Soft Drinks

  by Daniel J. Murphy, DC, FACO  

  Dan Murphy graduated magna cum laude from Western States Chiropractic College in 1978, and has more than 20 years of practice experience. He received Diplomat status in Chiropractic Orthopedics in 1986. Since 1982, Dr. Murphy has served part-time as undergraduate faculty at Life Chiropractic College West, currently teaching classes to seniors in the management of spinal disorders.  Dr. Murphy is on the post-graduate faculty of several chiropractic colleges. His post-graduate continuing education classes include “Whiplash and Spinal Trauma” and “Pain Neurology.” Dr. Murphy is the coordinator of a year-long certification program in “Chiropractic Spinal Trauma,” now (2000) in its twelfth year of being offered. This year, the program is being offered through the International Chiropractors Association of California. He has taught more than 700 post-graduate continuing education seminars.  Dr. Murphy is a contributing author to the book Motor Vehicle Collision Injuries, published by Aspen, 1996; and to the book Pediatric Chiropractic, published by Williams & Wilkins, 1998. He writes a quarterly column in the Journal of Clinical Chiropractic.   In 1987, 1991 and 1995 Dr. Murphy received the Post-graduate Educator of the Year award, given by the International Chiropractic Association.  In 1997, he received The Carl S. Cleveland, Jr., Educator of the Year award, given by the International Chiropractic Association of California.  

Information from a web site (1) notes the following:

In 1942, production of carbonated soft drinks was about 60 12-ounce
servings per person in the USA.

By 1998, soft-drink production had increased by nine-fold.

In 1997, Americans spent over $54 billion to buy 14 billion gallons of
soft drinks. That is equivalent to more than 576 12-ounce servings per
year or 1.6 12-ounce cans per day for every man, woman, and child in the
US. This production is more than twice the amount produced in 1974.

Artificially sweetened diet sodas account for 24% of sales, up from 8.6%
in 1970.

Children start drinking soda pop at a remarkably young age, and
consumption increases through adulthood.

One fifth of 1- and 2-year-old children consume soft drinks.

Almost half of all children between 6 and 11 drink soda pop, with the
average drinker consuming 15 ounces per day.

The most avid consumers of all are 12- to 29-year-old males. Among boys
12 to 19, those who imbibe soda pop drink an average of 28.5 ounces per
day.

Teenage girls drink large amounts of pop. Girls who drink soft drinks
consume about 1.7 sodas per day. Women in their twenties average
slightly more at two 12-ounce sodas per day.

One reason for increasing consumption is that the industry has steadily
increased container sizes. In the 1950s, Coca-Cola's 6.5-ounce bottle
was the standard serving. That grew into the 12-ounce can, and now those
are being supplanted by 20-ounce bottles and the 64-ounce Double Gulp at
7-Eleven stores.

Carbonated drinks are the single biggest source of refined sugars in the
American diet.

Soda pop provides the average American with seven teaspoons of sugar per
day.

Lots of soda pop means lots of sugar means lots of calories.

Heavy soft-drink consumption correlates with low intake of magnesium,
ascorbic acid, riboflavin, and vitamin A, as well as high intake of
calories, fat, and carbohydrate.

The soft-drink industry has consistently portrayed its products as being
positively healthful, saying they are 90% water and contain sugars found
in nature.

A poster that the National Soft Drink Association has provided to
teachers states:

"As refreshing sources of needed liquids and energy, soft drinks
represent a positive addition to a well-balanced diet."

"In your body it makes no difference whether the sugar is from a soft
drink or a peach."

M. Douglas Ivester, Coca-Cola's chairman and CEO, defending marketing in
Africa, said, 'Actually, our product is quite healthy. Fluid
replenishment is a key to health. Coca-Cola does a great service because
it encourages people to take in more and more liquids.'

Soda pop adds unnecessary, non-nutritious calories to the diet which
results in escalating obesity rates in children.

The risk of osteoporosis depends in part on how much bone mass is built
early in life. Girls build 92% of their bone mass by age 18, but if they
don't consume enough calcium in their teenage years they cannot 'catch
up' later.

High-sugar diets may contribute to heart disease in people who are
'insulin resistant.'

Caffeine is an addictive stimulant drug, is present in most cola and
'pepper' drinks, as well as some orange sodas and other products.

