Why this cola? Worry, ji

[Dr Lobsang Tsetim]

There has been a baffling urge and craze for aerated soft drinks in certain districts of Arunachal in the recent times. The yearning for effervescent drinks caught the national media’s glare when a video clip went viral, showing an unruly serpentine queue in one of the districts of Arunachal thronging to get their share of Pepsi/Mountain Dew during the initial lockdown period.

Such is the craving that gallons of colas are consumed in villages alone. The titillation of our taste buds before temporarily quenching the thirst is the driving force for the addiction. Such drinks are popular among all age groups and in fact, our people now consider such drinks to be an inseparable part of their lives.

Apong, poka and chhaang used to be and still are part and parcel of all the tribal rituals and festivals in Arunachal. In recent times, these non-alcoholic carbonated soft drinks have replaced the local apong in certain districts of Arunachal. They have substituted apong and now are a part of each customary ritual and festival. This shift from alcoholic intoxicating drinks to aerated non-alcoholic drinks is attributed to inclination towards a certain religion in recent times. Denunciation of alcohol is a welcome sign in the tribal population and there has been a significant decrease in domestic violence, accidents and crime related to alcohol use. On the other hand, the inexplicable consumption of non-alcoholic carbonated soft drinks has increased remarkably in our state, without our knowing their negative effects on our health.

Though we don’t have any population-based or epidemiological study of the health hazards caused by carbonated drinks, doctors of our state have been seeing a growing trend in obesity, diabetes mellitus, dental problems, kidney disease, etc, from these particular areas, which may be attributed to over-consumption of these drinks.

A soft drink is basically a drink that usually contains carbonate water, a sweeter and flavour.  The sweetener may be sugar, high-fructose corn syrup, fruit juice, a sugar substitute, or some combination of these. Soft drinks may also contain caffeine, colourings, preservatives and/or other ingredients. Small amounts of alcohol may be present in a soft drink, but the alcohol content must be less than 0.5 percent of the total volume of the drink.

Carbonated drinks or fizzy drinks are beverages that contain dissolved carbon dioxide. The dissolution of CO2 in a liquid, gives rise to the fizz or effervescence. The process usually involves carbon dioxide under high pressure. Carbonated beverages are prepared by mixing flavoured syrup with carbonated water.

Other popular drinks are energy drinks like Red Bull and Monster. They are marketed for their benefits as stimulants for improving mental and physical performance and increasing energy. They contain caffeine, added sugars, taurine and vitamins, in addition to other ingredients.

Although the ingredients in carbonated drinks are deemed safe by the Food and Drug Administration, these beverages may cause side effects, especially if you consume them on a regular basis. Familiarizing yourself with the possible side effects of carbonated drinks can help you make informed nutrition choices.

Side effects of carbonated aerated drinks

Dental hygiene: Sweetened, carbonated soda drinks cause tooth decay. The sweetener of aerated soft drinks remains in your mouth, and promotes the processes that lead to tooth decay. The acid in these carbonated drinks further increase the likelihood of developing cavities, because these chemicals also slowly cause erosion of the enamel of your teeth. Acid in soda drinks can dissolve tooth enamel in just 20 minutes and cause tooth sensitivity in your child. It also deprives teeth of the necessary amount of calcium needed to be strong and healthy.

Gastritis: Consuming carbonated soft drinks may cause repeated belching as your stomach stretches from the accumulation of carbon dioxide gas. Food and stomach acid may come up your food pipe as you belch, causing heartburn and a sour taste in your mouth.

Obesity: Obesity has recently emerged as a major global health problem. Consuming sugar-sweetened, carbonated drinks adds calories to your diet, which may increase your risk of becoming overweight and obese. A rising consumption of sugar-containing soft drinks has been suggested as a major contributor to the obesity epidemic. Overweight and obesity are significant risk factors for the development of Type 2 diabetes, hypertension, heart disease, stroke and osteoarthritis.

