The Diet-Soda Dilemma

It's a guilt-free delight, a weight-loss dud, a Frankenfood that'll "suck" the calcium right out of your bones. Love it or hate it, diet soda is nearly as controversial as the national debt in an election year. And even we YOU Docs are not immune to it: At one time (distant past), one of us (Dr. Mike) swigged 24 cans of the stuff a day. It took Dr. Oz's most determined self (with help from his wife, Lisa) to get Dr. Mike to cut back to one can a day.

That's not a bad goal for you, either. Recent research suggests that some diet sodas do indeed leach a little calcium from your bones, especially if you tend to chain-drink them. They may also raise your risk for diabetes and more. Should you give them up entirely? Here are the pros and cons:

The Cons

• Caffeinated sodas -- diet or not -- pose the biggest threat to your bones. Recent research shows that it may be the caffeine in some sodas, rather than the acids in all of 'em, that coaxes excess calcium out of your skeleton.


• Diet soda increases your risk for type 2 diabetes and heart disease. Three big studies have found that people who drink even one diet soda a day have a greater chance of developing metabolic syndrome, which is a precursor to diabetes and heart disease.Why? Maybe because diet-soda drinkers also tend to order the burger and fries (instead of the salad and fruit). Maybe because diet colas contain caramel flavoring that reduces your body's ability to process blood sugar at a molecular level. Or maybe because people whose extra weight already puts them at risk for diabetes and heart trouble drink diet soda in an attempt to consume fewer calories. Snacking on these helps reduce your risk of metabolic syndrome.


• Diet sodas don't help you lose weight. Bummer. True, but still a bummer, we know. Worse, there's some evidence that artificial sweeteners actually encourage weight gain, perhaps by fueling your taste for sweet foods. Drinking this, on the other hand, might help you lose belly fat.

The Pros
Despite the cons, as yet there's no definitive evidence that the ingredients in diet sodas are harmful, provided you don't drink more than 80 cans (yes, 80) a day. We assume you don't, so, generally speaking, do this:

• If you currently drink regular soda, diet is still a better choice. Every 12-ounce can of the real thing floods your body with 136 calories -- most of it courtesy of 33 grams of high-fructose corn syrup, which you totally don't need. ("Ditching liquid candy is a top Roizen Rule," says Dr. Mike.)


• Clean up the rest of your diet first. Don't sweat one or maybe two diet bubblies a day. It's way more important to get the rest of your food and drink up to good-for-YOU standards. By that we mean 100% whole grains instead of the processed white stuff; healthy fats from olive and canola oils, fish, and nuts; low- or no-fat dairy; skinless white-meat poultry; loads of fruit and veggies; and as little red meat, saturated fat, and refined sugar as you can stand.


• Get extra calcium. For every 12 ounces of soda you sip, bump up your calcium intake by 20 milligrams. All that takes is a few extra swallows of skim milk or a few extra stalks of broccoli. Just add that to the calcium supplement you should be taking anyway (1,000 milligrams before age 60, 1,200 milligrams from then on -- half in the morning, half at night; we like ours in the form of calcium citrate). Watch this video to learn more ways to boost your calcium intake.


• Steer clear of diet-soda "fantasy math." A zero-calorie soda doesn't cancel out the calories and fat in that Philly cheesesteak, or those four frosted rosettes on the office birthday cake, or that third slice of stuffed-crust pizza. Really.


• Love bubbles? Pour yourself a no-cal sparkler. Your bones and your metabolism have nothing to fear from the carbonation in club soda or seltzer. So if it's the fizzy, tickly tingle on your tongue that you really love, make sparkling water your calorie-free refresher. Want more taste? Choose a flavored type, or add a spritz of lemon or lime, a fistful of berries or frozen grapes, or an ounce or two of your favorite real fruit juice -- orange and grapefruit taste great. Just ask Dr. Mike.