Caffeine's addictiveness may be one reason why six of the seven most
popular soft drinks contain caffeine. Caffeine's addictiveness may keep
people hooked on soft drinks. When children age 6 - 12 stop consuming
caffeine, they suffer withdrawal symptoms.

Caffeine increases the excretion of calcium in urine. Drinking 12 ounces
of caffeine-containing soft drink causes the loss of about 20 milligrams
of calcium.

Caffeine can cause nervousness, irritability, sleeplessness, and rapid
heart beat. Caffeine causes children who normally do not consume much
caffeine to be restless and fidgety, develop headaches, and have
difficulty going to sleep.

Soft-drink companies are among the most aggressive marketers in the
world.

In 1997, Coca-Cola, which accounts for 44% of the soft-drink market in
the US, spent $277 million on advertising and the four major companies
$631 million.

Between 1986 and 1997 those companies spent $6.8 billion on advertising.

In 1997, 2.8 million soft-drink vending machines dispensed 27 billion
drinks worth $17.5 billion.

Coca-Cola's soft drinks are sold at two million stores, more than
450,000 restaurants, and 1.4 million vending machines and coolers.

The major companies target children.

Companies inculcate brand loyalties in children and boost consumption by
paying school districts and others for exclusive marketing agreements.

In one of the most despicable marketing gambits, Pepsi, Dr Pepper, and
Seven-Up encourage feeding soft drinks to babies by licensing their
logos to a major maker of baby bottles, Munchkin Bottling, Inc.

Infants and toddlers are four times likelier to be fed soda pop out of
those bottles than out of regular baby bottles.

The president of Coca-Cola bemoans the fact that his company accounts
for only 1 billion out of the 47 billion servings of all beverages that
earthlings consume daily. The company's goal is to: make Coca-Cola the
preferred drink for any occasion, whether it's a simple family supper
or a formal state dinner. . . . To build pervasiveness of our products,
we're putting ice-cold Coca-Cola classic and our other brands within
reach, wherever you look: at the supermarket, the video store, the
soccer field, the gas station -- everywhere.

.......

A recent article from the Washington Post (2) notes the following:

School principals in the District of Columbia who are struggling to find
money for extras such as school proms, bus tokens for needy students and
even replacement books have a new source to turn to: the Coca-Cola Co.
Six months ago, the District replaced its school-by-school soda vending
arrangements with a citywide exclusive contract with Coke--joining a
growing number of school districts across the nation trying to turn
their vending machines into cash machines.

Vending machine bonanzas for high schools, middle schools and even
elementary schools have produced an increasingly worried backlash from
health advocates.

Soda pop is hardly a health food, and it may have negative consequences
if children dose up on empty calories and caffeine.

At a time when an alarming number of teenagers are overweight and out of
shape, these advocates say the last thing America's schoolchildren need
is a cola war that stations more vending machines in hallways and makes
it easier for kids to buy soda.

The National Soft Drink Association has challenged the information being
presented by the health advocates, calling it 'an insult to consumer
intelligence.' Any attempts to link soft drinks to health problems, the
group says, 'are not supported by the facts.'

Americans now drink twice as much soda per person as they did 25 years
ago. According to statistics from the Beverage Marketing Corp., annual
soda consumption was 22.4 gallons per person in 1970; in 1998, it was
56.1 gallons per person.

The National Soft Drink Association said in a press release. 'The
message to American consumers is simple. Enjoy a well-balanced diet of
which soft drinks can be a refreshing part.'

In the late 1970s, the USDA tried to impose restrictions, prohibiting
the sale of soft drinks and other foods with 'minimal nutritional value'
throughout schools from the beginning of the school day until 30 minutes
after the end of the last lunch period. The National Soft Drink
Association challenged the regulation, and in 1983 the U.S. Court of
Appeals struck down the USDA prohibition.

.....

A recent article titled: Is Caffeine a Flavoring Agent in Cola Soft
Drinks?, from the Archives of Family Medicine, notes the following:

Caffeine is an added ingredient in approximately 70% of soft drinks
consumed in the United States.

The soft drink manufacturers' justification to regulatory agencies and
the public for adding caffeine to soft drinks is that caffeine is a
flavoring agent.

The finding that only 8% of a group of regular cola soft drink consumers
could detect the effect of the caffeine concentration found in most cola
soft drinks is at variance with the claim made by soft drink
manufacturers that caffeine is added to soft drinks because it plays an
integral role in the flavor profile.

