Sharmin+Mollah+Final

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Carbonated drinks are by far the most popular drinks sold worldwide despite the negative health effects associated with them. Two of the most popular carbonated drinks are Coca-Cola and Pepsi. Both Coca-Cola and Pepsi contain the same ingredients such as carbonated water, high fructose corn syrup, caramel color, phosphoric acid and caffeine, all of which affect the body negatively. Sometime soft drinks also contain contaminants that are extremely harmful to the body. Some of the most common health disorders associated with drinking carbonated beverages is obesity, hypertension, type II diabetes, kidney stone, dental cavities, osteoporosis, low nutrient levels and even risk of cancer.======

The list of ingredients and nutritional value listed on the company websites of both Coca-Cola and Pepsi are almost identical as seen from the tables below:

 * ======Table 1: List of Ingredients====== ||
 * ======Pepsi (12 oz can)====== || ======Coca-Cola (12 oz can)====== ||
 * ======Carbonated Water====== || ======Carbonated Water====== ||
 * ======High Fructose Corn Syrup====== || ======High Fructose Corn Syrup====== ||
 * ======Caramel Color====== || ======Caramel Color====== ||
 * ======Sugar====== || ======X====== ||
 * ======Phosphoric Acid====== || ======Phosphoric Acid====== ||
 * ======Caffeine====== || ======Caffeine====== ||
 * ======Citric Acid====== || ======X====== ||
 * ======Natural Flavor====== || ======Natural Flavor====== ||

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 * ======Table 2: Nutrition Facts====== ||
 * ======Pepsi (12 oz can)====== |||| ======Coca-Cola (12 oz can)====== ||
 * ======Amounts Per Serving====== |||| ======Amounts Per Serving====== ||
 * ======Calories====== || ======150====== || ======Calories====== || ======140====== ||
 * ======Total Fat====== || ======0 g====== || ======Total Fat====== || ======0 g====== ||
 * ======Sodium====== || ======30 mg====== || ======Sodium====== || ======45 mg====== ||
 * ======Sugars====== || ======41 g====== || ======Sugars====== || ======39 g====== ||
 * ======Protein====== || ======0 g====== || ======Protein====== || ======0 g====== ||

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Of the ingredients listed, high fructose corn syrup, caramel color, phosphoric acid and caffeine are all associated with adverse health effects. High fructose corn syrup is related to obesity, type 2 diabetes, and metabolic syndrome. Caramel color has been linked to cancer due to contaminants produced during the reaction. Phosphoric acid is linked to dental erosion, and osteoporosis. Caffeine is a stimulant and causes withdrawal symptom and has been linked to the development of osteoporosis also.======

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One of the negative effects of soft drink consumption is weight gain which leads to a higher likelihood of obesity. In an article published by Gortmaker et al it states that soft drink consumption has increased which has been linked to less healthy diets leading to obesity. While the consumption of soft drinks increased, the consumption of milk decreased. Although the relationship between soft drink consumption and weight gain is still disputed, the fact remains that individuals do not compensate for the excess calories from the soft drinks by reducing calories from other foods. Another effect of the sugar in the form of high fructose corn syrup in the soft drink is that it may induce hunger and increase consumption of other foods leading to weight gain (Gortmaker et al). The empty calories from the sugar in soft drinks contribute to obesity which increases the risk of diabetes, heart diseases, stroke, and cancer. Soft drink consumption also displaces intake of more healthily beverages such as water, juice and milk thus increasing the likelihood of developing osteoporosis (Jacobson).======

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Both Pepsi and Coca-Cola list high fructose corn syrup as its sweetener which has been linked to obesity. High fructose corn syrup is made by an industrical enzymatic isomerization of glucose to fructose (Ferder et al). It has been linked to obesity due to the fact that the digestion, absorption and metabolism of fructose are different from glucose. In an article published by the American Journal of Clinic Nutrition, it states that people gained more weight when they were given the same amount of carbohydrates in the form of calorically sweetened soda compared to solid food in the form of jelly beans. This supports the theory that high fructose corn syrup in soft drinks increase consumption of other foods leading to a higher total caloric intake. Another effect of high fructose corn syrup is that the fructose induces a low level of leptin, which regulate food intake. The low level of leptin enhances food intake leading to weight gain (Bray et al). The low leptin level is related to low insulin level because fructose does not stimulate insulin release like glucose does, which also directly inhibit food intake. Fructose does not release insulin because the b-cells of the pancrease do not possess the fructose transporter Glut-5. Therefore the insulin level is lower compared to the insulin level if same amount of glucose had been consumed (Bawa). Fructose can also from the backbone for triacylglycerols and is used for the synthesis of long-chain fatty acids (Bray et al).======

