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Sugary drinks are known to contribute significantly to high blood sugar levels and obesity. Many are turning to diet soda and fruit juice, hoping they can help prevent weight gain and chronic illnesses. However, one important question remains: Does diet soda raise blood sugar?
Moreover, can diet soda cause diabetes and other chronic diseases? Brace yourself for surprising insights into how diet sodas can impact your health. And if you’re re-considering your diet soda habit, we have plenty of healthier alternatives for you.
Does diet soda have sugar?
The American Heart Association (AHA) recommends limiting added sugars to (1):
- Six teaspoons (24 grams, or 100 calories) per day for women
- Nine teaspoons (37.5 grams, or 150 calories) per day for men
- Less than six teaspoons per day for children ages 2‒18
- Zero for children under two years old
Surprisingly, the average American consumes 22 teaspoons of sugar daily (2). That’s two to three times more than what is recommended.
Among sugar sources, sugary drinks are the real troublemakers, accounting for 33% of all the added sugar in the typical American diet (2). Notably, that seemingly harmless can of regular cola hides 48.9 grams of sugar inside (3).
To rock this sugar-savvy lifestyle, some may try diet sodas, which contain no sugar or calories but are still packed with a familiar taste punch (4).
With these properties, no wonder diet sodas and other low-calorie sweetener drinks have become a hit. They make up almost one-third of the beverage choices in the US (1).
Yet, are they guilt-free go-to for those craving a sweet fix?
How are diet sodas sweetened without sugar?
Adding artificial sweeteners to diet sodas could achieve the same sweet taste without a gram of sugar. These sweeteners are 200‒20,000 times sweeter than table sugar or sucrose (5).
- Aspartame, as in Nutrasweet, Equal, and Sugar Twin
- Saccharin, including Sweet and Low, Sweet Twin, Sweet’N Low, and Necta Sweet
- Sucralose, as in Splenda
- Acesulfame potassium (or Ace-K), including Sunett and Sweet One
So, does Diet Dr. Pepper have sugar? It is a sugar-free version of Dr. Pepper that is sweetened with aspartame, Ace-K, or sucralose instead.
Diet Coke in stores contains aspartame, sometimes mixed with sucralose. The food industry enhances Coke Zero Sugar with aspartame and Ace-K. Fountain Diet Coca-Cola combines aspartame and saccharin (7).
Among them, aspartame is one of the most commonly used artificial sweeteners. It may add up some calories but far less than sugar. Thus, it is considered a “nutritive sweetener” (8).
Other zero-calorie sweeteners are considered “non-nutritive sweeteners” (8).
How does diet soda affect blood sugar?
Artificial sweeteners in diet sodas do not directly affect blood sugar or insulin (the hormone responsible for lowering blood sugar levels). Acesulfame potassium, saccharin, and sucralose can traverse the body intact without undergoing metabolic breakdown (46, 47).
However, these sweeteners may complicate blood sugar management.
Artificial sweeteners can upset your gut microbiomes (those microbes in your gut), causing an imbalance known as dysbiosis. This disruption can then lead to gut inflammation and difficulties in processing sugar, driving glucose intolerance (49, 50, 51).
Artificial sweeteners in diet sodas do not immediately affect blood sugar or insulin. However, their consumption can complicate blood sugar management over time by disrupting the gut microbiomes. It can cause gut inflammation and glucose intolerance.
How does diet soda spike insulin?
Drinking diet soda alone does not directly raise your insulin resistance (53).
Conversely, even though artificial sweeteners in diet sodas are not digested in the gastrointestinal system, they can still send signals that affect insulin function with prolonged consumption (12, 36).
Beyond carbs in diet soda—What’s really at stake?
When artificial sweeteners interfere with the beneficial microbiome in your gut, it will trigger insulin resistance (36).
GLP-1 (a hormone that triggers insulin release) secretion could be another way to measure glucose control. Interestingly, when people drink diet soda, their bodies may secrete more GLP-1, thus producing more insulin (48, 54).
