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Why Drinking Diet Soda Makes You Crave Sugar

Recommendations on limiting sugar consumption vary around the world, with guidelines ranging from “[l]imit sweet desserts to one every other day” to “[k]eep sugar consumption to 4 or less occasions per day.” In the United States, the American Heart Association is leading the charge, “proposing dramatic reductions in the consumption of soft drinks and other sweetened products” and recommending fewer than about 5 percent of calories a day from added sugars, which may not even allow for a single can of soda.

Why is the American Heart Association so concerned about sugar? “Overconsumption of added sugars has long been associated with an increased risk of cardiovascular disease,” meaning heart disease and strokes. We used to think added sugars were just a marker for an unhealthy diet. At fast-food restaurants, for example, people may be more likely to order a cheeseburger with their super-sized soda than a salad. However, the new thinking is that the added sugars in processed foods and drinks may be independent risk factors in and of themselves. Indeed, worse than just empty calories, they may be actively disease-promoting calories, which I discuss in my video Does Diet Soda Increase Stroke Risk as Much as Regular Soda?.

At 1:14 in my video, you can see a chart of how much added sugar the American public is consuming. The data show that only about 1 percent meet the American Heart Association recommendation to keep added sugar intake down to 5 or 6 percent of daily caloric intake. Most people are up around 15 percent, which is where cardiovascular disease risk starts to take off. There is a doubling of risk at about 25 percent of calories and a quadrupling of risk for those getting one-third of their daily caloric intake from added sugar.

Two hundred years ago, we ate an estimated 7 pounds of sugar annually. Today, we may consume dozens of pounds of sugar a year. We’re hardwired to like sweet foods because we evolved surrounded by fruit, not Froot Loops, but this adaptation is “terribly misused and abused” today, “hijacked” by the food industry for our pleasure and their profits. “Why are we consuming so much sugar despite knowing too much can harm us?” Yes, it may have an addictive quality and there’s the hardwiring, but the processed food industry isn’t helping. Seventy five percent of packaged foods and beverages in the United States contain added sweeteners, mostly coming from sugar-sweetened beverages like soda, which are thought responsible for more than a 100,000 deaths worldwide and millions of years of healthy life lost. Given this, can we just switch to diet sodas? By choosing diet drinks, can’t we get that sweet taste we crave without any of the downsides? Unfortunately, studies indicate that “[r]outine consumption of diet soft drinks is linked to increases in the same risks that many seek to avoid by using artificial sweeteners—namely type 2 diabetes, metabolic syndrome heart disease, and stroke.” At 3:15 in my video, you can see data showing the increased risks of cardiovascular disease associated with regular soft drinks and also diet soda. They aren’t that dissimilar.

“In other words, the belief that artificially sweetened diet beverages reduce long-term health risks is not supported by scientific evidence, and instead, scientific data indicate that diet soft drink consumption may contribute to the very health risks people have been seeking to avoid.” But, why? It makes sense that drinking all that sugar in a regular soft drink might increase stroke risk, due to the extra inflammation and triglycerides, but why does a can of diet soda appear to increase stroke risk the same amount? It’s possible that the caramel coloring in brown sodas like colas plays a role, but another possibility is that “artificial sweeteners may increase the desire for sugar-sweetened, energy-dense beverages/foods.”

The problem with artificial sweeteners “is that a disconnect ultimately develops between the amount of sweetness the brain tastes and how much glucose [blood sugar] ends up coming to the brain.” The brain feels cheated and “figures you have to eat more and more and more sweetness in order to get any calories out of it.” So, “[a]s a consequence, at the end of the day, your brain says, ‘OK, at some point I need some glucose [blood sugar] here.’ And then you eat an entire cake, because nobody can hold out in the end.”

If people are given Sprite, Sprite Zero (a zero-calorie soda), or unsweetened, carbonated, lemon-lime water, but aren’t told which drink they’re getting or what the study is about, when they’re later offered a choice of M&M’s, spring water, or sugar-free gum, who do you think picks the M&M’s? Those who drank the artificially sweetened soda were nearly three times more likely to take the candy than those who consumed either the sugar-sweetened or unsweetened drinks. So, it wasn’t a matter of sweet versus non-sweet or calories versus no-calories. There’s something about non-caloric sweeteners that somehow tricks the brain.