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The high fracture corn syrup is also linked to an increased risk of kindney stones. A study published by Taylor and Curan found that the increased risk of kidney stones due to fructose intake was independent of other dietray factors, age, body size and the use of thiazide diuretics. The mechanism underlying the realtion between fructose consumption and kidney stone risk is still unknonw, but it may be related to the effect fructose has on urine composition. Fructose intake may alter calcium metabolism particually if magnesium intake is low. In this situation urinary loss of carlicum is also higher. Fructose intake also increases urinary excretion of oxalate, which is a risk factor for calcium oxalate nephrolithiasis. Fructose also decreases insulin sensitivity, which is also a risk factor for uric acid kidney stone. Another possible mechanism might be due to the fact that fructose intake may influence uric acid metabolism. A higher urinary uric acid levels are a risk factor for kindey stone formation and fructose increases the production of uric acid (Taylor and Curhan).======

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The sugar in both Pepsi and Coca-Cola has also been linked to increased risk of type II diabetes. A study conducted by Koning et al showed the link between sugar-sweetened beverages and type II diabetes. The study concluded that sugar-sweetended beverages increase risk of type II diabetes and that there are probably several mechanisms that result in the increase risk. The first mechanism is adipositt which is the most important risk factor. Due to the high calories present in the soft drinks, excessive drinking can lead to a 6.8 kg weight gain annualy. Another reason the risk of diabetes migh incease is because the soft drinks contain large quantities of easily absorbale sugars. The sugars in turn increase the glycemic load and insulin response. The caramel color in the soft drink also contains advanced glucation end products, which induces insulin resistance in animals (Koning et al).======

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Most of the negative health disorders assocaited with high fructose corn syrup falls under metabloic syndrome. Metabolic sydrome is a cluster of common disorders which include abdominal obesity linke to an excess of visceral fat, fatty liver, insulin resistance, hyperinsulinemia, dyslipidemia and hypertension. Intake of high fructose corn syrup can cause hypertension due to the fact that it causes insulin resistance and hyperinsulinemia. Both insulin resistance and hyoperinsulinemia can lead to an increase in blood pressure which incerases risk of hypertension. Other affects of high fructsone corn syrup consumption is inflammation, liver disease, and kidney damage. Chronic inflammation has been linked to development of insulin resistance and cardiovasvular diseases. The insulin resitance leads to liver dieases, which is also a predisposing factor for type 2 diabetes (Ferder et al).======

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Caramel color used in soft drinks has also been suspected of causing many different health issues. In an article published by the Journal of the American Medical Association, it states that the caramel color and the high fructose corn syrup may lead to an increased risk of hypertension in women. The study was originally intended to find the relationship between caffeine intake and the risk of hypertension in women, but the study concluded that caffeine intake did not increase the risk of hypertension. The risk of hypertension increased for the participants that were given soft drink as the caffeine source. The study concluded that something else present in the soft drink other than the caffeine increased the risk of hypertension (Winkelmayer et al).======

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There are four classes of caramel color: class I, class II, class III and class IV. Class IV is the one used in soft drinks. Caramel color IV is produced using sulfite and ammonium compound as reactants, which results in carmael color with good emulsifying propertiest and a net negative charge making it compatiable with the other ingreditens in soft drinks (Myers et al). A byproduct of the reaction is 4-methylimidazole, which is thought to cause cancer. The National Toxicology Program conducted a 2 year study in which they exposed rats and mice to 4-methylimidazole. They concluded that there was no evidence of carcinogenic activity in male rats, but there was clear evidence of carcinogenic activity in female rats and mice (Chan et al). The state of California has already listed 4-methylimidazole as a cancer causing agent in 2011 under their Safe Drinking Water and Toxic Enforcement Act of 1986.======