One explanation for this is diet sodas may activate the sweet taste receptors on your tongue. In turn, they can increase GLP-1 levels (after a 75-g glucose load) by 34% in healthy people and 43% in type 1 diabetes, but not in type 2 diabetes (48, 55).
So even when your blood sugar is unaffected by artificial sweeteners, there still could be an uptick in insulin levels.
Does Coke Zero raise blood sugar and insulin? The truth behind
Diet sodas like No-Cal, Tab, and Diet Coke for people with diabetes were first made in the 1950s and 1960s. This was a time when many people started caring about the calories they ate. Since then, diet sodas have become very popular, and Coke Zero made its way in 2005, offering the taste of a cola beverage (56).
Coke Zero’s sweetness comes from a mix of aspartame and acesulfame potassium (Ace-K). While they don’t cause an immediate rise in blood sugar or insulin, they could affect insulin sensitivity over time (36).
Another problematic compound in Diet Coke is caffeine, with an amount of 46 mg for each can. Caffeine has been shown to raise blood sugar and insulin levels after eating sugar (57).
How do artificial sweeteners in diet soda affect your health?
- Artificial flavors
- Artificial colors: caramel, carotenoids, or anthocyanins
- Acidic ingredients: phosphoric, citric, or malic acid
- Preservatives: sodium or potassium benzoate
Some soda companies add vitamins and minerals to their diet sodas. It’s their way of making these products seem like the healthier choice (10).
However, the amount of beneficial nutrients in fortified diet sodas is minor. You can easily get them from vegetables and fruits (with much greater content). Therefore, diet sodas have no special benefits.
Their main use is to help people cut down on calories, often seen as a way to lose weight and avoid chronic health issues. Yet, there’s no concrete proof to back up that assumption (11).
On the other hand, these tempting beverages may come with a few health concerns.
In a 2016 review, various studies found no connection between drinking soda and adverse health effects. However, all of them were funded by companies in the soda industry (12).
When soda companies put their money where the research is, the results are more positive about soda’s health effects. It may make us question how reliable those findings are (13).
Many other large-scale, long-term studies have shown that drinking diet soda can set you up for many health risks, including brain and heart diseases. Some potential problems including (14, 15, 16, 17):
- 14% increase in high blood pressure
- 59% increase in larger waist size
- 23‒53% increase in metabolic syndrome
- 38‒68% increase in diabetes
- 31% higher risk of depression
- 27% higher risk of stroke caused by bleeding
- 30‒43% higher risk of heart attack and stroke
- 50% higher risk of dying from heart problems
- 30% higher risk of dying from any cause
- Triple stroke and Alzheimer’s disease risk (People aged >45)
- Double the risk of kidney function decline
These studies considered multiple factors affecting the results—age, lifestyle, and family history. Interestingly, they still found solid evidence pointing to an increased risk in (14):
According to a study, sucralose could make women and people with obesity crave and eat more food. They had more robust brain responses to artificial sweeteners than regular sugar-sweetened drinks (18).
Other studies suggest that diet soda drinkers showed more activity in parts of the brain associated with reward (the midbrain and amygdala). Thus, it might trigger sweet cravings and even create sugar addiction (19, 20, 21).
Moreover, the carbon dioxide in sodas may drive your stomach cells to produce more ghrelin, which is the hormone that makes you feel hungry (22).
Overweight and obesity
The zero-calorie diet sodas can easily make you believe you’re being healthy. Yet it could also lead you to eat more unhealthy food as a ‘reward.’
Over time, people who drink diet sodas daily may be more susceptible to weight gain, stubborn belly fat, and an elevated BMI.
The more diet soda people drink, the bigger the increase in waist size, which may entail various metabolic issues (24).
Can diet soda cause diabetes? Unfortunately, consuming diet soda is associated with elevated A1c levels, meaning your body has difficulty keeping your blood sugar at bay (25).
