Did your mother ever say, “If you know what’s good for you, you’ll…?” Know what the matter is? Even as adults who know what’s good for us, we drop the ball as if we didn’t know what’s good for us. Some of us even put the ball down on purpose from time to time. Hey, if we don’t know what’s good for us, how are we supposed to know what’s bad for us?
Catch this newsy tidbit. A lady in Monaco (you know, the place where Grace Kelly used to hang out) made her way to the ER with a palpitating heart that played syncopated rhythms. Intermittent fainting spells were included…free. After all was said and done, it turned out that the only thing she drank for the previous sixteen years was soda—a half-gallon a day, cola at that. If you’re thinking she got her 8 x 8 (eight, 8-ounce glasses of fluids a day), she really got more than she bargained for. The water part of soda is good; the other part isn’t so good.
Ingredients in soda are basically useless. The caramel color comes from heating corn or cane sugar until it reaches the desired color. Desired? By whom? The amount of sugar in a can of regular, non-diet, soda can reach twelve teaspoons. Would you let your child eat even ten spoons of sugar right from the bowl? If a person opts for diet soda, aspartame or some other fake sweetener is in the mix. That earns a chapter of its own. Phosphoric acid adds tang and tartness, but the label doesn’t say it also erodes tooth enamel (Brown, 2007), borrows calcium from bones, and is associated with kidney problems. “Natural flavors” don’t turn soda into health food. Caffeine, we are told, is added to enhance flavor, even to non-colas. Funny thing…a panel of trained tasters couldn’t tell the difference between caffeinated and non-caffeinated colas (Keast, 2007). It adds a slight bitterness and, of course, acts as a stimulant. Soda does, however, contain less caffeine than a cup of coffee.
Caffeine is a diuretic. You well know that a cup of coffee after, say 7 PM, is gonna make you get out of bed at three in the morning. A cola nightcap might do the same thing. Excess urine production—and maybe even diarrhea—will flush potassium from the body. That’s what seems to have happened to the Monaco Miss—potassium deficit. Well, now, does that make any difference? Let’s see what potassium is all about. It’s the number one positively charged ion in the fluid inside a cell, having a sodium counterpart on the other side of the membrane. Their concentration differences create an electrochemical gradient known as membrane potential, which allows a cell to work like a battery to provide power for its function. Simply, sodium tells your fingers to pick up a pencil; potassium says to let it go. Sodium contracts, potassium relaxes. If potassium is in short supply, muscle—including the heart—keeps trying to contract without being relaxed. Not good, right? Right. It’s bad enough that most of us are potassium shy because we fail to get the 4700 milligrams a day that we need, but it’s worse that soda can dissolve what’s left. Potassium helps the heart maintain a regular beat; deficiencies cause irregularities (Poole-Wilson, 1984).
Additional concerns about caffeine intake involve weight loss “miracles” that propose to suppress appetite and increase energy. Most of us are unaware that supplements can contain caffeine without it being listed on the label. A Brazilian tea that is marketed as an energy enhancing beverage, guarana, actually has twice the caffeine of coffee. While that can zoom you up, it can also induce seizures and blurred vision (Pendleton, 2012). O.K., so caffeine keeps you awake, that is, if you’re not accustomed to it. But it is related to sleep-disordered breathing if it comes from soda, though not coffee or tea (Aurora, 2012).
Through a process called osmotic diuresis, glucose and water are eliminated in urine. The kidneys normally reabsorb water and glucose, but excess sugar interferes with normal kidney function. The extra sugar attracts water, which has to go somewhere…the drain…and it takes potassium with it (Packer, 2008) (Sharma, 2013). And then there’s the likelihood that fructose will elevate uric acid levels and cause gout (Choi, 2008). Gosh, heart trouble or arthritic agony? Choices, choices.
If you’ve been a heavy soda drinker for years, it only takes a week to set things straight. The CDC says that fewer than two percent of us get enough potassium (Cogswell, 2012). Potassium-rich foods aren’t that hard to find. Sweet and white potatoes, beet greens, tomatoes, bananas, orange, prune and tomato juices, spinach, sunflower seeds and molasses are some of the foods to consider. Keeping soda to less than a pint a day could keep you out of the ER. There are some places you really don’t need to be.
