Americans drink more soda pop than ever before:
These popular beverages account for
more than a quarter of all drinks
consumed in the United States.
More than 15
billion gallons were sold in 2000.
- That works out to at least one 12-ounce
can per day for every man, woman and child.
Kids are heavy consumers of soft drinks, according to the U.S.
Department of Agriculture, and they are guzzling soda pop at unprecedented
pop provides more added sugar in a typical 2-year-old toddler's
diet than cookies, candies and ice cream combined.
Fifty-six percent of 8-year-olds down soft drinks daily, and a
third of teenage boys drink at least
three cans of soda pop per day.
Not only are soft drinks widely available everywhere, from fast
food restaurants to video stores, they're now sold in 60
percent of all public and private middle schools and high schools
nationwide, according to the National Soft Drink Association.
A few schools are even giving away soft drinks to students who buy
As soda pop becomes the beverage of choice among the nation's young
-- and as soda marketers focus on brand-building among younger and
younger consumers -- public health officials, school boards, parents,
consumer groups and even the soft drink industry are faced with
Last week, representatives of the soft drink industry, concerned
that public opinion and public policy may turn against them, will
staged a three-day "fly-in" to lobby Congress to maintain
soft drinks sales in schools; and to educate lawmakers on the "proper
perspective" on soft drink use.
The industry plans to counter a US Department of Agriculture proposal,
announced in January, that would require all foods sold in schools
to meet federal nutrition standards. That would mean that snack
foods and soft drinks would have to meet the same standards as school
Nearly everyone by now has heard the litany on the presumed health
effects of soft drinks:
- Tooth decay
- Caffeine dependence
- Weakened bones
But does drinking soda pop really cause those things?
To help separate fact from fiction, the Health section reviewed
the latest scientific findings and asked an array of experts on
both sides of the debate to weigh in on the topic. Be forewarned,
however: Compared with the data available on tobacco and even dietary
fat, the scientific evidence on soft drinks is less developed. The
results can be a lot like soft drinks themselves, both sweet and
One very recent, independent, peer-reviewed study demonstrates
a strong link between soda consumption
and childhood obesity.
One previous industry-supported, unpublished study showed no link.
Explanations of the mechanism by which soda may lead to obesity
have not yet been proved, though the evidence for them is strong.
Many people have long assumed that soda -- high in calories and
sugar, low in nutrients -- can make kids fat. But until this month
there was no solid, scientific evidence demonstrating this.
Reporting in The Lancet, a British medical journal, a team of Harvard
researchers presented the first evidence linking soft drink consumption
to childhood obesity. They found that 12-year-olds who drank soft
drinks regularly were more likely to be overweight than those who
For each additional daily serving of sugar-sweetened
soft drink consumed during the nearly two-year study, the risk of
obesity increased 1.6 times.
Obesity experts called the Harvard findings important and praised
the study for being prospective. In other words, the Harvard researchers
spent 19 months following the children, rather than capturing a
snapshot of data from just one day. It's considered statistically
more valuable to conduct a study over a long period of time.
Researchers found that schoolchildren who drank soft drinks consumed
almost 200 more calories per day than their counterparts who didn't
down soft drinks. That finding helps support the notion that we
don't compensate well for calories in liquid form.
Here's one health effect that even the soft drink industry admits,
grudgingly, has merit. In a carefully worded statement, the NSDA
says that "there's no scientific evidence that consumption
of sugars per se has any negative effect other than dental caries."
But the association also correctly notes that soft drinks aren't
the sole cause of tooth decay.
In fact, a lot of sugary foods, from fruit juices to candy and
even raisins and other dried fruit, have what dentists refer to
as "cariogenic properties," which is to say they can cause
Okay, so how many more cavities are soft drink consumers likely
to get compared with people who don't drink soda? This is where
it gets complicated.
A federally funded study of nearly 3,200 Americans 9 to 29 years
old conducted between 1971 and 1974 showed a direct link between
tooth decay and soft drinks. Numerous other studies have shown
the same link throughout the world, from Sweden to Iraq.
But sugar isn't the only ingredient in soft drinks that causes
tooth problems. The acids in soda pop are also notorious for etching
tooth enamel in ways that can lead to cavities. "Acid begins
to dissolve tooth enamel in only 20 minutes," notes the Ohio
Dental Association in a release issued earlier this month.
The stimulant properties and dependence potential of caffeine in
soda are well documented, as are their effects on children.
Ever tried going without your usual cup of java on the weekend?
If so, you may have experienced a splitting headache, a slight rise
in blood pressure, irritability and maybe even some stomach problems.
These well-documented symptoms describe the typical withdrawal
process suffered by about half of regular caffeine consumers who
go without their usual dose.
The soft drink industry agrees that caffeine causes the same effects
in children as adults, but officials also note that there is wide
variation in how people respond to caffeine. The simple solution,
the industry says, is to choose a soda pop that is caffeine-free.