The researchers did another study in which everyone was given Oreos and were then asked how satisfied the cookies made them feel. Once again, those who drank the artificially sweetened Sprite Zero reported feeling less satisfied than those who drank the regular Sprite or the sparkling water. “These results are consistent with recent [brain imaging] studies demonstrating that regular consumption of [artificial sweeteners] can alter the neural pathways responsible for the hedonic [or pleasure] response to food.”

Indeed, “[t]he only way really to prevent this problem—to break the addiction—is to go completely cold turkey and go off all sweeteners—artificial as well as fructose [table sugar and high fructose corn syrup]. Eventually, the brain resets itself and you don’t crave it as much.”

We’ve always assumed the “[c]onsumption of both sugar and artificial sweeteners may be changing our palates or taste preferences over time, increasing our desire for sweet foods. Unfortunately, the data on this [were] lacking”…until now. Twenty people agreed to cut out all added sugars and artificial sweeteners for two weeks. Afterwards, 95 percent “found that sweet foods and drinks tasted sweeter or too sweet” and “said moving forward they would use less or even no sugar.” What’s more, most stopped craving sugar within the first week—after only six days. This suggests a two-week sugar challenge, or even a one-week challenge, may “help to reset taste preferences and make consuming less or no sugar easier.” Perhaps we should be recommending it to our patients. “Eating fewer processed foods and choosing more real, whole, and plant-based foods make it easy to consume less sugar.”


Speaking of stroke, did you see my Chocolate and Stroke Risk video?

For more on added sugars, see:

You may also be interested in my videos on artificial and low-calorie sweeteners:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


45 responses to “Why Drinking Diet Soda Makes You Crave Sugar

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  1. This is an interesting article, and while I agree with the addictive nature of both ‘natural sugars’ and artifical sweeteners, my own experience has been that they are not related at all. With the artifical sweeteners, I found myself consuming a specific product, artifically sweetened, in ridiculous amounts. The detox took almost one week, and after that no cravings, nothing. I can walk down any of the store aisles with no craving…not even a thought about it.

    Sugar on the other hand is a different story. I am haunted by sugar cravings on an almost daily basis. Fruit is great but not the same category to my addictive mind. Detoxing does not reduce cravings (unlike artificial sweeteners) and eating wfpb for years and years doesn’t change things. I think though we can all agree that what we don’t buy, we don’t eat.

    1. Barb, I struggled with sugar addiction for years–and one or two weeks was definitely not enough for me to get over it. But after adopting a WFPB diet–and two 9-month periods of abstinence from added sugar AND any kind of refined grain (even whole grain flours)–I no longer crave it. I’m curious, are you eating flour products or breakfast cereals (even whole grain)? If so, I wonder if those foods keep your cravings alive?

      1. caroline, thanks for your comments. I said detox from artificial sweetners took a week, and now I wouldnt eat that product if you paid me.

        I have eaten wfpb for over 10 yrs, in fact , decades… food as grown. I have soy milk and one bottle of salad dressing in the fridge, no condiments, no baking supplies, no maple syrup or honey,… ever. Everything else is fruit and veg, whole foods.
        I don’t eat flour products except a slice of bread with soup sometimes, never eat out. I didn’t say I eat sugar. I said I crave it. I love the taste of some sugary things, and if I see a picture or an item in a store I can imagine what it tastes like.
        I have always chosen to be slim and fit (by habit! thanks mims!) so it doesn’t cause me problems, just aggravation.

        YR’s article today on genetics, tastebuds and food preferences is interesting. Some people are volume eaters and wfpb can really appeal to them Others like myself are drawn to specific foods and tastes but food in general is ho hum.

        One point that Dr Mirkin mentioned about eating whole plant foods was that for some people, eating potatoes or other high starch content foods can fan the flames of sugar cravings. Hmm, that might be worthwhile experimenting with….

