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It's What We Swig That Makes Us Big

Study finds more calories come from soft, fruit drinks

THURSDAY, Nov. 20, 2003 (HealthDayNews) -- It may not be what we eat that's making us obese as much as what we drink.

In 1996, Americans consumed 83 more calories each day from caloric sweeteners than they did in 1997. Eighty percent of that (66 calories) came from soft drinks and fruit drinks, a new study says.

But Americans are not the only ones experiencing a surge in the use of these sweeteners (a general category that includes sugar, high fructose corn syrup, maltose, dextrose and other products). The average diet increased by 74 calories per day worldwide, although it's not clear how much of that increase was due to beverages.

Consuming an additional 10 calories per day adds one extra pound per year, says Barry Popkin, lead author of the study appearing in the November issue of Obesity Research. Popkin is a professor of nutrition at the University of North Carolina School of Public Health in Chapel Hill.

One way or another, the change is contributing to the rising tide of obesity, which in turn is increasing the risk of diabetes, heart disease, stroke and other conditions.

"If we are going to consume more beverages, we are going to gain weight," Popkin states. "We consume a little more from ready-to-eat cereals, candy, a little extra dessert, but those pale in comparison to the soft drinks and fruit drinks."

Not so, says the National Soft Drink Association (NSDA), which represents the makers. The group assailed the study as "short on significant new information" and a "self-selected collection of old information and discredited theories."

One concern is that calories from fluids are less satisfying than those from solid foods. "When you drink highly sweetened beverages, they don't feel like a thick, rich, creamy, high-calorie treat -- but they are," says Samantha Heller, senior clinical nutritionist at New York University Medical Center. "You don't necessarily feel it until you step on the scale or try to fit into your blue jeans."

Another problem is that these highly sweetened drinks may be replacing healthier choices such as nonfat milk or even high-fiber foods. "In children and teens this may increase the risk of nutrient deficiencies like calcium and vitamin D," Heller adds.

Popkin and his co-author, doctoral student Samara Joy Nielsen, looked at food data from 103 countries in 1962 and 127 countries in 2000 along with U.S. Department of Agriculture surveys from the 1970s, 1980s and 1990s. Worldwide, the average diet increased by 74 calories a day, 82 percent of that change attributable to urbanization and income growth. The caloric intake of sugar increased more in lower- and middle-income countries than in higher-income countries between 1962 and 2000.

The 83 calorie-per-day increase in caloric sweetener use in the United States represented a 22 percent spike in the proportion of energy people were deriving from the sweeteners. After soft drinks and fruit drinks, desserts and sugar/jellies represented the major sources of caloric sweeteners in this country.

And soft drinks and fruit drinks are disproportionately consumed by the under-30 crowd, particularly 10-to-30-year-olds. "That's the time when it's even scarier, when we get our bone density, when we need milk and need many of the foods that have nutrients, not just nothing which is what sugar has," Popkin says. "Sugar has calories to make us fat with no other benefit."

The only good news is that at least researchers now know what the culprit is, certainly in the United States and quite probably in other parts of the world as well.

"The bottom line is we've got to do several things in this country," Popkin says. "We've got to think about labeling added sugar on all products. We don't know it's hidden. Secondly, most of the soft drinks in America come from parents so we've got to start educating them. They've got to start feeding their kids milk and slow down themselves on soft drinks."

The World Health Organization (WHO) recommends limiting "added sugar" (which includes other caloric sweeteners) to 10 percent of total calories.

"Sugar isn't necessarily evil," Heller says. "It's just that added sugars are more calories than we need and they're not nutritive."

The NSDA says other studies have found no connection between being overweight and drinking nonalcoholic beverages. Rather, it says, the obesity problem is rooted more in lack of exercise. "When you slash physical activity in schools, when television and computer time skyrockets, when only 'lip service' is paid to increasing energy expenditure, it is no wonder obesity rates increase," the group says in a statement.

More information

The World Health Organization has more on nutrition. The American Dietetic Association has a statement on added sugars.

SOURCES: Barry Popkin, Ph.D., professor, nutrition, schools of public health and medicine, University of North Carolina, and fellow, Carolina Population Center, Chapel Hill; Samantha Heller, M.S., R.D., senior clinical nutritionist, New York University Medical Center, New York City; statement, National Soft Drink Association; November 2003 Obesity Research
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