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Soft drink consumption also increases level of caffeine intake that has a negative impact on health. Studies have shown that doses of 50-150 mg of caffeine per day cause withdrawal symptoms, decreased alertness and headaches. Caffeine can also cause poor sleep quality and reduction which have been associated with motor vehicle accidents, irritability, behavior problems and vulnerability to drugs and alcohol (Gortmaker et al). Large amount of caffeine in the diet may also decrease bone mass density which leads to osteoporosis. Moderate amount of caffeine in the diet is not harmful. High amount of caffeine is also harmful to a fetus; therefore consumption of soft drinks during pregnancy should be reduced to one soft drink per week (Evert).======

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Dental cavity is one the negative effects of soft drink consumption due to the sugar and phosphoric acid. Cavities are a result of plaque buildup. The bacteria present in the mouth convert all foods into acids, especially sugar and starch. The acid combines with food debris, bacteria and saliva to form plaque. The acids in plaque dissolve the enamel surface in of the tooth and create holes or cavities (Rosenburg). In a study conducted by Parry et Al, in which they investigated the effects of mineral water and soft drinks on tooth decay, they concluded that sparkling mineral water (carbonated water) show slightly greater dissolution than still mineral water, but the level of dissolution was very low. The dissolution of soft drinks compared to mineral water was found to be one hundred times greater. It is evident from the study that carbonated water does not contribute significantly to tooth decay, rather the other ingredients such as sugar and phosphoric acid in the soft drinks leads to tooth decay (Parry et al).======

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Another cause of tooth decay due to soft drink consumption is the acidic nature of soft drinks. The intraoral pH is about 6.8, which decreases within 2, 3 minutes to below 5 after drinking soft drinks. The oral bacteria also turn the sugars from the soft drinks into acid in turn reducing the pH to below 4. Teeth are composed of c alcium-deficient carbonated hydroxyapatite, and hydroxyapatite has a critical pH of 5.5, under which decalcification occurs. In the first part of the experiment, volunteers were asked to swish with the soft drinks for sixty seconds, and the post swish was analyzed for the presence of calcium, phosphate and fluoride. Compared to pre swish samples, the post swish contained an increase amount of calcium (Borijan et al). In the second part of the experiment, extracted teeth were submerged in colas for sixty seconds total and then examined using scanning electron microscopy. The result showed that that a significant loss of hard tissue due to erosion. After the teeth were exposed to the soft drinks, the loss of calcium caused cracks to widen and surface crenellations developed. The overall conclusion of the study showed that soft drink consumption causes loss of calcium from the teeth due to the acidic nature of the soft drink from the phosphoric acid and critic acid. After the intraoral pH decreases due to soft drink consumption, it takes a very long time for the pH to become neutral again. The fluoride present in the soft drinks combined with protective properties of saliva is not enough to prevent loss of calcium. The effects described in the experiment is due to just one time exposure to the soft drink, but a case study shows that long ======

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Phosphoric acid is also linked to risk of osteophoris. A study published by the American Journal of Clinical Nutrition collected experimental data linking soft drink consumption to a low bone mineral density (BMD). The study was conducted on 1413 women 1125 men by measuring their BMD using dual-energy X-ray absorptiometry in relation to colas and other carbonated beverages. The study concluded that low BMD was linked only to colas and not other carbonated beverages. The difference between colas and other carbonated beverages is that colas contain caffeine, phosphoric acid and cola extract. The study concluded that although caffeine contributes to lower BMD, low BMD was also observed decaffeinated colas also. Therefore phosphoric acid is the cause of low BMD. Antother possibility that study mentions is that the cola extract may cause low BMD but no research has been conducted on that topic (Tucker et al). ======

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Caffeine is another ingredient in soda that has many physical effects on the body. First of all caffeine is a stimulant and can be addictive. Caffeine also increases excretion of calcium in urine and the loss of calcium leads to an increased risk to osteoporosis. While caffeine increases alertness, it can also cause nervousness, irritability, sleeplessness and rapid heartbeat. Due to caffeine additive properties, people do suffer withdrawal symptoms (Jacobson).======

