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Nutritional Pearls: A Single Soft Drink Per Day Increases Mortality Risk
John, a 42-year-old man with a body mass index (BMI) of 30 kg/m2, is beginning to struggle with several lifestyle changes he made recently in an attempt to get healthier. He is finding it particularly hard to quit his previous habit of drinking 2 sugar-sweetened sodas in the afternoon. Rather than giving them up completely, he asks if it would still be "healthier" to switch to diet sodas instead.
How do you advise your patient?
(Answer and discussion on next page)
Dr. Gourmet is the definitive health and nutrition web resource for both physicians and patients with evidence-based resources including special diets for coumadin users, patients with GERD/acid reflux, celiac disease, type 2 diabetes, low sodium diets (1500 mg/d), and lactose intolerance.
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Answer: Both sugar-sweetened and artificially sweetened beverages have their share of associated health risks.
Previous research has shown that sugar-sweetened soft drinks contribute to weight gain and even diet (non-caloric) soft drinks are implicated in weight gain for reasons we have yet to fully understand.
Recently, an international team of researchers published the results of their analysis of data from a multi-national, long-term observational study known as EPIC (European Prospective Investigation into Cancer and Nutrition). Their analysis focused on soft drink consumption overall as well as differentiating between sugar-sweetened and artificially sweetened soft drinks.
The Research
The EPIC study recruited over 500,000 participants in 10 European countries between 1992 and 2000 and follow-up is ongoing. These participants responded to demographic and dietary questionnaires and gave permission for the researchers to access their medical information, including cause of death if necessary, often through the individual countries' health systems.
For their analysis, the authors excluded any participant who reported having cancer, heart disease, diabetes, or history of stroke of any kind. Similarly, they excluded those with unrealistic or incomplete dietary questionnaires. This left them with over 450,000 participants when they performed their analysis in 2018.
The researchers defined "total soft drinks" as "a combination of soft drinks, carbonated and isotonic drinks, and diluted syrups," then further broke down those soft drinks into "sugar-sweetened" and "artificially sweetened." How much people drank was measured in glasses per day, with one glass being about 250ml (about 8.5 ounces), then grouped into increasing amounts: less than 1 glass per month, 1-4 glasses per month, 1-6 glasses per week, 1-2 glasses per day, and 2 or more glasses per day.
After an average of just over 16 years of follow-up, the authors correlated the soft drink consumption of those who passed away with those who did not, taking into account such variables as BMI; alcohol consumption; smoking status; age, gender, and education level; total caloric intake and intake of red and processed meats, coffee, fruits and vegetables (and their juices); and physical activity levels.
Their results are concerning.
The Results
Those who consumed at least 2 glasses of artificially sweetened soft drinks every day were 26% more likely to die of any cause compared to those who drank less than 1 glass per month of a soft drink of any kind.
Those who drank the same amount of sugar-sweetened soft drinks were only 17% more likely to die of any cause, but the results were worse for those clinically classified as obese (with a BMI over 30) than those clinically classified as overweight (with a BMI between 25 and 30).
Those with a BMI over 30 who drank 2 or more glasses of sugar-sweetened soft drinks per day were at a 23% greater risk of death from all causes as compared to those who drank less than 1 glass of sugar-sweetened soft drinks per day, while the risk for those with a BMI between 25 and 30 was the same as those who were of clinically normal weight.
More specifically, drinking any soft drinks was associated with the participants' risk of death from circulatory diseases like heart disease or cerebrovascular diseases, while drinking sugar-sweetened soft drinks alone did not appear to affect that risk. On the other hand, drinking at least 1 sugar-sweetened soft drink every day meant a 59% greater risk of dying from a digestive disorder that includes liver, esophageal, and gall bladder disorders.
Consuming more soft drinks, whether sugar-sweetened or not, also appeared to contribute to a participants' risk of death from colon cancer, but not breast cancer or prostate cancer.
