Rethink Your Drink: Liquid Calories Fail to Trigger Satiety and May Lead to Weight Gain
by David Hite PhD
In a previous post I described how large amounts of fructose in the diet induce a cascade of metabolic changes that directly contribute to insulin resistance and the corresponding abnormalities described as the metabolic syndrome. Research suggests that how and where we get our fructose is also important. Most of the fructose in our diet is concentrated in sugar-sweetened beverages, such as soda and juice drinks. Data show that over the last 30 years Americans have consumed 278 more calories per day, and the largest concentration during that period is from an increase in soda consumption, accounting for 43 percent of all new calories.
In the Framingham Heart Study, the relationship between soft drinks and cardiovascular risk factors demonstrated that drinking more than one can of soft drink per day was significantly associated with the prevalence of the metabolic syndrome. Data gleaned from the Nurses’ Health Study show that consumption of sugar-sweetened soft drinks was positively associated with increased calorie intake, weight gain, and incidence of diabetes.
Any excess calories will contribute to weight gain, but sugar-sweetened beverages are by far the single most important source of fructose and surplus calories in our diet. Studies suggest that liquid carbohydrates promote positive energy balance, and thus weight gain, because they produce an incomplete satiation. The human digestive system seems to overlook liquid calories.
Caloric energy balance is preserved by competing hormones that signal hunger and satiety (grehlin and leptin). The satiety hormone, leptin, acts on receptors in the hypothalamus of the brain to inhibit appetite. When a solid form of carbohydrate is eaten it elicits precise dietary compensation through the release of leptin resulting in increased satiety. A comparable amount of liquid calories is not perceived the same way. Someone who drinks 140 calories of soda will not subconsciously eliminate 140 calories elsewhere in the diet. 140 extra calories per day is enough to add one pound of fat every 25 days. That fact has led New York City to ban the sale of large sugary sodas in an effort to address the issue of obesity.
As diabetes educators we need to caution our patients to limit fructose in the diet and urge them to pay closer attention to liquid calories.
Babey SH, Jones M, Yu H, Goldstein H. New research shows direct link between soda and obesity. UCLA Health Policy Research (website). 2009. Available at: http://www.healthpolicy.ucla.edu/pubs/Publication.aspx?pubID=375. Accessed September 26, 2012.
Beverage Consumption A Bigger Factor In Weight, Study Shows. Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. ScienceDaily[online]. April 2, 2009. Available at: http://www.sciencedaily.com/releases/2009/04/090402104732.htm. Accessed September 26, 2012.
DiMeglio DP, Mattes RD. Liquid versus solid carbohydrate: effects on food intake and body weight. Int J Obes Relat Metab Disord. 2000 Jun;24(6):794-800. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10878689. Accessed September 26, 2012.
Mattes RD, Campbell WW. Effects of Food Form and Timing of Ingestion on Appetite and Energy Intake in Lean Young Adults and in Young Adults with Obesity. J Am Diet Assoc. 2009 Mar;109(3):430-437. Available at: http://www.journals.elsevierhealth.com/periodicals/yjada/article/S0002-8223(08)02194-9/abstract. Accessed September 26, 2012.
Welsh J, Dietz W. Sugar-sweetened beverage consumption is associated with weight gain and incidence of type 2 diabetes. Clinical Diabetes. 2005 Oct; 23(40:150-152. Available at: http://clinical.diabetesjournals.org/content/23/4/150.full. Accessed September 26, 2012.
Wolf A, Bray GA, Popkin BM. A short history of beverages and how our body treats them. Obes Rev. 2008 Mar;9(2):151-64. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18257753. Accessed September 26, 2012.
Wood S. Sugary drinks and sodas linked to increased diabetes, metabolic syndrome. The Heart (online). October 28, 2010. Available at: http://www.theheart.org/article/1141681.do. Accessed September 26, 2012.
About The Author
David Hite PhD, is a lifelong educator, spending 20 years teaching biology, chemistry, and health education at the high school and community college levels, two years teaching science at Cairo American College in Egypt, and two years at Shanghai American School in China. Dr. Hite developed the patient-friendly "Take Control - Diabetes Basics", a diabetes educational DVD used by clinicians to encourage their patients to implement and maintain effective self-care strategies, and has spent the past 11 years working daily with diabetes patients as a Clinical Health Educator in the Chronic Conditions Management Department for a large non-profit healthcare provider in Sacramento, California. Dr. Hite is a member of the American Association of Diabetes Educators, and the American Diabetes Association.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of DiabetesProductSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.