Ask Tufts Experts: Diet Soda; Cardiometabolic Disease; Processed Meats
Q. Is it safe to drink one diet soda a day? My doctor says one should be fine, but I read a lot of bad things about diet beverages.
A. Diane McKay, PhD, an assistant professor at Tufts’ Friedman School and a scientist in the HNRCA Antioxidants Research Laboratory, answers: “Some studies have linked diet soda consumption to negative health effects. These include obesity, type 2 diabetes, stroke and heart attack. But keep in mind that these studies are observational in nature, which means they can’t be used to show cause and effect. That raises the possibility that something other than the diet soda could explain the increased health risks.
“We do know from food safety studies that the amount of artificial sweetener you get in one diet soda a day has not been shown to be harmful. So if you’re also eating an overall healthy diet, one diet soda in a day could be safe. This is consistent with the latest Dietary Guidelines for Americans.
“There are alternatives, of course. If you like the bubbles, drink more sparkling water (there are lots of options to choose from). You can flavor your own with a little spritz of fruit juice, allowing you to control how much and what kind of sugar goes into it. You can also add a little sprig of mint. Or you can have unsweetened iced coffee, tea or even herbal tea. The bottom line is to minimize these sodas in general because they have little nutritional value.”
Q. What is cardiometabolic disease and how is it different from cardiovascular disease?
A. Cardiovascular disease can be thought of as one of many different cardiometabolic diseases. José Ordovás, PhD, director of the Nutrition and Genomics Research Lab at Tufts’ HNRCA, explains further: “Cardiovascular diseases include heart attack, stroke, angina (chest pain) and other disorders of the vascular system. Cardiometabolic diseases include these cardiovascular conditions, plus others, such as insulin resistance, diabetes and non-alcoholic fatty liver disease. Cardiometabolic diseases tend to have a number of risk factors in common.
“Cardiometabolic risk factors include, at minimum, abdominal obesity (waistline 40 inches or more in men, 35 inches or more in women); high fasting triglycerides; low ‘good’ HDL cholesterol; and elevated blood pressure. These four factors together are often referred to as metabolic syndrome.
“When two or more of these risk factors coexist, it doubles the risk of heart attack and stroke and increases the risk of diabetes by a factor of 5 (both over a period of 5 to 10 years). Some experts have proposed additional cardiometabolic risk factors, including high levels of C-reactive protein in the blood, a marker of chronic inflammation thought to contribute to cardiovascular disease.
“Risk factors allow doctors and researchers to identify individuals who may be at risk of more serious cardiometabolic diseases and take corrective action. If you have risk factors for cardiometabolic disease, the first step is to institute changes in lifestyle, such as losing weight and eating a healthier diet.”
Q. I often read that to help reduce risk of heart disease, I should limit processed meats. Are low-sodium deli sliced turkey breast and uncured turkey pastrami better choices?
A. Alice H. Lichtenstein, DSc, director of Tufts’ HNRCA Cardiovascular Nutrition Laboratory and executive editor of Tufts Health & Nutrition Letter, explains: “The best recommendation we can make at this time is to avoid processed meats. We don’t have enough information to suggest one type is different from another. Consider substituting processed deli meats with sliced roast chicken (either prepared at home or store bought), roasted turkey, tuna salad, broiled fish, hummus or reduced fat cheeses. If you are preparing a sandwich, don’t forget to load on the vegetables and leafy greens, and use whole grain bread. If you are making a salad, you have even more flexibility: add raw and cooked vegetables and fruits, along with some nuts and seeds.”
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