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Health Matters: Soft drinks and the obesity epidemic

Conway McLean, DPM, Journal columnist

Let’s talk about Tom, an average American. Tom wakes up, wanders downstairs to prepare for his workday. When he’s running on time, he’ll sit down for breakfast. Along with a bowl of cereal, Joe has a glass of orange juice. At lunch, he washes down his chicken sandwich with an energy drink, which seems to help him through his day. With dinner, he’ll often have a bottled iced tea or two. In this, his typical day, our protagonist consumed about 120 grams of sugar, equal to 32 teaspoons of the stuff.

Soft drinks are consumed by many Americans and often in large quantities. These are classified as beverages with added sugar or some sweetener, such as high fructose corn syrup, sucrose, fruit juice concentrates, and others. These beverages include soda, pop, fruit punch, lemonade, sweetened powdered drinks, energy drinks, as well as many iced teas. Many of the “fancy” coffee drinks are loaded with sugar, as well. As a category, these beverages are the single largest source of added sugar in our diets. Because of aggressive marketing and globalization, consumption of sweetened beverages is rising dramatically world-wide.

There is an innate human desire for sweetness. The craving of sweet things is present in newborn babies and increases in intensity through childhood. It is believed the yearning for sweets can be enhanced by early exposure to intensely sweetened food items. Certainly, the ability of humanity to consume all the sugar that has been produced would give weight to this idea.

Many are asking if the current levels of sugar consumed pose a health risk. The average soft drink contains about 7 to 10 teaspoons of sugar, which totals a whopping 30 to 40 grams of sugar in a single bottle. And though the big food manufacturers claim benefits from some added vitamins, these drinks provide excessive calories and virtually no other nutritional value.

Yet, these drinks are being consumed in record amounts. The data shows an increase of more than 38 gallons of sugar-sweetened beverages consumed per person between 1950 and 2000, growing from 10 to 48. It is unfortunate but this is not the only source of added sugar in our diet. Most processed foods contain extra sugar, generally to make the item more palatable and more desirable. The food manufacturers have found that playing to “Man’s sweet tooth” sells. Many foodstuffs that you wouldn’t think of as having much sugar are loaded with the stuff. For example, 25% of what is in that bottle of ketchup is sugar. Almost one teaspoon of sugar makes up a tablespoon of ketchup.

The history of sugar consumption is fascinating, a study on the interaction of culture and diet. In 1776, Americans consumed roughly four pounds of sugar per person each year. By 1850, the number had increased to 20 lbs. A report released in the mid-1980’s felt the greatest concern regarding sugar consumption was dental, you can get more cavities. By 1994, the amount of sugar ingested by Americans was up to 120 lbs. Current levels place the average sugar intake at 300% of the recommended daily intake.

Recent history tells us the connection, sugar and obesity, is real. It now appears from the studies to date that sugar consumption is the biggest driver of the obesity epidemic. No one will argue that there aren’t a multitude of factors at play, but sugar and the related caloric sweeteners in the amounts now consumed pose a substantial health risk. Indeed, they seem to have resulted in the obesity epidemic, which has reached epic proportions. There are more than 1 billion adults overweight globally. Those classified as obese likely number in the 300 million’s. Obesity clearly is a primary contributor to the global burden of chronic disease and resulting disability.

Studies have demonstrated a close relationship with sugary drinks and obesity. A 1% rise in soft drink consumption is associated with an additional 48 overweight adults per 100 people. These findings have been found accurate even in low-income countries, again showing the dangerous effects of a larger sugar intake with one’s risk of becoming overweight or obese. Indeed, the numbers don’t lie: the drastic increase in sugar consumption from the 70’s to the 1990’s was followed by a subsequent exponential growth in the prevalence of obesity.

There is no question that multiple factors have come into play in this rising tide of obesity. For one, drink portion sizes have risen dramatically over the past 40 years, obviously leading to increased consumption. Genetic make-up is always a consideration in any such discussion. And the marketing budgets of the food giants could feed and house the denizens of a decent sized country. Beverage companies have spent billions of dollars marketing their beverages, yet generally rebuff suggestions that these marketing tactics, and resulting sale of product, play any role in the obesity epidemic.

Weight gain is not the only consequence of routinely drinking these sugar-laden beverages. Both obesity and excessive sugar consumption can increase the risk of type 2 diabetes. The risk of heart disease is also increased in by being both: obese and consuming excess sugar. But there’s more, since several other chronic diseases, from gout to liver disease, show a clear relationship. Not least, the gut microbiome is negatively altered, and in a way that further encourages obesity. Finally, in every sense of the word, higher consumption of these popular beverages has been linked with an increased risk of premature death.

If consumption of these beverages were offset by an associated reduction of calories in solid foods there would not be a problem. But this is not the case and people are not eating less food. Heedless, the food industry continues to find new ways to increase liquid sugar consumption by constantly creating new products, be it fruit juice, energy drinks, vitamin waters, protein waters, sports drinks. All are enhanced with excessive quantities of sugar, in whatever form is deemed most marketable.

Many would posit increasing physical activity is the answer to curbing the obesity epidemic. And yet studies have indicated that increasing physical activity alone is not effective in treating obesity without an appropriate meal plan. The increases in obesity have been attributed to a multitude of factors, from this lack of physical activity to the increase in food portion sizes. The dramatic changes in sugar consumption is clearly the most impactful candidate for the cause of the obesity epidemic. Still, most Americans remain willfully ignorant of the consequences of their food choices.

Obesity is the number one nutritional issue in the world today. More than two-thirds of U.S. adults have a body weight exceeding recommended ranges. The ultimate toll from the excessive consumption of sweetened beverages on our health and well-being, our health care expenditures, our economy in general, is unknown. But it will be significant; that much is certain. How will you respond?

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.

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