Aurora RN, Crainiceanu C, Caffo B, Punjabi NM. Sleep-disordered breathing and caffeine consumption: results of a community-based study. Chest. 2012 Sep;142(3):631-8.
Barri YM, Wingo CS. The effects of potassium depletion and supplementation on blood pressure: a clinical review. Am J Med Sci. 1997 Jul;314(1):37-40.
Brown CJ, Smith G, Shaw L, Parry J, Smith AJ The erosive potential of flavoured sparkling water drinks. Int J Paediatr Dent. 2007 Mar;17(2):86-91.
Brown CM, Dulloo AG, Montani JP. Sugary drinks in the pathogenesis of obesity and cardiovascular diseases. Int J Obes (Lond). 2008 Dec;32 Suppl 6:S28-34.
Jee Woong J. Choi, Earl S. Ford, Xiang Gao, Hyon K. Choi Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: The third national health and nutrition examination survey Arthritis Care & Research. January 2008; Volume 59, Issue 1: pages 109–116,
Cogswell ME, Zhang Z, Carriquiry AL, Gunn JP, Kuklina EV, Saydah SH, Yang Q, Moshfegh AJ. Sodium and potassium intakes among US adults: NHANES 2003-2008. Am J Clin Nutr. 2012 Sep;96(3):647-57.
Corti R, Binggeli C, Sudano I, Spieker L, Hänseler E, Ruschitzka F, Chaplin WF, Lüscher TF, Noll G. Coffee acutely increases sympathetic nerve activity and blood pressure independently of caffeine content: role of habitual versus nonhabitual drinking. Circulation. 2002 Dec 3;106(23):2935-40.
Fukumoto M, Yamashiro N, Kobayashi F, Nagasaka T, Takiyama Y. A case of hypokalemic myopathy induced by excessive drinking of a beverage containing green tea extract. Rinsho Shinkeigaku. 2013;53(3):239-42.
Griffiths RR, Vernotica EM. Is caffeine a flavoring agent in cola soft drinks? Arch Fam Med. 2000 Aug;9(8):727-34.
Harvard Health Letter. Aug. 2012; 37(10): 4 Do you really need that diet soda?
He FJ, Marciniak M, Carney C, Markandu ND, Anand V, Fraser WD, Dalton RN, Kaski JC, MacGregor GA. Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension. 2010 Mar;55(3):681-8.
Keast RS, Riddell LJ. Caffeine as a flavor additive in soft-drinks. Appetite. 2007 Jul;49(1):255-9. Epub 2006 Dec 26.
Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation. 2008 Feb 12;117(6):754-61.
O'Keefe JH, Bhatti SK, Patil HR, Dinicolantonio JJ, Lucan SC, Lavie CJ. Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health, and All-cause Mortality. J Am Coll Cardiol. 2013 Jul 3. pii: S0735-1097(13)02601-6.
Packer CD. Chronic hypokalemia due to excessive cola consumption: a case report. Cases J. 2008 Jul 14;1(1):32.
Pendleton M, Brown S, Thomas C, Odle B. Potential toxicity of caffeine when used as a dietary supplement for weight loss. J Diet Suppl. 2012 Dec;9(4):293-8.
Poole-Wilson PA. Potassium and the heart. Clin Endocrinol Metab. 1984 Jul;13(2):249-68.
Sharma R, Guber HA. Cola-induced hypokalemia-a case report and review of the literature. Endocr Pract. 2013 Jan-Feb;19(1):e21-3. doi: 10.4158/EP12241.CR.
Striegel-Moore RH, Thompson D, Affenito SG, Franko DL, Obarzanek E, Barton BA, Schreiber GB, Daniels SR, Schmidt M, Crawford PB. Correlates of beverage intake in adolescent girls: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr. 2006 Feb;148(2):183-7.
Temple JL, Dewey AM, Briatico LN. Effects of acute caffeine administration on adolescents. Exp Clin Psychopharmacol. 2010 Dec;18(6):510-20.
Tsimihodimos V, Kakaidi V, Elisaf M. Cola-induced hypokalaemia: pathophysiological mechanisms and clinical implications. Int J Clin Pract. 2009 Jun;63(6):900-2.
*These statements have not been evaluated by the FDA. These products are not intended to treat, diagnose, cure, or prevent any disease.