Data v Dogma: Low-Calorie Sweetened Beverages

Nutrition and dietary advice is a realm where a contest of data v dogma plays out repeatedly. Low-calorie sweetened beverages lie at the center of one such contest. A new study just published in Obesity provides further evidence that low-calorie sweetened beverages can be useful for people who want to achieve and maintain a lower weight.

A team of researchers led by Victoria Catenacci collected new data from 434 participants in the landmark National Weight Control Registry. These are people who have successfully achieved and maintained a loss of 30 pounds or more for more than a year — something that makes them successful outliers in the realm of obesity studies. They found that only 10% of these people regularly consume sugar-sweetened beverages, but most (53%) of them regularly consume low or no-calorie sweetened beverages. They gave reasons of taste, thirst, routine, and calorie control. They reported that changing their beverage consumption had been very important for their weight loss and maintenance. Their strategies were primarily to drink more water and reduce their consumption of caloric beverages.

On the other side of this debate, you can find plenty of warnings about low-calorie sweetened beverages:

“I believe artificial sweeteners cultivate a sweet tooth, and cause people to want — or need — a sweeter diet overall.” — David Katz, Yale University

“The folks that drink diet sodas consume a lot more calories.” — Sara Bleich, Johns Hopkins University

 “Diet soda can sabotage your diet.” — WSJ MarketWatch

“Sweet, fizzy diet soda may seem like a dieter’s dream — but the lack of calories come with some pretty unpleasant side effects.” — Prevention Magazine Infographic

This sort of advice is backed by observations in animals that haven’t been reproduced in humans, correlations that prove nothing about causation, personal preferences, and the dismissal of data that contradict personal opinions. The infographic from Prevention magazine includes a remarkable range of dire warnings. But they are grounded more in suspicion than evidence.

Objective reviews of the evidence by regulatory authorities and independent scientific bodies have concluded that low-calorie sweetened beverages provide a safe, reasonable means for reducing the consumption of added sugars.

It’s okay to have an opinion and a personal preference. But it’s best to represent them as such, rather than dispensing something that might be mistaken for evidence-based advice.

“In God we trust, all others bring data.” — W. Edwards Deming

Click here to read the study in Obesity. Click here to read the scientific statement on non-nutritive sweeteners by the American Heart and American Diabetes Associations.

Diet Coke on Ice, photograph © arbyreed / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


9 Responses to “Data v Dogma: Low-Calorie Sweetened Beverages”

  1. July 23, 2014 at 11:51 am, Susan Burke March said:

    I’m in full agreement with you here – love the quote you posted! “In God we trust, all others bring data.” — W. Edwards Deming – going to steal that!

    • July 23, 2014 at 2:07 pm, Ted said:

      Susan, this seems to be striking a chord with a lot of people. The mis-infographic from Prevention Magazine is truly egregious.

  2. July 23, 2014 at 2:46 pm, Zola said:

    I couldn’t help but notice this about the study’s authors:

    Disclosure: JOH serves as an advisor to The Coca Cola Company, McDonalds, and the Walt Disney Company. JOH and HRW have received research funding from the American Beverage Association. SAR is an employee of The Coca-Cola Company.

    While I think there may still be merit to the study, I am always cautious when I see a clear conflict of interest.

    • July 23, 2014 at 5:21 pm, Ted said:

      Zola, in response to your comment, some of the most egregious bias I see comes in the form of “white hat” bias from people who believe so deeply in their righteous cause that they distort their conclusions for free. The infographic from Prevention Magazine might be an embodiment of such bias. Such bias is seldom directly disclosed. Another concern is the documented tendency to pay more attention to the funding of a study than the quality of its data, documented here in NEJM.

      The researchers involved in the National Weight Control Registry study, most notably Jim Hill and Rena Wing, have distinguished reputations that they have earned and protected over a lifetime. They should indeed offer their expertise to organizations who can affect the lives of so many people and they should be compensated when they do.

      For more on this subject, I suggest you read this position statement of the Obesity Society.

  3. July 23, 2014 at 5:06 pm, Maria Faires, RD said:

    I don’t see any reason to completely eliminate diet soda from someone’s diet if they really like it. In the context of an overall healthy diet I feel there is little to no harm. I counsel my clients to limit their consumption to one a day.

  4. July 26, 2014 at 3:34 am, Sigrid gibson said:

    Thank you for your thoughtful article and follow up comments. The tendency to disregard legitimate science funded via industry is concerning and comes close to character assassination of respected scientists.
    Would it be popular to fund these studies entirely from the public purse?

  5. July 26, 2014 at 5:30 pm, Angela Wills said:

    I feel that fizzy juice can help in certain circumstances:-)eg getting ur sugar level back after a big operation and i couldnt drink or eat for 5days so i was on empty plus it showed in my urine i needed sugar:-)so i got toldaby my doc to drink flat fizzy sugary juice to get my sugar level back up and it did even tho i didnt want to drink the stuff cos i da drink fizzy it does have some good going for it:-)even tho they take the sugarmout they stil leave the artificial colours and e numbers in them i think they do more harm.

  6. August 01, 2014 at 2:02 pm, Becky S said:

    I’m surprised to see you quote anything from Prevention magazine. I do not consider them a reliable science-based organization. Stick to those backed by clinical trials! Fair and balanced!

    • August 01, 2014 at 5:48 pm, Ted said:

      Becky, I quote Prevention as being a source of dogma that is not grounded in evidence. So, I agree with you completely. Unfortunately, they present themselves as being credible and reach about 10 million readers a month. So I think it’s worth mentioning their transgressions.