Finally, although Alzheimer disease did not appear to be linked to soft drink intake, the authors found that drinking at least one glass per day of any type of soft drink was linked to a 59% greater risk of death from Parkinson disease, with similar associations for both sugar-sweetened and artificially-sweetened soft drinks.
NO DAILY COKE
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///////////////////"When your children are teenagers, it's important to have a dog so that someone in the house is happy to see you."
-- Nora Ephron
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Risk Factors for Low Vitamin D
Several things raise your chances of having low levels of vitamin D:
- Age: Your skin and kidneys don't make it as easily in your older years.
- Darker skin: It doesn't convert sunlight as well.
- Digestive problems: Crohn's disease, celiac disease, and problems with fat digestion can limit your levels.
- Obesity: Fat traps some vitamin D and stops it from getting into your blood.
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SURAT: Garba-goers may recite the famous aarti 'Jay Adhya Shakti, Akhand Bharmand Dipavya, Padve Pragatya Maa', daily during Navratri. However, very few know that the words were originally composed on the banks of Narmada by a Surti poet Shivanand Vamdev Pandya who later became Swami Shivanand.
Navratri is devoted to the worship of Goddess Amba. Devotees, especially Gujaratis, celebrate the festival reciting this melodious 'aarti' for Ma Amba.
Swami Shivanand lived at Nagarfalia on Ambaji Road in Surat. He was born to Vamdev Harihar Pandya in 1541. After the death of his father, Shivanand was brought up by his uncle, Sadashiv Pandya. Shivanand's grandfather Harihar Kakdev Pandya, who hailed from Vadnagar, had settled in Surat in the 14th century after shifting base from Mandva Buzargh near Ankleshwar.
The Ma Amba 'aarti' was written by him after completing a 'yagya' at Devi Ambaji Temple at Markand Muni Ashram in Mandva Buzargh village near Ankleshwar in 1601.
In a book on Swami Shivanand titled 'Swami Shivanand Rachit Aarti' written by a city-based spiritual writer and former chief engineer of water resources and Narmada project department, G T Panchigar has given a detailed account of him and his famous composition.
"Swami Shivanand's ancestors were the caretakers of Markand Muni Ashram and Devi Ambaji Temple in Mandva Buzargh," said Panchigar, who writes that Swami Shivanand had become an important figure in Surat among the community.
Pallavi Vyas, 75, a retired school teacher, who is the ninth generation of Swami Shivanand, said, "We feel proud that the Maa Amba 'aarti' written by my great grandfather is recited the world over."
Navratri is devoted to the worship of Goddess Amba. Devotees, especially Gujaratis, celebrate the festival reciting this melodious 'aarti' for Ma Amba.
Swami Shivanand lived at Nagarfalia on Ambaji Road in Surat. He was born to Vamdev Harihar Pandya in 1541. After the death of his father, Shivanand was brought up by his uncle, Sadashiv Pandya. Shivanand's grandfather Harihar Kakdev Pandya, who hailed from Vadnagar, had settled in Surat in the 14th century after shifting base from Mandva Buzargh near Ankleshwar.
The Ma Amba 'aarti' was written by him after completing a 'yagya' at Devi Ambaji Temple at Markand Muni Ashram in Mandva Buzargh village near Ankleshwar in 1601.
In a book on Swami Shivanand titled 'Swami Shivanand Rachit Aarti' written by a city-based spiritual writer and former chief engineer of water resources and Narmada project department, G T Panchigar has given a detailed account of him and his famous composition.
"Swami Shivanand's ancestors were the caretakers of Markand Muni Ashram and Devi Ambaji Temple in Mandva Buzargh," said Panchigar, who writes that Swami Shivanand had become an important figure in Surat among the community.
Pallavi Vyas, 75, a retired school teacher, who is the ninth generation of Swami Shivanand, said, "We feel proud that the Maa Amba 'aarti' written by my great grandfather is recited the world over."
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