All big soda makers offer products with either low or no caffeine.
That may be a good idea, though it raises the question of whether
soda machines in schools should be permitted to offer caffeinated
beverages or at least be obligated to offer a significant proportion
of caffeine-free products.
It also raises the question of how one determines a product's caffeine
content. Nutrition labels are not required to divulge that information.
If a beverage contains caffeine, it must be included in the ingredient
list, but there's no way to tell how much a beverage has, and there's
little logic or predictability to the way caffeine is deployed throughout
a product line.
Okay, so most enlightened consumers already know that colas contain
a fair amount of caffeine. It turns out to be 35
to 38 milligrams per 12-ounce can, or roughly 28 percent
of the amount found in an 8-ounce cup of coffee. But few know that
diet colas -- usually chosen
by those who are trying to dodge calories and/or sugar -- often
pack a lot more caffeine.
A 12-ounce can of Diet Coke, for example, has about 42 milligrams
of caffeine -- seven more than the same amount of Coke Classic.
A can of Pepsi One has about 56 milligrams of caffeine -- 18 milligrams
more than both regular Pepsi and Diet Pepsi.
Even harder to figure out is the caffeine distribution in other
flavors of soda pop. Many brands of root beer contain no caffeine.
An exception is Barq's, made by the Coca-Cola Co., which has has
23 milligrams per 12-ounce can. Sprite,
7-Up and ginger ale are caffeine-free. But Mountain Dew,
the curiously named Mello Yellow, Sun Drop Regular, Jolt and diet
as well as regular Sunkist orange soda all pack caffeine.
Caffeine occurs naturally in kola nuts, an ingredient of cola soft
drinks. But why is this drug, which is known to create physical
dependence, added to other soft drinks?
The industry line is that small amounts are added for taste, not
for the drug's power to sustain demand for the products that contain
it. Caffeine's bitter taste, they say, enhances other flavors. "It
has been a part of almost every cola -- and pepper-type beverage
-- since they were first formulated more than 100 years ago,"
according to the National Soft Drink Association.
But recent blind taste tests conducted by Roland Griffiths at Johns
Hopkins Medical Institutions in Baltimore found that only
8 percent of regular soft drink consumers
could identify the difference between regular and caffeine-free
The study included only subjects who reported that they drank soft
drinks mainly for their caffeine content. In other words, more than
90 percent of the self-diagnosed caffeine cravers in this small
sample could not detect the presence of caffeine.
That's why the great popularity of caffeinated soft drinks is driven
not so much by subtle taste effects as by the mood-altering and
physical dependence of caffeine that drives the daily self-administration.
And the unknown could be especially troublesome for the developing
brains of children and adolescents. Logic dictates that when you
are dependent on a drug, you are really upsetting the normal balances
of neurochemistry in the brain. The fact that kids have withdrawal
signs and symptoms when the caffeine is stopped is a good indication
that something has been profoundly disturbed in the brain.
Exactly where that leads is anybody's guess -- which is to say
there is little good research on the effects of caffeine on kids'
Animal studies demonstrate that phosphorus,
a common ingredient in soda, can deplete bones of calcium.
And two recent human studies suggest that girls who drink more
soda are more prone to broken bones. The industry denies that soda
plays a role in bone weakening.
Animal studies -- mostly involving rats -- point to clear and consistent
bone loss with the use of cola beverages. But as scientists like
to point out, humans and rats are not exactly the same.
Even so, there's been concern among the research community, public
health officials and government agencies over the high phosphorus
content in the US diet. Phosphorus -- which occurs naturally in
some foods and is used as an additive in many others -- appears
to weaken bones by promoting the loss of calcium. With less calcium
available, the bones become more porous and prone to fracture.
The soft drink industry argues that the phosphoric acid in soda
pop contributes only about 2 percent of the phosphorus in the typical
US diet, with a 12-ounce can of soda pop averaging about 30 milligrams.
There's growing concern that even a few cans of soda today can
be damaging when they are consumed during the peak bone-building
years of childhood and adolescence. A 1996 study published in the
Journal of Nutrition by the FDA's Office of Special Nutritionals
noted that a pattern of high phosphorus/low calcium consumption,
common in the American diet, is not conducive to optimizing peak
bone mass in young women.
A 1994 Harvard study of bone fractures in teenage athletes found
a strong association between cola beverage
consumption and bone fractures in 14-year-old girls.
The girls who drank cola were about five times more likely to suffer
bone fractures than girls who didn't consume soda pop.
Besides, to many researchers, the combination of rising obesity
and bone weakening has the potential to synergistically undermine
future health. Adolescents and kids don't think long-term. But what
happens when these soft-drinking people become young or middle-aged
adults and they have osteoporosis, sedentary living and obesity?
By that time, switching to water, milk
or fruit juice may be too little, too late.