        1. Barb, you said you eat a slice of bread with soup “sometimes.” Nosy moi wants to know the brand of the bread.

          The two I knock off are Ezekiel (toast with breakfast) and Bread Alone’s delicious sourdough bread. If it’s ever inconvenient to pick up loaves of sourdough, guess I’ll just have to “do a Dr. J.” :-)

          1. Ezekial Bread and Dave’s Killer Bread are sold here, frozen, for $10. There is a similar textured one from the bakery for $8 , or what I normally get is one that is cheaper, that fits Dr Greger’s rule of 5. It’s ok. Basically I don’t buy things I like. I never have. My cupboards lined with canned tomatoes in various forms, beans and dog food. And we don’t own a toaster! I figure what’s toast without jam? Not happening!

            1. “Basically I don’t buy things I like. I never have.”
              – – – –

              Yer a strong lady, Barb. No toaster? (I put just a few drops of EVOO on my toast…never any jam.) And I thought I was unusual not owning a microwave oven!.

              I don’t know where you live, but $10 for a lousy package of Ezekiel is pure robbery! We get it here (frozen section) for $4.75 when it’s on sale — which is when I’ll buy it. Healthy, whole-grain bread is considered the staff of life. Just don’t eat a lot of it, maybe two slices a day at the most.

              Carnies who scarf down nothing but bloody cattle carcasses probably think bread is poison.

      2. Wholegrain bread isn’t all bad, though. The addition of yeast to leaven bread has a phytate-degrading effect, although sourdough is the best. That’s why Indian people are with their chapatis often struggle to extract enough Iron from their grains. If you are going to avoid leavened bread you might want to add onions, fruit or greens to a meal to counteract the inhibitors in the food.

  2. I’ve never tasted artificial soda. The rare times I do drink soda is at a restaurant where I might order a Ginger Ale. And that’s only because, if I decide to have a piece of pie or something, I like (decaf) coffee or tea to go with it and the waiters take so darn long to come back to the table and refill the cup. Plus, it’s never hot enough. The other option is no dessert and just the Ginger Ale.

    IMO, the best things to drink are coffee, tea or filtered water. Chew everything else with your teeth.

    When I was a kid I had a sweet tooth and was always baking up a storm for the rest of the family. Delicious fudge, mincemeat bars (waay too sweet), and etc. Yuck. If I had to make a choice I’d choose (god-forbid) salty foods over sweet foods. Which are worse health-wise? Some people do need more salt, but I don’t think people really need sugar, do they? What’s the scientific research on this?

    https://recipes.howstuffworks.com/sweet-or-salty-food-preferences.htm

    1. YR,

      That is interesting. You were like the drug dealer of the family.

      So what were you getting out of the baking process?

      I liked the article.

      My mother was a salt craver. My father craved sugar.

      With my mother, I know that it was low blood pressure and she would at times even pour some salt on the back of her hand and lick it. My brother did the same thing. I would wet my finger and eat the salt after french fries. All of us had low blood pressure back then.

      I think I craved both. I would make a salty mac and cheese and then add more salt at the end.

      Was it here above, or WNPR that talked about Coke adding salt to soda? It seems like that topic came up yesterday, but that might be my brain’s way of processing time.

      The sentence “But soybeans contain much more tryptophan — and when did you last hear, “I need tofu right now”?” is true.

        1. One of the cultural parts of the article was about how people could get 60 ounces of soda, a bag of chips and a candy bar for a total cost of 99 cents.

          I think that reality of getting things cheap to free or for a dollar was what made it such a drug of choice.

  3. YR, agree with you on the coffee, tea or water. I have never (fortunately!) been a pop drinker, but I enjoy fizzy water occasionally, and herbal teas like blueberry tea.

    I have friends with the ‘salt orientation’. They would prefer munching on nuts, chips, or nachos or starter dishes vs desserts though I couldn’t say which is worse. Dr Klaper says the worst thing we can eat is ice cream and other custard type concoctions are the most inflammatory.

    1. Barb, Fumbles won’t like that bit about ice cream being the “worst thing.”

      He admits to enjoying a (I’ll bet it’s really huge) bit of ice cream on occasion, doncha Fumbles! :-)

      1. Of course, ice cream is bad. It’s basically just dairy fat, sugar and water after all. I have never pretended that it is anything but unhealthy (as you well know).

        Probably we all eat something that is bad for us from time to time. Even Dr G has hinted that he might eat candy occasionally. I’m no saint …. possibly even you are less than perfect when it comes to diet.

        .

