Okay - I subscribe to a small locally produced newsletter called "Beyond Change - Information Regarding Obesity and Obesity Surgery" (
www.beyondchange.com). They are so small that they oftentimes take months to transfer current printed newsletters to their website, so I will hand type their most recent research on carbonated beverages here (please forgive any typos – I spell checked only, but didn’t re-read the whole thing). Forgive me as it is really long:
"Why Carbonated Beverages are "TABOO" after bariatric Surgery"
By: Cynthia Buffington, Ph.D
Did you drink carbonated soft drinks prior to your Bariatric surgery? Do you still consume carbonated soft drinks? Were you advised by your surgeon or his/her nutritional staff NOT to drink carbonated drinks after surgery? Do you understand why drinking carbonated beverages, even if sugar-free, could jeopardize your weight loss success and, perhaps even your health?
A carbonated beverage is an effervescent drink that releases carbon dioxide under conditions of normal atmospheric pressure. Carbonated drinks include most soft drinks, champagne, beer, and seltzer water. If you consume a soft drink or other carbonated beverage while eating, the carbonation forces food through he stomach pouch, reducing the time food remains in the pouch. The less time food remains in your stomach pouch, the less satiety (feelings of fullness) you experience, enabling you to eat more with increased risk for weight gain.
The gas released from a carbonated beverage mat "stretch" your stomach pouch. Food forced through the pouch by the carbonation could also significantly enlarge the size of your stoma (the opening between the stomach pouch and intestines of patients who have had a gastric bypass or biliopancreatic diversion). An enlarged pouch or stoma would allow you to eat larger amounts of food at any one setting. In this way, consuming carbonated beverages, even if the drinks are diet or calorie free, may cause weight gain or interfere with maximal weight loss success.
Soft drinks may also cause weight gain by reducing the absorption of dietary calcium. Dietary calcium helps to stimulate fat breakdown and reduce its uptake into adipose tissue. Epidemiological and clinical studies have found a close association between obesity and low dietary calcium intake. Recent studies have found that maintaining sufficient amounts of dietary calcium helps to induce weight loss or prevent weight gain following diet.
The high caffeine in carbonated sodas is one way that drinking carbonated soft drinks may reduce the absorption of calcium into the body. Studies have found that caffeine increases urinary calcium content, meaning that high caffeine may interfere with the uptake of dietary calcium into the body. Keep in mind that one 12 oz. can of Mountain Dew has 50 mg of caffeine, and Pepsi and Coke (diet or those with sugar) contain 37 mg of caffeine each.
Colas, such as Pepsi and Coke (diet or with sugar), may also cause calcium deficiencies from the high amounts of phosphoric acid that they contain. Phosphate binds to calcium and the bound calcium cannot be absorbed into the body. Both animal and human studies have found that phosphoric acid is associated with altered calcium homeostasis and low calcium.
Drinking carbonated beverages may also reduce dietary calcium because these beverages replace milk and other nutrient-containing drinks or foods in the diet. Several studies report inverse (negative) relationships between carbonated beverage usage and the amount of milk (particularly children) consume.
Carbonated beverages, then, may reduce dietary calcium because of their high caffeine or phosphoric acid content or because drinking such beverages tends to reduce the consumption of calcium-containing foods and beverages. Such deficiencies in dietary calcium intake may be even more pronounced in Bariatric surgical patients.
Calcium deficiencies with Bariatric surgery have been reported following gastric restrictive and/or malabsorptive procedures. The reduced amounts of calcium with bariatric surgery may occur as a result of low nutrient intake, low levels of vitamin D, or, for patients who have had gastric bypass
pr the biliopancreatic diversion (with or without the duodenal switch), from bypass of the portion of the gut where active absorption of calcium normally occurs. Drinking carbonated beverages may further increase the risk for dietary calcium deficiencies and, in this way, hinder maximal weight loss success.
For all the reasons described above, including calcium deficits, reduced satiety, enlargement of pouch or stoma, drinking carbonated beverages, even those that are sugar-free, could lead to weight gain. Carbonated beverages that contain sugar, however, pose a substantially greater threat to the Bariatric patient in terms of weight loss and weight loss maintenance with surgery.
Sugar-containing soft drinks have a relatively high glycemic index, meaning that blood sugar levels readily increase with their consumption. The rapid rise in blood sugar, in turn, increases the production of the hormone, insulin. , that acts to drive sugar into tissues where it is metabolized or processed for storage. High insulin levels, however, also contribute to fat accumulation, driving fat into the fat storage depots and inhibiting the breakdown of fat.
Soft drinks with sugar are also high in calories. An average 12 oz. soft drink contains 10 teaspoons of refined sugar (40g). The typical 12-oz. can of soda contains 150 calories (Coke = 140 calories; Pepsi = 150; Dr. Pepper = 160; orange soda = 180; 7-up = 140; etc.). Soft drinks are the fifth largest source of calories for adults, accounting for 5.6% of all calories that Americans consume. Among adolescents, soft drinks provide 8%- to 9% of calories. An extra 150 calories per day from a soft drink over the course of a year, is equivalent to nearly 16 pounds and that weight gain multiplied by a few years could equate to “morbid obesity”.
In addition to the adverse effects that carbonated drinks have on weight loss or weight loss maintenance, carbonated beverages may also have adverse effects on health. Soda beverages and other carbonated drinks are acidic with a pH of 3.0 or less. Drinking these acidic beverages on an empty stomach in the absence of food, as Bariatric patients are required to do, can upset the fragile acid-alkaline balance of the gastric pouch and intestines and increase the risk for ulcers or even the risk for gastrointestinal adenomas (cancer).
Soft drink usage has also been found to be associated with various other health problems. These include an increased risk for diabetes, cardiovascular disease, kidney stones, bone fractures and reduced bone density, allergies, cancer, acid-peptic disease, dental carries, gingivitis, and more. Soft drinks may, in addition, increase the risk for oxidative stress. This condition is believed to contribute significantly to aging and to diseases associated with aging and obesity, i.e. diabetes, cancer, cardiovascular disease, liver disease, reduced immune function, hypertension, and more.
From the above discussion, do you now have a little better understanding of why your Bariatric surgeon or Bariatric nutritionist advised you NOT to consume carbonated sodas after surgery? Your Bariatric surgeon and his/her staff want to see you achieve the best results possible from your surgery – both in terms of weight loss and health status – and so do YOU. Consider the consequences of drinking such beverages now that you understand more clearly why such drinks are “Bariatric taboo”.
Does carbonation really stretch our pouches?
Mandolyn
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