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The FDA published that many soft drinks are contaminated with benzene, since the contamination is less than the regulated limit of 5 parts per billion (ppb) it is not considered a health concern. It states that any beverage that had a benzene concentration of greater than 5 ppb reformulated their products so that the concentration was less than 5 ppb. (FDA). The concern with benzene concentration is due to the fact that benzene is a carcinogen. It form in beverages that contain both benzoate salts and ascorbic or erythoribic acids. Through a series of reactions, a hydroxyl radical forms that can decarboxylate benzoate to form benzene. Elevated temperature and light stimulates these reactions. An analytical study published by the Journal of Agricultural and Food Chemistry also supported the FDA statement that soft drinks contain less than 5 ppb of benzene (Nyman et al). There is still possibility that other contaminants might exists in the soft drinks, but more research is required. One incident in particular occurred in India in which pesticides were found in soft drinks. The Center for Science and Environment in India conducted a study using gas chromatography analysis of various brands of soft drink and found significant amounts of pesticides present in all of them. Each of the soft drink was analyzed for organochlorines, organophosphorus, and synthetic pyrethroides pesticides. The concentrations of pesticides found in the sample were about forty-five times greater than EEC norms. The health impact of ingesting pesticides include liver damage, increased risk of cancer, decrease in testosterones levels in men and decreasing estrogen levels in women. Some of the pesticides also affect fetus brain development. This incident occurred in part due to the fact that the beverage industry in India is not regulated like it is in the United States (Mathur et al). The fact that this did not occur in the US, does not mean that it is not a significant problem since Pepsi and Coca-Cola are not only popular in the US, but rather they are popular all over the world.======

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Even though soft drinks lead to many health disorders, the consumption of soft drink has not decreased. Despite that fact that all of the studies conclude that soft drink consumption should be reduced to avoid increasing risk of the various health disorders, soft drink consumption has increases and most likely will keep increasing. There are many studies published that deny that there are any negative health effects associated with soft drink consumption, while a similar study shows that negative health effects are in face associated with soft drink consumption. One factor that might lead to the difference in conclusion might be bias due to financial sponsorship of the study by the industry. In a study by Lesser et al on bias in research due to industry sponsorship, they concluded that bias was approximately four to eight times more likely to be favorable to the financial interest of the sponsors than studies without industry-related funding. There are several factors that might introduce bias. Is it possible that industries sponsor only those studies that will present their products favorably and their competitor’s products unfavorably. Another possibility for bias might be due to the investigator formulating hypothesis, designing studies, and analyzing data in way that are consistent with the interest of the industrial sponsors. If a negative outcome it obtain, the investigator and sponsors may not publish the study or delay in publish it. In order to remove the bias due to industrial sponsorship, scientist should refuse industrial support. There should be more regulation by academic institutions to ensure that publication decision and editorial control should remain with the researcher. Government and other independent sponsorship should increase to remove the bias also (Lesser). Nutritional studies affect the general public therefore they should be free of bias. Soft drink consumption is increasing greatly, and many people do not consider it a harmful drink. Most people are not aware of exactly how many health disorders are linked to soft drink consumption. The beverage companies market the soft drink as healthy options, when in reality soft drink contain mostly artificial ingredients and may contain trace amount of contaminants. Beverage companies should strive to make the drinks more healthy since as it stands now, there are too many negative health disorder related to soft drink consumption.======

 SOURCES

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 * 21) ====== <span style="font-family: 'Arial','sans-serif';">Winkelmayer, Wolfgang, Meir Stampfer, et al. "Habitual Caffeine Intake and the Risk of Hypertension in Women." //Journal of the American Medical Association//. 294.18 (2005): 2330-2335. Web. 2 Dec. 2011. <[] > <span class="slug-doi" style="font-family: 'Arial','sans-serif'; font-size: 16px;">//doi:// <span class="slug-doi-value" style="font-family: 'Arial','sans-serif'; font-size: 16px;">//10.1001/jama.294.18.2330//  ======