Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Go Easy on the Soft Drinks

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Coke Bottle

We are a nation stricken with an epidemic of obesity, which contributes to the increasing incidence of diabetes and heart disease. Each of these has been linked to consumption of sugar, and in particular, sugar-sweetened beverages. There is nothing evil about sugar in and of itself—it's just that too much of it in certain forms is bad for you. For the purpose of definition, sugar-sweetened beverages contain added, naturally-derived caloric sweeteners such as sucrose (table sugar), high-fructose corn syrup, or fruit juice concentrates.

In an article (New England Journal of Medicine 2009;361:1599-1605) entitled "The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages," Kelly Brownell, MD and colleagues used a discussion about a proposed tax system to highlight the trends in consumption of sugar-sweetened beverages and the evidence linking these beverages to adverse health outcomes. Leaving the effects and wisdom of a tax system aside, it's noteworthy to examine the trends and health effects. I'm certainly guilty of drinking more than my fair share of these beverages, but the more I learn about them, the greater effort I make to avoid them.

The statistics are informative. Between 1977 and 2002, the per person intake of caloric beverages doubled in the U.S. across all age groups. There appears to be a strong association between the intake of sugar-sweetened beverages and body weight. Weight gain over time is influenced by the consumption of these beverages. The weight gain is adipose tissue—translated, that means the weight gain is not muscle, not bone, and not brain tissue. It is fat. Furthermore, the strongest effect appears to be in people who are already overweight. So, too much sugar in the diet creates a vicious cycle. Next on the list of "bads" is the positive association between the consumption of sugar-sweetened beverages and diabetes. It is possible that this risk is at least in part a function of weight gain. The same holds true for coronary artery (heart) disease—the risk is increased by consuming these beverages, and that risk may be associated at least in part as a function of weight gain.

Drilling down into the physiological details, consumption of sugar-sweetened beverages has been shown to increase blood triglyceride levels and blood pressure, and to decrease high-density lipoprotein cholesterol levels. These increase the risk of coronary artery disease (e.g., heart attacks) and perhaps stroke. The high glycemic load of these beverages may increase insulin resistance, and thus promote diabetes. In addition, people may become psychologically habituated to tasting the sweetness of sugary foods, and therefore select sugar-containing foods when possible, not because they need the sugar, but in order to satisfy a food preference. If they do this to the exclusion of healthful foods, then the impact upon health is obvious.

Under the assumption that persons who love the outdoors are to a certain extent health-minded, and trying to not be "preachy," I would suggest that you review your diet and do what you can to eliminate sugar-sweetened beverages—indeed, all unnecessary sugar—from your diet. If you can move gradually to a more healthful diet, you will come to recognize the incredible value of proper nutrition in keeping you fit and feeling well, and will take more enjoyment out of the physical activity that is part and parcel of the outdoor experience.

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Tags: General Interest , Staying Safe

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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