How many cola cancer cases are estimated to be caused by Coke and Pepsi in New York versus California, where a carcinogen labeling law (Prop 65) exists?
Which Has More Caramel Coloring Carcinogens: Coke or Pepsi?
Caramel coloring may be the most widely consumed food coloring in the world. Unfortunately, its manufacture can sometimes lead to the formation of a carcinogen called methylimidazole, which was identified as a cancer-causing chemical in 2007. And so, for the purposes of their Prop 65 labeling law, California set a daily limit at 29 micrograms a day. So, how much cancer may caramel-colored soft drinks cause? We didn’t know, until now.
A hundred and ten soft drink samples were tested off store shelves in California and around New York. None of the carcinogen was found in Sprite, which is what you’d expect since it’s not caramel-colored brown. Among sodas that were, the highest levels were found in a Goya brand soda, and the lowest in Coke products—about 20 times less than in Pepsi products. Interestingly, California Pepsi was significantly less carcinogenic than New York Pepsi. This supports the notion that labeling laws like Prop 65 can incentivize manufacturers to reduce foodborne chemical risks. Rather than just “wish they could all be California” to protect consumers around the rest of the country, federal regulations could be a valuable approach to reducing excess cancer risk. But how much cancer are we talking about?
Johns Hopkins researchers calculated the cancer burden—an estimate of the number of lifetime excess cancer cases associated with the consumption of the various beverages. So, at the average U.S. soda intake, with the average levels of carcinogens found, Pepsi may be causing thousands of cancer cases—especially non-California Pepsi products, which appear to be causing 20 times more cancer than Coke. Of course, no need for any of them to have any these carcinogens at all. But we don’t have to wait for government regulation, or corporate social responsibility; we can exercise personal responsibility and just stop drinking soda altogether.
Cutting out soda may reduce our risk of becoming obese, and getting diabetes, fatty liver disease, hip fractures, rheumatoid arthritis, chronic kidney disease, and maybe gout.
In children, daily soda consumption may increase the odds of asthma five-fold, and increase the risk of premature puberty in girls, raising the likelihood they start getting their periods before age 11 by as much as 47%.
If you look at the back of people’s eyes, you can measure the caliber of the arteries in their retina. And the narrower they are, the higher the risk of high blood pressure, diabetes, and heart disease. When researchers did these kinds of measurements on thousands of 12-year-olds, and asked them about their soda-drinking habits, children who consumed soft drinks daily had significantly narrower arteries. So, the message to patients can no longer just be “eat less, exercise more.” It matters what you eat. Specific dietary advice should be to significantly reduce the consumption of processed food and added sugar, and to eat more whole foods.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- M F Jacobson. Carcinogenicity and regulation of caramel colorings. Int J Occup Environ Health. 2012 Jul-Sep;18(3):254-9.
- M Hengel, T Shibamoto. Carcinogenic 4(5)-methylimidazole found in beverages, sauces, and caramel colors: chemical properties, analysis, and biological activities. J Agric Food Chem. 2013 Jan 30;61(4):780-9.
- T J Smith, J A Wolfson, D Jiao, M J Crupain, U Rangan, A Sapkota, S N Bleich, K E Nachman. Caramel color in soft drinks and exposure to 4-methylimidazole: a quantitative risk assessment. PLoS One. 2015 Feb 18;10(2):e0118138.
- J Ma, C S Fox, P F Jacques, E K Speliotes, U Hoffmann, C E Smith, E Saltzman, N M McKeown. Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts. J Hepatol. 2015 Aug;63(2):462-9.
- T T Fung, M H Arasaratnam, F Grodstein, J N Katz, B Rosner, W C Willett, D Feskanich. Soda consumption and risk of hip fractures in postmenopausal women in the Nurses' Health Study. Am J Clin Nutr. 2014 Sep;100(3):953-8.
- Y Hu, K H Costenbader, X Gao, M Al-Daabil, J A Sparks, D H Solomon, F B Hu, E W Karlson, B Lu. Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women. Am J Clin Nutr. 2014 Sep;100(3):959-67.
- N T Mueller, D R Jacobs Jr, R F MacLehose, E W Demerath, S P Kelly, J G Dreyfus, M A Pereira. Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche. Am J Clin Nutr. 2015 Sep;102(3):648-54.
- L O'Connor, F Imamura, M A Lentjes, K T Khaw, N J Wareham, N G Forouhi. Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia. 2015 Jul;58(7):1474-83.
