Editors Choice

Why I Stopped Drinking Diet Coke

For more than a year, I have stopped consuming diet soda. My go to drink was Diet Coke, and it was not uncommon for me to consume almost a 12 pack a day. I enjoyed the taste, it did not have any sugar, and it was a substitute for food, allowing me to decrease my daily caloric intake.

I won’t lie: I do miss it. In a lot of parties to which I go, and restaurants in which I’m dining, there are not many alternatives to diet soda other than water (or perhaps iced tea). Still, I remain steadfast in my abstinence from diet soda

This is not because of the recent World Health Organization classification of aspartame, a ubiquitous nonnutritive sweetener (and the one used in Diet Coke) as “possibly carcinogenic to humans.” I was never worried about getting cancer from an artificial sweetener. I was concerned, however, of the effect of aspartame on my microbiome.

The microbiome is the collection of billions of bacteria that reside normally in our gut. In the past, it was not believed to have much of an effect on human health and well-being, although it is known that gut bacteria are mainly responsible for the production of vitamin K, which is critical to the formation of the clotting factors in our blood. It is also known that it is the gut bacteria’s metabolism of lactose, in lactose intolerant individuals, that is causing the discomfort when dairy products are consumed.

Recent research, however, has shown that the Microbiome exerts a real effect on our health, such as metabolism of glucose and glucose intolerance, along with appetite and possibly even weight gain. And, there may be even a link between the microbiome and our mental health. The research in this arena is only beginning. 

For me, I was concerned that the bacteria in my gut were consuming the aspartame I was drinking and adding to my coffee and tea, and that it was having an effect on my overall well-being. Recent research has confirmed my concern. 

Yet. the data are all over the place. There are studies that show no effect of nonnutritive sweeteners on glucose metabolism, and there are others that show consumption of artificial sweeteners may contribute to weight gain. That said, there seems to be increasing evidence that the microbiome definitely interacts with the nonnutritive sweeteners we are consuming, and it may have an effect on our overall health.

Whether or not this can lead to cancer is unclear. Indeed, when the WHO declared aspartame “ possibly carcinogenic,” a related body indicated that a 150 pound individual can safely consume a 12 pack of Diet Coke without any risk. This is annoyingly confusing. 

All of that said, my own study of an N = 1 (that is, me) showed that the aspartame I was consuming did indeed have an effect on my health: when I stopped, I lost a little bit of weight. Now, I am consuming beverages containing Stevia, and I am adding Stevia to my coffee and tea for the most part.

Could later research shows that this is also detrimental? Of course. For now, it seems to be working for me, and that is what I am going with. And that is the main message we should take away.

Not everybody will be affected by nonnutritive sweeteners. Not everyone’s microbiome will be affected by these sweeteners. For some, it can be detrimental. For others, there could be no effect. The main thing is to assess how it affects us individually and make our own choices.

Sign up for Dr. Hassaballa’s Newsletter, Healthcare Musings, at www.healthcaremusings.com

Dr. Hesham A. Hassaballa

Dr. Hesham A. Hassaballa is a NY Times featured Pulmonary and Critical Care Medicine specialist in clinical practice for over 20 years. He is Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine. He is a prolific writer, with dozens of peer-reviewed scientific articles and medical blog posts. He is a Physician Leader and published author. His latest book is "Code Blue," a medical thriller.

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