Studies found that daily diet soda intake was associated with a 67% higher risk of landing in the type 2 diabetes zone (26).
High blood pressure (hypertension)
In a large study, people who drank one or more artificially sweetened drinks daily had a 14% likelihood of high blood pressure. Those carbonated, cola-infused sodas packed an even higher risk (2, 28).
Despite being sugar-free, diet soda can still wreak havoc on your smile. Its acidic nature can gradually erode your enamel, making your teeth more sensitive and leaving them susceptible to cavities (29, 30).
Carbon dioxide inside fizzy soda is the troublemaker contributing to its acidic environment. The acidity may also come from citric, malic, and phosphoric acids, which are used to make soda drinks taste tart (31, 32, 33).
Dentists often recommend that cutting down on soda is a crucial part of your healthy diet (29).
In older people, going overboard with more than four cans of diet soft drinks daily was associated with a 31% increased risk of depression. In contrast, regular soft drink sippers are associated with a 22% risk increase of depression (16).
Even less than a can of regular soft drinks (containing table sugar) a day may have its share of depression risks. However, they’re lower than their diet counterparts (16).
Only a few studies have examined the link between artificial sweetener intake from all dietary sources and cancer. One study in 2022 reported cancer incidence in more than 102,000 French adults and the association with artificial sweeteners (34). The 2022 study found that people who consumed larger quantities of sweeteners (above 17‒19 mg/day and followed them for almost eight years) had a 13% increased risk of developing cancer ) compared to non-consumers (34, 35).
Furthermore, the study pinpointed aspartame as a factor contributing to a 22% higher risk of breast cancer and a 15% higher risk of cancers by 15% related to obesity.
Acesulfame-K can also upsurge the risk by 13%.
No link was found between sucralose and cancer risk (34).
The sweeteners in diet soda may harm the beneficial bacteria in your gut, which are essential for digestion and your immune system. Sucralose, aspartame, ace-k, and saccharin can all upset the balance and diversity of your gut microbiomes (36, 37).
Kidney (renal) health
A study spanning 25 years found that people who drank more than seven glasses of diet soda per week had an 83% higher chance of developing kidney disease (38) caused by the phosphorus content in sodas, which could put too much acid in the kidneys (4, 39).
Studies found that people who drank soft drinks (but not diet soda) every day were 4.69 times more likely to get a fracture compared to non-drinkers over five years (40) due to their caffeine and phosphorus content (41, 42, 43).
Another significant research on women after menopause found that having one diet soda daily increased the risk of hip fracture by 12% (17). Drinking carbonated beverages is also linked to a higher risk of bone fractures in teenage girls who are physically active (41).
In a study of more than 60,000 pregnant women, those who drank more artificially sweetened carbonated drinks, including diet sodas, increased their likelihood of having a child with asthma by 30% as compared to non-consumers (44).
These women were also 31% more likely to report their child experiencing allergic rhinitis during the next seven years than non-consumers, though it was not statistically significant.
In another study, infants whose mothers drank artificial sweeteners every day had double the risk of obesity by age one compared to those whose mothers didn’t drink. In this case, choosing sugary beverages was a better option (45).
In terms of sweetness, diet sodas rely on artificial sweeteners that have zero calories and sugar yet pack a punch of sweetness that’s 200‒20,000 times stronger than table sugar (sucrose). However, these sweeteners have potential health consequences, such as heightened risks of developing chronic diseases and cancer.
Is it safe for people with diabetes to drink diet soda?
Unfortunately, most artificial sweeteners in diet sodas don’t have any positive effects on managing diabetes. They may even increase the risk of developing pre-diabetes and diabetes by targeting hormones (50, 59, 60).
One study of 200 diabetic patients found a correlation between diet soda and artificial sweetener intake and diabetic retinopathy (25).