- W Cheungpasitporn, C Thongprayoon, O A O'Corragain, P J Edmonds, W Kittanamongkolchai, S B Erickson. Associations of sugar-sweetened and artificially sweetened soda with chronic kidney disease: a systematic review and meta-analysis. Nephrology (Carlton). 2014 Dec;19(12):791-7.
- G A Bray, B M Popkin. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the sugar. Diabetes Care. 2014 Apr;37(4):950-6.
- J M Bruun, M Maersk, A Belza, A Astrup, B Richelsen. Consumption of sucrose-sweetened soft drinks increases plasma levels of uric acid in overweight and obese subjects: a 6-month randomised controlled trial. Eur J Clin Nutr. 2015 Aug;69(8):949-53.
- L R DeChristopher, J Uribarri, K L Tucker. Intakes of apple juice, fruit drinks and soda are associated with prevalent asthma in US children aged 2-9 years. Public Health Nutr. 2016 Jan;19(1):123-30.
- L Dorfman, A Cheyne, L C Friedman, A Wadud, M Gottlieb. Soda and tobacco industry corporate social responsibility campaigns: how do they compare? PLoS Med. 2012;9(6):e1001241.
- C Sun, J J Wang, D A Mackey, T Y Wong. Retinal vascular caliber: systemic, environmental, and genetic associations. Surv Ophthalmol. 2009 Jan-Feb;54(1):74-95.
- F M Kearney, X J Fagan, S Al-Qureshi. Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease. Clin Experiment Ophthalmol. 2014 Aug;42(6):564-73.
- B Gopinath, V M Flood, J J Wang, W Smith, E Rochtchina, J C Louie, T Y Wong, J Brand-Miller, P Mitchell. Carbohydrate nutrition is associated with changes in the retinal vascular structure and branching pattern in children. Am J Clin Nutr. 2012 May;95(5):1215-22.
Image thanks to rusticusa via Pixabay
Caramel coloring may be the most widely consumed food coloring in the world. Unfortunately, its manufacture can sometimes lead to the formation of a carcinogen called methylimidazole, which was identified as a cancer-causing chemical in 2007. And so, for the purposes of their Prop 65 labeling law, California set a daily limit at 29 micrograms a day. So, how much cancer may caramel-colored soft drinks cause? We didn’t know, until now.
A hundred and ten soft drink samples were tested off store shelves in California and around New York. None of the carcinogen was found in Sprite, which is what you’d expect since it’s not caramel-colored brown. Among sodas that were, the highest levels were found in a Goya brand soda, and the lowest in Coke products—about 20 times less than in Pepsi products. Interestingly, California Pepsi was significantly less carcinogenic than New York Pepsi. This supports the notion that labeling laws like Prop 65 can incentivize manufacturers to reduce foodborne chemical risks. Rather than just “wish they could all be California” to protect consumers around the rest of the country, federal regulations could be a valuable approach to reducing excess cancer risk. But how much cancer are we talking about?
Johns Hopkins researchers calculated the cancer burden—an estimate of the number of lifetime excess cancer cases associated with the consumption of the various beverages. So, at the average U.S. soda intake, with the average levels of carcinogens found, Pepsi may be causing thousands of cancer cases—especially non-California Pepsi products, which appear to be causing 20 times more cancer than Coke. Of course, no need for any of them to have any these carcinogens at all. But we don’t have to wait for government regulation, or corporate social responsibility; we can exercise personal responsibility and just stop drinking soda altogether.
Cutting out soda may reduce our risk of becoming obese, and getting diabetes, fatty liver disease, hip fractures, rheumatoid arthritis, chronic kidney disease, and maybe gout.
In children, daily soda consumption may increase the odds of asthma five-fold, and increase the risk of premature puberty in girls, raising the likelihood they start getting their periods before age 11 by as much as 47%.
If you look at the back of people’s eyes, you can measure the caliber of the arteries in their retina. And the narrower they are, the higher the risk of high blood pressure, diabetes, and heart disease. When researchers did these kinds of measurements on thousands of 12-year-olds, and asked them about their soda-drinking habits, children who consumed soft drinks daily had significantly narrower arteries. So, the message to patients can no longer just be “eat less, exercise more.” It matters what you eat. Specific dietary advice should be to significantly reduce the consumption of processed food and added sugar, and to eat more whole foods.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- M F Jacobson. Carcinogenicity and regulation of caramel colorings. Int J Occup Environ Health. 2012 Jul-Sep;18(3):254-9.
