Six common beliefs addressed, Part 260 - Soda Edition

1. What makes soda so detrimental for metabolism? Every time we think of obesity and diabetes, the first thing everyone mentions is soda. Does soda really deserve such a bad rap?

I really do not like to over dramatize the ill effects of any one food item but even I can agree that soda is the most obesogenic form of sugar known. It truly does deserve the bad rap, and then some. Unfortunately, most of the bad rap it receives is misdirected. When people think of soda, they think of "fast food", "high calories" or "empty calories" without truly understanding just how much soda can negatively impact their health irrespective of any of these. 

Soda is particularly harmful for blood glucose regulation through three different mechanisms. The trifecta is - sugar, caffeine and sweet taste. All three things work in conjunction to ensure you develop intractable obesity through hypothalamic damage. One thing is to consume something that disrupts your blood glucose regulation and another thing is to consume something that will disrupt every single glucoregulatory system in your body, even when you no longer consume it.

Sugar

This one is pretty self explanatory. We have discussed the effects of sugar extensively on this blog. Dietary sugar will disrupt your blood glucose regulation which in turn will abnormalize insulin expression over time. This effect promotes a metabolic adaptation that chronically under expresses leptin and purposely keeps blood glucose, insulin and body fat set points to high. This is the mechanism of metabolic syndrome and once it begins, it is very difficult to reverse as multiple systems in the body, now work together in feed back loops, to continue its progression.

But soda doesn't just contain sugar. It contains a special type of sugar - high fructose corn syrup. Don't worry about the "corn" or the "syrup" in that name. Don't concern yourself with how it's highly processed or who subsidizes it to make it cheap. Only focus on the "high fructose" part because that's all that matters. 

Sugar is a disaccharide, which consists of a glucose and fructose molecule linked together. This gives sugar a composition of 50% glucose and 50% fructose. This is the composition of honey and regular table sugar. High fructose corn syrup also consists of glucose and fructose, but the composition is varied to be about 55% fructose and 42% glucose. Fructose is what provides the sweet taste in sugar. High fructose corn syrup is sweeter as it has a higher concentration of fructose.

Fructose is metabolized in the liver, like alcohol, and is a hepatotoxin. Do not let them gaslight you into thinking that because alcohol is also metabolized in other tissues and organs, including the brain, and it's a depressant, that it is somehow metabolized differently than fructose. It is not. It is metabolized in the liver, just like fructose, and results in the same liver damage. Its effects on the liver are absolutely toxic. Everything else is pedantic word play. Consuming liquid fructose, such as high fructose corn syrup, can lead to a more rapid absorption of fructose into the bloodstream, which can exacerbate liver damage and metabolic alterations.

Some of the damage that fructose causes to the liver are:

• The development of non-alcoholic fatty liver disease (NAFLD), a condition characterized by the accumulation of fat in the liver.
• Promoting the storage of fat in the liver and increasing the production of insulin which dysregulates blood glucose through hypoglycemia.
• Damage to liver mitochondria, leading to impaired fat metabolism and increased liver fat storage.
• Inhibits the liver’s ability to properly metabolize fat, leading to an increase in the synthesis of fatty acids in the liver and an inhibition of lipid oxidation.

You would think that all of this is pretty bad, but the problems don't stop there.

Caffeine

Caffeine is a stimulant which is naturally found in coffee bans, tea leaves, certain seeds and nuts and chocolate. It is also added to other foods such as energy drinks, energy bars, sodas and some flavored waters. You will never be able to obtain proper blood glucose regulation as long as you are consuming caffeine. You would be surprised how many diabetics caffeine has made. It can give sugar a run for its money.

Caffeine stimulates the nervous system via the hypothalamus and hormones via the adrenal glands, activating the hypothalamic/pituitary/adrenal axis (HPA) and releasing catecholamines. Catecholamines are a group of hormones/neurotransmitters which play a crucial role in the body’s stress response. These "stress hormones" disrupt blood glucose regulation and insulin expression when chronically released. Studies have consistently shown that caffeine increases the levels of catecholamines in the body.

The catecholamines are:

• Epinephrine (Adrenaline): Released in response to intense stress. Epinephrine increases heart rate, blood pressure, and energy levels, preparing the body for immediate action.
• Norepinephrine (Noradrenaline): Released in response to chronic stress. Norepinephrine helps regulate blood pressure, heart rate, and energy levels, and is involved in the body’s “fight or flight” response.
• Cortisol: Released in response to chronic stress. Cortisol helps regulate metabolism, immune response, and energy levels, and is involved in the body’s response to stress and its regulation of inflammation.
• Dopamine: Released in response to various stimuli, including sweet taste. Dopamine is a very powerful metabolic regulator, involved in reward, motivation, and movement which we will discuss in the following segment.  
  

The exact mechanisms by which caffeine affects catecholamine levels are not fully understood, but several theories have been proposed:

• Caffeine may stimulate the release of catecholamines from the adrenal glands, leading to increased levels in the bloodstream.
• Caffeine may also increase the activity of enzymes involved in the synthesis of catecholamines, leading to increased production.
• Caffeine may also have a direct effect on the brain, stimulating the release of catecholamines from neurons.

