Just the other day, a man weighing 470 pounds lumbered into Dr. Caroline Apovian’s office at Boston Medical Center. He was young - only 32 years old - but already, his heart had begun to fail him, a legacy of his extreme obesity.
Discuss
COMMENTS (21)
Maybe, he asked Apovian, I should have weight-loss surgery. She told him that first, he would need to alter what he eats - and drinks, especially the 2 liters of sugary soft drinks he drains every day.
“I gave him a high-protein, low-fat diet,’’ Apovian recalled. “Everything was fine until I said, ‘No soda.’ And he said, ‘You don’t understand. The soda calls to me.’ ’’
Last week, federal disease investigators reported that the cost of treating obesity has doubled in the past decade, and they pointed to sugar-laden beverages - sodas, energy drinks, fruity libations - as a prime culprit.
Three months earlier, one of the nation’s premier nutrition specialists, Dr. Walter Willett of the Harvard School of Public Health, embarked on a personal crusade to persuade consumers to forgo sugary drinks. Research conducted by Willett and other Boston scientists has shown that women who quaffed more than two sweetened beverages a day had an almost 40 percent higher risk of heart disease than those who rarely touched the drinks.
By Willett’s calculations, a 20-ounce soft drink - a pretty standard volume these days - contains the equivalent of 17 teaspoons of sugar. “If you can just imagine spooning down 17 teaspoons of sugar,’’ Willett said, “it makes you want to gag.’’
As the nation’s love affair with cigarettes wanes, health authorities increasingly worry that the gains achieved by reducing tobacco use will be eclipsed by the medical woes blamed on obesity. But obesity has proved to be a dauntingly complex foe, largely resistant to simple interventions.
That is why sugary beverages - once served in modest bottles, now available in 32-ounce, even 64-ounce tumblers - have emerged as a popular target. Unlike other approaches that require dramatic lifestyle changes - say, exercising more or eating much less - switching to less sugary beverages is viewed as a straightforward way to lower weight and, possibly, decrease the most common form of diabetes.
“It is empowering because it is such a concrete change you can make - it should be the cornerstone of public-health strategies to reduce obesity and prevent type 2 diabetes,’’ said Dr. JoAnn Manson, preventive medicine chief at Brigham and Women’s Hospital and an author of a 2004 study that showed consuming at least one sugary drink a day made women substantially more prone to develop diabetes and pack on pounds.
As recently as the 1950s, American children consumed far more milk than soft drinks and fruit-flavored beverages. But by the turn of the century, the balance had shifted starkly.
From the mid-1970s to 2000, the number of calories in the average Americans’ daily diet attributed to sugary drinks rose from 70 to 190, one study found. That paralleled a doubling in the percentage of Americans who weigh too much. And by 2000, soft drinks bursting with sugary high-fructose corn syrup were the single-biggest calorie contributor to Americans’ diet, accounting for 7 percent of what we consume, a California scientist has reported.
“Sugar-sweetened beverages,’’ Dr. Thomas Frieden, director of the US Centers for Disease Control and Prevention, wrote in April in The New England Journal of Medicine, “may be the single-largest driver of the obesity epidemic.’’
Americans may be hearing the message about soft drinks. Consumption peaked in 1998, when soft drinks - both regular and diet - constituted nearly 30 percent of all liquids consumed, according to Beverage Digest. That had slipped to 26 percent by last year, and diet sodas were gaining ground on sugary beverages.
The companies producing sugary drinks dispute that they are responsible for the obesity epidemic. “It’s counterproductive when you have folks out there trying to single out one particular product as a unique contributor to a problem so complex,’’ said Kevin Keane, senior vice president of the American Beverage Association, which represents the makers of Coca-Cola, Pepsi, and other leading drinks. “You could get rid of soft drinks tomorrow, and you would still have overweight and obese people.’’
He cited research challenging the supposed link between sugary soda and obesity. One of the three studies was paid for by the association itself, while another was conducted by scientists at a food conglomerate. In contrast, research critical of the beverages’ health consequences is frequently underwritten by the National Institutes of Health.
What’s most important, Keane said, is helping consumers adjust their calorie intake. But a Boston researcher said it’s not just the sheer number of calories in sugary sodas that matters - it’s also the type of calories.
“Calories in liquid form appear to be inherently less filling than calories in solid form,’’ said Dr. David Ludwig, director of the Optimal Weight for Life Program at Children’s Hospital Boston. “They somehow slip underneath the appetite-regulating radar system.’’
Researchers suspect evolution has something to do with it. For most of the time humans roamed Earth, we relied on water to slake our thirst. So it was important for survival that the body did not routinely send out a signal that it was getting satiated because of water intake.
But then beverages packed with calories came along, and, suddenly, we were ingesting hundreds of calories bereft of nutritional benefit - and they don’t even make us eat less.
It turns out, though, that those empty calories have, as Harvard’s Willett put it, “a silver lining.’’
“The fact that we don’t register the calories in the same way from beverages that we do from solid foods,’’ Willett said, “means it’s easier to give them up.’’
A novel study conducted by Children’s Hospital supports that point.
Researchers went to a Cambridge high school and recruited 103 adolescents to see if they could change their drinking habits. Half received weekly deliveries of a healthier beverage of their choosing - bottled water and diet sodas, iced teas, lemonade, and punch - while the other half maintained their old drinking habits.
Those who got the healthier beverages reduced their consumption of sugar-sweetened beverages by 82 percent over six months. And the one-third who weighed the most at the start lost an average of three or four pounds.
“It told us the heavier you are,’’ Ludwig said, “the greater the benefit of reducing sugar-sweetened beverages, which makes sense.’’
That’s one of the strategies Eli Sugarman used to trim 28 pounds in half a year. Looking back, it was obvious her son needed to shed weight, Allison Paul acknowledges. But the urgency of that task became clearer when testing showed that if the family didn’t do something, Eli was destined to become diabetic.
So, in January, Paul took her son to Children’s Hospital, where doctors told him to cut back on the Mountain Dew, Pepsi, and juice boxes he used to drink each day.
“When you go out with your friends, you go to the movies with them and they have these big drinks and you’re sitting there with your water, it’s tough not to order a big soda,’’ said Eli, who celebrates his 13th birthday Saturday. “I just think about it like this: A soda’s great for half an hour, an hour. Those calories, that sugar, sticks with you a lot longer than that soda will.’’
Stephen Smith can be reached at stsmith@globe.com.
© Copyright 2009 Globe Newspaper Company.
Single Page 1 2 |