It is valuable for the general public, the medical community, and
regulatory agencies to recognize that the high rates of consumption of
caffeinated soft drinks more likely reflect the mood-altering and
physical dependence-producing effects of caffeine as a central nervous
system-active drug than its subtle effects as a flavoring agent.

In 1998, Americans consumed 15 billion gallons of flavored carbonated
beverages, which is the equivalent of 585 twelve-oz cans for every man,
woman, and child.

Soft drinks are the single largest source of added sugar in the American
diet and there is continuing concern that consumption of soft drinks,
particularly by children and teenagers, adversely affects health by
increasing sugar and calorie consumption and by displacing consumption
of more healthful foods, thereby possibly increasing the likelihood of
tooth decay, obesity, and bone fracture.

Adults and children can become physiologically and psychiatrically
dependent on caffeinated soft drinks, experiencing a withdrawal syndrome
if they terminate regular use, and feeling compelled to continue
consuming soft drinks despite desires and recommendations to quit.

A 1981 proposal by the US Food and Drug Administration to delete
caffeine from cola-type beverages, resulted in soft drink manufacturers
to justify adding caffeine to soft drinks on the basis that caffeine is
a flavor enhancer.

Soft drink manufactures assert that caffeine is an integral part of the
overall flavor profile of soft drinks, which have attained their
popularity because they activate a variety of flavor sensations.

The National Soft Drink Association argues that the high consumer appeal
of caffeinated soft drinks is due to the important role of caffeine in
the overall flavor profile of these beverages.

This "overlooks the central nervous system-mediated stimulating,
reinforcing, and physical dependence-producing actions of caffeine that
provide a compelling alternative explanation for the high rates of
consumption of caffeinated soft drinks."

Since 1981, the 2 most popular brands of cola soft drinks (Coke and
Pepsi) account for more than a third of all soft drinks consumed in the
United States, and have caffeine concentrations of about 0.1 mg/mL.

No subject was able to significantly detect a difference at the lowest
caffeine concentration of 0.05 mg/mL.

At the 0.1 mg/mL concentration, 2 subjects (8%) significantly detected a
flavor difference.

Increasing concentrations of caffeine (0.2 mg/mL, 0.4 mg/mL, 0.8 mg/mL,
and 1.6 mg/mL) were significantly detected by 56%, 96%, 100%, and 100%
of subjects, and they most often described the caffeine samples as being
"bitter" and/or as having an "aftertaste."

"Higher caffeine concentrations were often further described as being
extremely unpleasant (e.g., 'like medicine' or 'nasty')."

"At 0.2 mg/mL, which is the highest caffeine concentration permitted in
soft drinks by the Food and Drug Administration, 56% of the subjects
were able to detect a flavor difference. At this concentration, subjects
usually described the caffeine-containing sample as bitter or as having
an aftertaste."

"Overall, the results of the study are at variance with the claim made
by soft drink manufacturers that caffeine is added to soft drinks
because it plays an integral role in the flavor profile."

"Caffeine's effects on the central nervous system provide a compelling
alternative explanation for the strong preference for
caffeine-containing over caffeine-free cola drinks claimed by
participants in this study, and for the high rates of consumption of
these caffeinated soft drinks."

"With daily consumption of caffeine at a dose equivalent to that of 3
servings of cola soft drink (100 mg), caffeine has been shown to produce
physical dependence characterized by lethargy and headache on cessation
of intake." Suppression of low-grade withdrawal symptoms after overnight
abstinence has been suggested as a principal mechanism by which caffeine
engenders daily self-administration.

"In addition to caffeine producing physical dependence and playing a
prominent role in maintaining beverage consumption, various other
caffeine-related health concerns have been recently expressed, including
the displacement of nutritionally healthful foods by caffeinated
sugar-containing soft drinks, and possible adverse effects of caffeine
in anxiety and sleep disorders and in pregnancy."

"In conclusion, the findings of our study suggest that despite claims to
the contrary, caffeine plays a relatively minor role as a flavoring
agent in cola soft drinks for the majority of regular consumers."

"In the meantime, we believe that it is worthwhile for the general
public, the medical community, and regulatory agencies to recognize the
possibility that the high consumption rates of caffeine-containing soft
drinks are more likely to reflect the mood-altering and physical
dependence-producing effects of caffeine as a central nervous
system-active drug than its subtle effects as a flavoring agent."

.....