  4. I was thinking about this topic this morning.

    I saw a Coca-Cola truck and on the back it said something, “Keep on loving us over and over again” and that wasn’t the exact wording, but it is close.

    A euphemism for food addiction.

  5. What I will say is that from someone who took years getting off of soda, I do know firsthand that I went from drinking probably 1000 calories of regular sugar soda to drinking diet soda and eating 1000 calories of sugary foods.

    It was more like a wine tasting with a season or two of seltzer water between doing that process again.

    Tap water tasting like chlorine probably added length of years before I finally graduated to water.

    Kept the sugar for a long time, but the horizontal nail ridges and not wanting to go to a doctor was better than anything the advertisers could come up with.

  6. Tab was God’s gift to people with soda addictions.

    It tasted bad enough that it was easier to portion control.

    But then came Diet Coke and Diet Pepsi and the Zeros and Frees.

    And it becoming complicated was God’s gift to people with confusion problems because they all canceled each other out and required researching and eventually bottled water becomes the next thing that became so complicated and, yes, tap water tasting like chlorine led to my plastic bottles stretching out to the moon and back.

    1. Deb, if your water tastes like chlorine, just filter it. Or pour a jug of it, and let it sit overnight before using. There are even hand held filters available for camping use.
      No need to buy bottled water unless you live in an area with a totally undrinkable water supply. Too much plastic waste.

  7. Luckily, I was finished with the soda chapters by the time Soda Stream came around.

    Coffee became the next research thing alternating with bottled water and filters and tap water.

    But now Dr. Greger reads the beverage studies so that I don’t have to.

  8. Going off the soda really did help break the sweet tooth off.

    Taking Magnesium helped.

    Eating fruit helped.

    At one point, I started eating one date per day or one 90 to 100% dark chocolate square per day and that felt like I was eating sweets again.

    Lara bars would have dragged me back in.

    Never eat vegan junk food.

    Also, never watch commercials. Reeses brand seems to mentally be able to bring it back with their advertising.

    I honestly won’t look at their packaging.

    Also, don’t let 8 year olds push you around because they will want you to eat cookies and brownies and they will bake for you.

  9. I believe sugar is addictive and the more you have, the more you crave for. The palate changes and you want your dessert sweeter and sweeter. I remember my mom used to make cakes with one cup of sugar. Now, recipes call for 2 cups. I like French desserts and cookies because they are not too sweet. I took a cruise and the dessert chef was French. His desserts were overly sweet. I asked him and he said, “You know, the majority of the passengers are Americans”. Once in Champagne, the guide at Moet & Chandon said they made a sweeter version of their champagne for the USA market. The love affair the country has with sugar will not end any time soon, unfortunately.

    What is the verdict on Stevia? Is it bad too?

    1. Carolina, even a small amount of stevia is really sweet. If you are trying to change your palette and tongue taste buds, so you don’t crave sweet, I doubt stevia would help.

  10. On occasion I would like a fizzy drink but not the typical soda type drink. I open a can of fizzy water (they are all over the place and often plain and on sale as various flavors). I put a teeny sprinkle of organic stevia powder in it and it seems to satisfy my urge. While many consider the stevia as a plant, do you think it is processed and still be avoided. Mine has no additives in the ingredients. Your thoughts please. Thanks and be well!

    1. Sugar is every bit as natural as Stevia. Neither are white granules that are scooped up in nature. If it “satisfies” it is lighting up the part of the brain that can lead to addiction. If you are not craving more the more you have – count yourself lucky, but I would monitor how much and how often I partake.

  11. I was surprised that sugar consumption was even as high as 7# a year. If my calculations are correct, that’s still about 9gm., or 2 tsp. per day. Sugar was fairly expensive in the past. Maybe most of that intake happened at holidays?

  12. The problem with artificial sweeteners “is that a disconnect ultimately develops between the amount of sweetness the brain tastes and how much glucose [blood sugar] ends up coming to the brain.” The brain feels cheated and “figures you have to eat more and more and more sweetness in order to get any calories out of it.” So, “[a]s a consequence, at the end of the day, your brain says, ‘OK, at some point I need some glucose [blood sugar] here.’ And then you eat an entire cake, because nobody can hold out in the end.”
    ——————————————————————————————————-
    I bought like a 20 lb. sack of sugar a few years ago… not for me but for the hummingbirds that visit during the summer. I’ve still got a bunch of it.

