for coffee.

Pancreatic Cancer

This study, done back in the 80s, is interesting in that it finds a correlation between diet soda intake and risk of one type of cancer. As would be expected, veggies and fruits are protective. White bread, on the other hand, is associated with increased risk.

Gold, E. B., Gordis, L., Diener, M. D., Seltser, R., Boitnott, J. K., Bynum, T. E. and Hutcheon, D. F. (1985), Diet and other risk factors for cancer of the pancreas. Cancer, 55: 460–467.

The findings of a case-control study of cancer of the pancreas, which was conducted in the Baltimore metropolitan area, are reported. Two hundred one patients with pancreatic cancer were matched on age (±5 years), race, and sex to hospital and non-hospital controls, the latter selected by random-digit-dialing (RDD). All subjects were interviewed regarding diet, beverage consumption, occupational and environmental exposures, and medical and surgical history. Significantly decreased risks were associated with consumption of raw fruits and vegetables and diet soda, and significantly increased risks were associated with consumption of white bread when cases were compared with hospital and RDD controls. A significantly reduced risk was associated with consumption of wine when cases were compared to RDD controls. Risk ratios for consumption of coffee were not significantly different from one, although there appeared to be a dose-response relationship in women. A moderate but statistically nonsignificant increase in relative odds was found for cigarette smoking, and cessation of smoking was associated with a marked reduction in risk. No significant associations were found with particular occupational exposures. Tonsillectomy was associated with a significantly reduced risk, a finding that has been observed for other cancers as well. The current evidence indicates that pancreatic cancer is likely to result from a complex interaction of factors and suggests that the study of its etiology requires a multidisciplinary approach involving both laboratory and epidemiologic components.

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