Another recent article titled: Teenaged Girls, Carbonated Beverage
Consumption, and Bone Fractures, from the Archives of Pediatric and
Adolescent Medicine, notes the following:

There is an association between carbonated beverage consumption and bone
fractures among teenaged girls.

The mean age of the girls was 15 years 8 months.

Of the total sample of 460 girls, 55.65% did not participate in any
sports activity.

10.9% reported themselves as being inactive

22.0% reported as engaging in light activity

28.7%, reported as engaging in moderate activity

17.2%, reported as engaging in high-level activity

18.5%, reported as engaging in vigorous activity

Nearly 80% drink carbonated beverages:

49.8% drank cola beverages only

11.5% drank non-cola beverages only

15.0% drank both cola and non-cola beverages

Therefore, nearly two thirds of the 460 high school girls consumed cola
beverages.

Of those who consumed carbonated beverages, most drank regular sugar
drinks in contrast to diet drinks; only 20% of the participants drank
diet drinks.

"One health impact of carbonated beverage consumption among teenaged
girls, the risk of bone fractures, is reported herein."

This association between cola drinks and bone fractures among physically
active adolescents confirms results from previous work (1994).

Teens have doubled or tripled their consumption of soft drinks.

Adolescence is a critical period for bone mass formation, which will
then deliver benefits throughout life.

Laboratory investigators have reported bone resorption from high levels
of phosphorus intake. The high phosphoric acid content in cola drinks
alters the calcium-phosphorus ratio in the diet. It has been known for
more than 100 years that there is an increase in bone fractures from
occupational exposure to phosphorus.

"The results obtained in this study confirm the relationship between
cola consumption and bone fractures among physically active girls."

"In conclusion, nationally, there is great concern about the effects of
carbonated beverage consumption on obesity, tooth decay, osteoporosis,
and other health problems."

"Concern about the health impact of carbonated beverage consumption, in
particular, the association with bone fractures in adolescent girls, is
validated by our findings. Our findings have implications both for the
health of teenagers and for the health of women at later ages."

This article generated the following comment (5), in "Osteoporosis
Prevention; A Pediatric Challenge:"

"Osteoporosis affects 25 to 30 million American adults and fractures
related to osteoporosis cost the US health care system an estimated
$13.8 billion per year."

The major determinants of future fracture risk is the amount of bone
present at skeletal maturity, often referred to as 'peak bone mass'
which is achieved during the late stages of pubertal.

By 2 years postmenarche, bone mass gains decline rapidly, and therefore
adolescence is a crucial time for bone development, and 'any factors
adversely impacting on bone acquisition during adolescence can
potentially have long-standing detrimental effects."

Girls who consumed carbonated beverages had a 3 times increased risk of
fracture when compared with those who did not drink carbonated beverages.

"This study adds to a growing body of literature showing that there is
an association between soda consumption and increased fracture risk."

"Cola beverages are processed with phosphoric acid which can affect
calcium metabolism and bone mass."

Between 1970 and 1997, the per capita consumption of carbonated soft
drinks increased 118%.

"Today's teenagers are consuming diets that are high in phosphorus and
low in calcium and this combination can impact negatively on attainment
of peak bone mass."

.....

In conclusion, these articles:

1. Have important health implications.

2. Give an interesting view into contemporary teenage America.

3. Show that our schools value economics over health concerns.

4. Give us a window into the workings of Corporate America on the issue
of profits vs. health.

Dan Murphy, DC

References:

1. Michael F. Jacobson; Liquid Candy: How Soft Drinks are Harming
Americans' Health; www.cspinet.org/sodapop/liquid_cansy.htm.

2. Marc Kaufman; Rousing Kids to Caffeine's Consequences: Fighting
the Cola Wars in Schools; Washington Post; March 23, 1999; Page Z12.

3. Roland R. Griffiths, PhD; Ellen M. Vernotica, PhD; Is Caffeine a
Flavoring Agent in Cola Soft Drinks?; Arch Fam Med.; Vol. 9 No. 8;
August 2000; pp 727-734.

4. Grace Wyshak, PhD; Teenaged Girls, Carbonated Beverage Consumption,
and Bone Fractures; Arch Pediatr Adolesc Med; Vol 154 No 6; June 2000;
pp 610-613.

5. Neville H. Golden, MD; Osteoporosis Prevention: A Pediatric
Challenge; Arch Pediatr Adolesc Med; Vol 154 No 6; June 2000.