In turn, the American Diabetic Association recommends diet soda should be avoided in the setting of diabetes (61).
The existing research quality has been limited (most deal with healthy individuals), making it difficult to draw definitive conclusions about whether people with diabetes can drink diet soda safely (48, 25).
The key is to exercise restraint. You can opt for diet sodas occasionally when you have a strong sweet tooth. Still, try to stay moderate (1).
Alternative healthy drinks for people with diabetes
- Some fruit slices, such as cucumber or berries, for a detoxifying fragrance
- Puréed fruit, like passion fruit or mango, for a guilt-free sweet kick
- a splash of fruit juice like lime or lemon, but not from concentrated juice sold at the supermarket
- Herbs like basil, cinnamon, ginger, or mint for a refreshing taste
- Herbal infusions, including citrus, lavender, chamomile, peppermint, and hibiscus tea
- Seltzer water or sparkling water
- Kombucha is a refreshing fermented tea with probiotics that help with fermentation, where the sugar is converted into healthy organic acids
Don’t suddenly stop drinking diet sodas containing caffeine to avoid caffeine withdrawal headaches, especially if you drink them daily (65).
Instead, gradually remove them from your diet or consider unsweetened tea or black coffee for a quick caffeine boost. They may also be packed with antioxidants and beneficial nutrients (66).
When your sweet tooth strikes, there are numerous healthier options available to fulfill your desire:
- Stevia, a natural sweetener that is 450 times sweeter than sucrose. Stevia leaves also contain antioxidants that help prevent heart disease, atherosclerosis, and cancer (5, 67).
Erythritol, a sugar alcohol from corn, is 60‒80% as sweet as sugar. This sweetener doesn’t usually cause digestive problems or make your blood sugar or insulin levels go up. It can even help protect your cells from damage when you eat other sugary foods (68).
Why is diet soda linked to diabetes?
The sweetness in diet sodas mostly comes from artificial sweeteners like aspartame, sucralose, Ace-K, or saccharin. These sweeteners may hamper glucose metabolism and insulin sensitivity. They may also affect the appetite and satiety signals, making you gain weight, a risk factor for type 2 diabetes.
Does diet soda affect A1C?
There is conflicting evidence regarding whether diet soda increases glucose levels enough in people with diabetes to cause an increase in their A1C levels. There is contradictory evidence that diet soda increases glucose levels in persons with diabetes sufficient to cause an increase in your A1C.
What three drinks should diabetics avoid?
It’s best to avoid sugary culprits like regular soda, fruit juices, and energy drinks due to their excessive added sugars. Even some sports drinks can pack a sugar punch, so double-check the label or skip them altogether. Additionally, alcohol potentially contributes to long-term spikes in your blood sugar.
Can drinking a lot of water lower your blood sugar?
While drinking water won’t directly reduce your blood sugar levels. Still, by enhancing insulin sensitivity and helping with appetite regulation (thirst can sometimes be mistaken for hunger), proper hydration plays a valuable role in maintaining optimal blood sugar control.
What is the healthiest drink besides water?
Besides water, several beverages can provide you with some nutritional benefits. Herbal teas, packed with various antioxidants, can be excellent choices. Regularly drinking them may support your liver health and reduce the risk of certain chronic diseases. Vegetable and fruit juices with high fiber and nutrient content can also be a great sip.
Diet soda doesn’t bring any significant health benefits except as a tool for those looking to transition away from regular soda.
Clinical studies have revealed that artificial sweeteners in diet sodas can worsen specific health conditions. They can also heighten the risk of depression and chronic diseases.
So, does diet soda affect blood sugar? The answer is yes. It can impair insulin sensitivity and trigger glucose intolerance in the long run. Henceforth, it shouldn’t be considered a healthy alternative to sugary drinks.
Stevia and erythritol are better choices to satisfy your cravings. For bubble drink lovers, choose sparkling water and kombucha with healthy sweets from nutrient-dense fruits.