Poor nutrition: Consumption of carbonated soft drinks can adversely affect your overall nutrient intake. Drinking these beverages may reduce your consumption of proteins, starch, dietary fibre and vitamins. Children who engage in frequent drinking of aerated drinks tend to lose their appetite towards nutritious food. People who drink carbonated beverages also tend to eat less fruit and drink less fruit juice, compared to those who do not drink sodas.

Reduced bone strength: Women who consume regular and diet cola tend to have weaker hipbones compared to those who do not drink these beverages. The degree of bone weakness correlates to the amount of cola consumed. Too much intake of carbonated drinks inhibits fulfillment of necessary requirement of vitamins, calcium and other vital nutrients in a child’s body. In fact, high amount of phosphorus in soda leads to depletion of calcium from the child’s bones and makes him/her more prone to bone problems in the future.

Mental health: Aerated drinks may not only physically affect your child, but also affect the child mentally. It may make your child moody and restless. If consumed regularly and in large proportions, soda drinks can prove fatal to your child’s learning capacities and hamper his cognitive abilities. It can trigger aggression and mood changes.

Addiction: Soda drinks contain about 35 to 38 milligrams of caffeine per 12-ounce can. The amount of caffeine in most of the energy drinks is usually three times the concentration in cola drinks. Caffeine affects the brain of the child and to some extent inhibits growth and development of the brain. Caffeine can also leads to adrenal exhaustion in children.

High consumption of energy drinks (caffeine >?400 mg per day) has been associated with adverse effects on health, including anxiety, restlessness, aggression, headaches, and depression.

Kidney and liver diseases: The presence of phosphorus acid in the drinks causes kidney stones and many other renal problems, along with causing impairment in the functionality of the kidneys. High content of sugar and fructose leads to problems in the liver.

Dehydration: Since children take soda drinks to be an alternative to water, they don’t realize how much it can dehydrate them. Sodas have no health benefits for the body and on top of that, they dehydrate the body. Children need proper amount of water in their body, since they engage in heavy physical activities throughout the day.

Artificial sweeteners and their side effects: Artificial sweeteners are used to give diet soft drinks a sweet taste without sugar. They reduce the risks of obesity, diabetes and dental caries. However, their safety has been controversial. The breakdown product of these sweeteners has controversial health and metabolic effects. Some research has linked the consumption of artificial sweeteners with adverse health conditions, including obesity, lymphomas, leukemia, cancers of the bladder, and brain, chronic fatigue syndrome, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, autism, and systemic lupus. The carcinogenic potential of artificial sweeteners, mainly aspartame and saccharine, has been investigated.

Conclusion: Soft drink consumption has become a highly visible and controversial public health and public policy issue. The consumption of soft drinks has increased dramatically in our state, with the greatest increase among children and adolescents. People who cherish such drinks should also know its ill effects on one’s own health.

Abstract: In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (eg, diabetes).

Study design significantly influenced results: Larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (eg, gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.

Our nascent state should also wake up and realize the potential harmful effects of these aerated drinks on the individual’s health and state as a whole. Our health department, NGOs, student bodies and CBOs also need to do serious programmes to raise the level of awareness and educate the masses about the harmful effects of different types of soft drinks.

Meanwhile, efforts also need to be made by manufacturers and government agencies to reduce the potential harmful effects of sugar-containing soft drinks on teeth and general health. These include banning the sale of soft drinks in schools, restricting soft drinks advertisements, modifying the composition of soft drinks, and introducing tax on sugar-containing soft drinks.

Aerated drinks entice children and youths because it is hard for them to understand the side effects on their body. It is the responsibility of parents to teach their child the possible harms soda could do to them.

The next time you grab a bottle of Pepsi, remember that the search for swag in each of its drop may be detrimental to your health. A delusional soul would only believe that a sip of Mountain Dew would guarantee courage or victory over fear.

All stakeholders should join hands and address this issue seriously, lest it becomes a public health emergency. (Dr Lobsang Tsetim is Senior Consultant Ophthalmologist, RKMH, Itanagar)