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If you drink too much soda pop, either sugar-sweetened or diet, you may be at risk of developing type 2 diabetes or cardiovascular complications. This recent finding comes from a long-term study on cardiovascular disease in the United States.

Many people choose diet over sugar-sweetened beverages to reduce caloric consumption and associated weight gain. People with diabetes frequently must avoid sweetened soda pop due to its content of high fructose corn syrup which results in increases in blood glucose.

However, investigators with the Framingham Heart Study, a longitudinal cardiovascular outcomes study involving residents of the town of Framingham, Massachusetts, report that among over 5,000 middle-aged people, consumption of 1 or more diet soft drinks a day was associated with over 50% increased risk of developing metabolic syndrome, a clustering of risk factors for diabetes and cardiovascular disease that includes:

• Increased waist size
• Elevated blood sugar, blood pressure, and triglycerides
• Low HDL (good) cholesterol

In this study, Framingham researchers administered a questionnaire on food and beverage consumption over 4 years. Study participants were asked to report their average number of 12-oz sweetened or diet soft drinks consumed per day including Coke, Pepsi, Sprite, or other caffeinated or decaffeinated beverages. People with cardiovascular disease or metabolic syndrome were not eligible for participation.

Over the course of the study, people who consumed 1 or more soft drinks (either diet or regular) a day were 44% more likely to develop metabolic syndrome.

People who consumed 1 or more sugar-sweetened beverages were at 62% greater risk for metabolic syndrome, but people who consumed only diet were not any less susceptiblethey were 53% more likely to develop metabolic syndrome than people who consumed less than 1 beverage a day.

Soft drink consumption was also associated with greater likelihood of having each risk factor for metabolic syndrome. People who consumed 1 or more soft drinks a day were:

• 30% more likely to be obese
• 25% more likely to have high blood sugar
• 20% more likely to have high blood pressure
• 25% more likely to have high triglycerides
• 30% more likely to have low HDL cholesterol

The increased risk of metabolic abnormalities among people consuming diet beverages is a new finding. However, this does not necessarily mean that if you drink diet beverages you are going to develop metabolic syndrome. Importantly, this was an observational study which is not designed to determine a direct cause-effect relationship.

In any event maintaining a healthy diet and obtaining regular exercise should be priorities in reducing your risk for metabolic syndrome, diabetes, and cardiovascular disease. A few dietary recommendations from the American Diabetes Association include:

• Consumption of plenty of fruit and vegetables
• Select whole grains over processed products
• 2-3 servings of fish per week
• Avoid saturated fats
• Cut back on high-calorie snack foods
• Limit portion sizes

Although the American Diabetes Association also recommends diet soda over sweetened, they also suggest more water consumption. Based on the findings from the Framingham study, the phrase everything in moderation may be prudent advice.

The author is Managing Editor of Diabetes And Vascular Education (DAVE.md) an online resource for healthcare professionals, patients and others seeking the latest news and information on diabetes and vascular disease. Under the direction of an internationally-recognized editorial board, DAVE.md is committed to being an independent, unbiased educational resource on diabetic and vascular complications. Visit Diabetes And Vascular Education to learn more about diabetes and ways to reduce risk of heart attack and practical advice for diabetic patients