- M Hengel, T Shibamoto. Carcinogenic 4(5)-methylimidazole found in beverages, sauces, and caramel colors: chemical properties, analysis, and biological activities. J Agric Food Chem. 2013 Jan 30;61(4):780-9.
- T J Smith, J A Wolfson, D Jiao, M J Crupain, U Rangan, A Sapkota, S N Bleich, K E Nachman. Caramel color in soft drinks and exposure to 4-methylimidazole: a quantitative risk assessment. PLoS One. 2015 Feb 18;10(2):e0118138.
- J Ma, C S Fox, P F Jacques, E K Speliotes, U Hoffmann, C E Smith, E Saltzman, N M McKeown. Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts. J Hepatol. 2015 Aug;63(2):462-9.
- T T Fung, M H Arasaratnam, F Grodstein, J N Katz, B Rosner, W C Willett, D Feskanich. Soda consumption and risk of hip fractures in postmenopausal women in the Nurses' Health Study. Am J Clin Nutr. 2014 Sep;100(3):953-8.
- Y Hu, K H Costenbader, X Gao, M Al-Daabil, J A Sparks, D H Solomon, F B Hu, E W Karlson, B Lu. Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women. Am J Clin Nutr. 2014 Sep;100(3):959-67.
- N T Mueller, D R Jacobs Jr, R F MacLehose, E W Demerath, S P Kelly, J G Dreyfus, M A Pereira. Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche. Am J Clin Nutr. 2015 Sep;102(3):648-54.
- L O'Connor, F Imamura, M A Lentjes, K T Khaw, N J Wareham, N G Forouhi. Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia. 2015 Jul;58(7):1474-83.
- W Cheungpasitporn, C Thongprayoon, O A O'Corragain, P J Edmonds, W Kittanamongkolchai, S B Erickson. Associations of sugar-sweetened and artificially sweetened soda with chronic kidney disease: a systematic review and meta-analysis. Nephrology (Carlton). 2014 Dec;19(12):791-7.
- G A Bray, B M Popkin. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the sugar. Diabetes Care. 2014 Apr;37(4):950-6.
- J M Bruun, M Maersk, A Belza, A Astrup, B Richelsen. Consumption of sucrose-sweetened soft drinks increases plasma levels of uric acid in overweight and obese subjects: a 6-month randomised controlled trial. Eur J Clin Nutr. 2015 Aug;69(8):949-53.
- L R DeChristopher, J Uribarri, K L Tucker. Intakes of apple juice, fruit drinks and soda are associated with prevalent asthma in US children aged 2-9 years. Public Health Nutr. 2016 Jan;19(1):123-30.
- L Dorfman, A Cheyne, L C Friedman, A Wadud, M Gottlieb. Soda and tobacco industry corporate social responsibility campaigns: how do they compare? PLoS Med. 2012;9(6):e1001241.
- C Sun, J J Wang, D A Mackey, T Y Wong. Retinal vascular caliber: systemic, environmental, and genetic associations. Surv Ophthalmol. 2009 Jan-Feb;54(1):74-95.
- F M Kearney, X J Fagan, S Al-Qureshi. Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease. Clin Experiment Ophthalmol. 2014 Aug;42(6):564-73.
- B Gopinath, V M Flood, J J Wang, W Smith, E Rochtchina, J C Louie, T Y Wong, J Brand-Miller, P Mitchell. Carbohydrate nutrition is associated with changes in the retinal vascular structure and branching pattern in children. Am J Clin Nutr. 2012 May;95(5):1215-22.
Image thanks to rusticusa via Pixabay
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Which Has More Caramel Coloring Carcinogens: Coke or Pepsi?
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Content URLDoctor's Note
Prop 65 is lambasted by vested interests, but as this video shows, it may push manufacturers to make their products less carcinogenic. Other Prop 65 videos include:
- Heavy Metals in Protein Powder Supplements
- Nutritional Yeast to Prevent the Common Cold
- Lead Contamination of Tea
For more background on caramel coloring, see my previous video: Is Caramel Color Carcinogenic?
There are other soda additives that are potentially toxic too. See my three-part series on phosphates:
- Phosphate Additives in Meat Purge and Cola
- Phosphate Additives in Chicken
- How to Avoid Phosphate Additives
There are other coloring agents that are less than healthy: Artificial Food Colors and ADHD, and Seeing Red No. 3: Coloring to Dye For.
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