    But I do get added sugar and while I find some things too sweet, still I gravitate to anything with a little sweetness.

    But after reading from the study linked below, I am hoping by eating a couple tablespoons of C-8 MCT oil spaced during the day, I can switch my brain (and body) from relying on glucose for energy and supplementing with ketones for some of that energy. I think the data below from the study helps make my point as the added ketone also goes into the Krebs Cycle and makes ATP. (And the MCT oil is processed by the liver rather than the gut so it is available quicker (giving it priority?)
    ______________

    “Brain relies on blood glucose as its predominant energy source. Interestingly, while brain glucose utilization decreases in mild cognitively impaired elderly and in Alzheimer’s disease patients, ketone metabolism remains intact (1). Interventions using ketones or their precursors have shown therapeutic potential in several neurometabolic disorders (2), demonstrating the possible value of ketones as an alternative source of brain energy. The two main ketones, beta-hydroxybutyrate (BHB) and aceto-acetate (AcA), are actively transported to the brain by the monocarboxylic transporter 1 (MCT1), resulting in brain levels directly proportional to their blood concentrations (3). They are then further metabolized to Acetyl-CoA and enter the Krebs cycle to generate ATP (2)…”

    https://www.frontiersin.org/articles/10.3389/fnut.2018.00062/full

  13. After drinking 1-2L of Diet Coke/day for 40 yrs, will quitting cold-turkey (and for good) alleviate any of the negative impact this has had on me, or is the damage done and I am just preventing it from getting worse?

    1. Steve, the analogy that Dr. Greger likes to use is that eating an unhealthy diet or processed foods is like hitting your body with a hammer. Your body won’t heal until you stop hitting it with a hammer. You can reduce the damage you do if you start using lighter hammers but the healing starts when the hammers go away.

      The great news is that he’s gone over multiple studies showing that it’s never too late to start eating better. Seniors and younger folk have the chance to improve their wellbeing no matter their age. Diet changes can reduce your mortality until you hit the coffin. The best example is that people can reverse heart disease, our number one killer.

      I hope this helps =D

      1. Steve, the analogy that Dr. Greger likes to use is that eating an unhealthy diet or processed foods is like hitting your body with a hammer. Your body won’t heal until you stop hitting it with a hammer. You can reduce the damage you do if you start using lighter hammers but the healing starts when the hammers go away.
        —————————————————————————————————-
        I may have seen the video described above… but the hammer analogy did not stick with me. But I’ll bet it was what most took away from the video in question.

        Well played Anonymous Script writer!… whoever you are?

  14. Hey Doc. Greger
    When are you are any of the other Plant Based Doctors going to discuss the Corona virus ??
    Its awfully quiet in the Plant Based world while the Virus is causing havoc in China and the rest of the world.

      1. Yes, I am up to date with whats going on with the Corona virus via the *worldometer*, but that is not my question here.
        I want to know what Dr. Greger thinks is the REASON for the virus.
        No-body can pinpoint the reason.
        No-body wants to give the solution.
        They talk about working on a vaccine but they are not talking about uprooting THE CAUSE of the virus.

  15. I want to know what Dr. Greger thinks is the REASON for the virus.
    ——————————————————————————————
    I’m guessing he would just say something mundane like “a wild animal specific virus, probably found in bats, mutated and became able to jump to humans.”

    It sounds like you are asking for the metaphysical “REASON” for the virus but I don’t remember him approaching health from that perspective in his videos, blogs, or personal appearances.

    1. It just came to me… the REASON may be the coming end of times.

      That is, Christians may have gotten the rapture thing all wrong. They say that the believers will ascend to heaven en masse, IIRC. But I think China is a nontheistic society and they seem to be the ones most affected… so my thinking is they will be the “raptured-ones” and the believers are the ones who will be left behind to deal with the hell-fire and brimstone yet to come.

      So, anyone who has been sacrificing pleasure of the palate to eat vegetables they hated as a kid, they may as well pig-out (pun intended ‘-) on foods they previously avoided for their health.

      ‘Cause no matter which side of the (religious) fence they are on, either way they are still gonna die.

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