Whatever the mechanism, the end result is still the same - blood glucose dysregulation. Some of the effects that catecholamines have on the body are:

• Catecholamines can directly stimulate the liver to release glucose into the bloodstream, increasing blood glucose levels. This is achieved by stimulating the breakdown of glycogen to glucose, a process known as glycogenolysis. This release of glucose impacts insulin release/expression.
• Catecholamines stimulate the release of other hormones, such as glucagon, which further increases blood glucose levels by stimulating glycogenolysis and inhibiting glucose uptake by muscles and adipose tissue. This again impacts insulin release/expression.
• Catecholamines can worsen blood glucose control in individuals with diabetes by stimulating the release of glucose from the liver and inhibiting insulin secretion worsening hyperglycemia. Insulin is once again impacted.
  
• Catecholamines can contribute to stress hyperglycemia, a common complication in critically ill patients, by stimulating the release of glucose from the liver and inhibiting insulin secretion causing extreme and deadly hyperglycemia.
• Catecholamines break down lean muscle mass into glucose, disrupting blood glucose regulation further and shifting body composition to more fat than muscle. A body composition of more fat than muscle further progresses blood glucose dysregulation. 
  

Some people are much more sensitive to caffeine than others. Aside from blood glucose dysregulation, caffeine affects blood pressure through the same mechanism of catecholamine release and through its anti diuretic properties. Like diabetes, you would be surprised how much hypertension caffeine has caused.  

This adrenal stress response continues long after the offending food is removed and is the driving force behind diabetes and its progression. Everything now causes this stress response from the night time fast, to exertion, to the common cold, to one night of insomnia. With each incident, the metabolic adaptation causing it is further reinforced. This is why it is vital to eliminate all caffeine from the diet because it will take a very long time to stop this vicious circle once it is.

By now, you would think it's gotten pretty bad but there's more.

Sweet Taste

When a person tastes something sweet, the brain produces huge surges of dopamine. With time, this chronic release of dopamine dysregulates it. Just like all other hormones, dopamine was made to work in pulses and not to be released chronically. Sweet taste was very hard to come by during our history as hunter/gatherers. It was limited to particular seasons and only in certain regions. It is a taste that tells the body to store for winter and dopamine obliges in sending that signal.

Dopamine, which is also a neurotransmitter, plays a crucial role in regulating metabolism, particularly in the context of food intake and energy balance. The relationship between dopamine and its effects on blood glucose homeostasis is complex and multifaceted. Dysregulation of dopamine signaling has been linked to obesity and metabolic disorders, as chronic release of dopamine profoundly disrupts blood glucose regulation.

Some of dopamine's effects on metabolism are:

• Chronic exposure to dopamine can lead to insulin resistance, which can impair glucose uptake in peripheral tissues and contribute to hyperglycemia.
• Dopamine can stimulate the release of glucagon, a hormone that promotes glucose production in the liver, which can lead to hyperglycemia.
• Dopamine can also suppress appetite, which can lead to reduced food intake and potentially lower blood glucose levels (hypoglycemia).
• Dopamine dysregulation has been implicated in the development of Type II diabetes, as it can lead to insulin resistance and impaired glucose metabolism.
• Dopamine also plays a role in regulating hunger and satiety. It has been shown that when dopamine levels lower, individuals will experience increased hunger and cravings particularly for more sweet tasting foods.
  

Dopamine dysregulation has been found to be implicated in the following:

• Studies have shown that obese individuals have fewer dopamine receptors in their brains. This reduced dopamine receptor density can lead to decreased insulin sensitivity, making it more challenging to regulate blood sugar levels and maintain a healthy weight.
• Research suggests that dopamine dysregulation may contribute to the development of obesity. For example, a study found that obese individuals had altered dopamine signaling in the brain, which may lead to overeating and poor food choices (seeking more sweet taste).
• Dopamine signaling dysregulation has been implicated in the development of  various metabolic disorders, including Type II diabetes, metabolic syndrome, and polycystic ovary syndrome (PCOS).

Because of these powerful metabolic effects, dopamine receptors have been targeted as potential therapeutic targets for the treatment of diabetes and related metabolic disorders. Since dopamine is stimulated by sweet taste, and impacts metabolism so profoundly, the introduction of artificial sweeteners has done nothing to curb the obesity/diabetes epidemic. You are now disrupting blood glucose through dopamine dysregulation instead of directly through dietary sugar.

It is not surprising that the obese, who usually have a "drinking problem", suffer from intractable obesity. They have succumbed to the trifecta of blood glucose dysregulation and it will be very difficult for them to reverse their condition. For this reason, on this blog, we tackle anything that disrupts proper blood glucose regulation, whether it's through dietary carbohydrates, the stress response or sweet taste.

Keep In Mind

• Decaffeinated coffee is not "caffeine free". It simply has less caffeine than regular coffee. So be careful of the amounts you drink a day as that caffeine adds up.
• It is even more difficult to find decaffeinated tea and it is also not" caffeine free". It simply has less caffeine that regular tea. Tea is not regulated the same as coffee so you don't know exactly what caffeine is in it, nor does it have to be labeled in any particular way. Be leery of any claims made.
• Diet soda does not mean "caffeine free". The soda must be marked as having 0 sugar and 0 caffeine.
• Diet soda or unsweetened tea at restaurants are usually not available decaffeinated so don't bother ordering them as the "diet" label will not save you.