Diet Coke and Electrolytes: The Shocking Truth You Need to Know!

Diet sodas, including Diet Coke, have become ubiquitous, particularly among individuals aiming to curtail their sugar or calorie consumption. Marketed initially towards people with diabetes in the 1950s, their appeal broadened to those focused on weight management and reducing sugar intake. These beverages often utilize artificial sweeteners like aspartame, cyclamates, saccharin, acesulfame-k, or sucralose, standing in for sugar. Almost every popular sugar-sweetened beverage on the market has a “light” or a “diet” version - Diet Coke, Coke Zero, Pepsi Max, Sprite Zero, etc. But what exactly is in Diet Coke, and how does it affect your health, particularly concerning electrolytes?

What is Diet Coke?

Diet soda is essentially a mixture of carbonated water, artificial or natural sweetener, colors, flavors, and other food additives. Diet Coke, like other diet sodas, is a concoction of carbonated water, artificial sweeteners, coloring agents, flavoring, and various food additives. It usually has very few to no calories and no significant nutrition. For example, one 12-ounce (354-mL) can of Diet Coke contains no calories, sugar, fat, or protein and 40 mg of sodium (1). While recipes differ from brand to brand, some common ingredients in diet soda include:

Carbonated water. While sparkling water can occur in nature, most sodas are made by dissolving carbon dioxide into water under pressure (4).
Sweeteners. These include common artificial sweeteners, such as aspartame, saccharin, sucralose, or an herbal sweetener like stevia, which are 200-13,000 times sweeter than regular sugar (4, 5).
Acids. Certain acids, such as citric, malic, and phosphoric acid, are used to add tartness to soda drinks. They’re also linked to tooth enamel erosion (4).
Colors. The most commonly used colors are carotenoids, anthocyanins, and caramels (4).
Flavors. Many different kinds of natural juices or artificial flavors are used in diet soda, including fruits, berries, herbs, and cola (4).
Preservatives. These help diet sodas last longer on the supermarket shelf. A commonly used preservative is potassium benzoate (4).
Vitamins and minerals. Some diet soft drink manufacturers add vitamins and minerals to market their products as healthier no-calorie alternatives (4).
Caffeine. Just like regular soda, many diet sodas contain caffeine. A can of Diet Coke contains 46 mg of caffeine, while Diet Pepsi contains 35 mg (1, 6).

It's important to note that not all sodas that use artificial sweeteners are low in calories or sugar-free. Some use sugar and sweetener together. For example, one can of Coca-Cola Life, which contains the natural sweetener stevia, contains 90 calories and 24 grams of sugar (2).

Diet Coke and Weight Management: A Complex Relationship

Because diet soda is usually calorie-free, it would be natural to assume it could aid weight loss. However, research suggests the association may not be so straightforward.

The question of whether diet soda aids weight loss is complex. Several observational studies have found that using artificial sweeteners and drinking high amounts of diet soda is associated with an increased risk of obesity and metabolic syndrome (7, 8, 9, 10). There are theories suggesting that diet soda may increase appetite by stimulating hunger hormones, altering sweet taste receptors, and triggering dopamine responses in the brain (11, 12, 13, 14). Given that diet soft drinks have no calories, these responses may cause a higher intake of sweet or calorie-dense foods, resulting in weight gain. However, evidence of this is not consistent in human studies (5, 11, 15).

Another theory suggests that diet soda’s correlation to weight gain may be explained by people with bad dietary habits drinking more of it. The weight gain they experience may be caused by their existing dietary habits - not diet soda (16, 17).

Experimental studies do not support the claim that diet soda causes weight gain. In fact, these studies have found that replacing sugar-sweetened drinks with diet soda can result in weight loss (18, 19). One study had overweight participants drink 24 ounces (710 mL) of diet soda or water per day for 1 year. At the end of the study, the diet soda group had experienced an average weight loss of 13.7 pounds (6.21 kg), compared with 5.5 pounds (2.5 kg) in the water group (20).

However, to add to the confusion, there’s evidence of bias in the scientific literature. Studies funded by the artificial sweetener industry have been found to have more favorable outcomes than non-industry studies, which may undermine the validity of their results (21).

Overall, more high quality research is needed to determine the true effects of diet soda on weight loss.

Diet Coke, Diabetes, and Heart Health: Potential Risks

Although diet soda has no calories, sugar, or fat, it has been linked to the development of type 2 diabetes and heart disease in several studies.

Research has found that just one serving of an artificially sweetened drink per day is associated with an 8-13% higher risk of type 2 diabetes (22, 23). A study in 64,850 women noted artificially sweetened drinks were associated with a 21% higher risk of developing type 2 diabetes. However, this was still half the risk associated with regular sugary drinks. Other studies have observed similar results (24, 25, 26, 27). Conversely, a recent review found that diet soda is not associated with an increased risk of diabetes. Also, another study concluded that any association could be explained by the existing health status, weight changes, and body mass index of participants (28, 29).

Diet soda has also been linked to increased risks of high blood pressure and heart disease. A review of four studies including 227,254 people observed that for each serving of artificially sweetened beverage per day, there is a 9% increased risk of high blood pressure. Other studies have found similar results (30, 31, 32). Additionally, one study has linked diet soda to a small increase in the risk of stroke, but this was only based on observational data (33).

Because most of the studies were observational, it may be that the association could be explained another way. It’s possible that people who were already at risk of diabetes and high blood pressure chose to drink more diet soda (24, 34, 35).

More direct experimental research is needed to determine whether there’s any true causal relationship between diet soda and increased blood sugar or blood pressure.

Diet Coke and Kidney Health: A Possible Connection

Drinking diet soda has been linked to an increased risk of chronic kidney disease. A recent study analyzed the diets of 15,368 people and found that the risk of developing end-stage kidney disease increased with the number of glasses of diet soda consumed per week. Compared with those who consumed less than one glass per week, people who drank more than seven glasses of diet soda per week had nearly double the risk of developing kidney disease (36).

Read also: Weight Loss Meds & BCBS

A suggested cause for the kidney damage is the high phosphorus content of soda, which may increase the acid load on the kidneys (36, 37). However, it has also been suggested that people consuming high amounts of diet soda may do so to compensate for other poor dietary and lifestyle factors that may independently contribute to the development of kidney disease (36, 38).

Interestingly, studies investigating the effects of diet soda on the development of kidney stones have found mixed results. One observational study noted that diet soda drinkers have a slightly increased risk of kidney stone development, but the risk was much smaller than the risk associated with drinking regular soda. In addition, this study has not been supported by other research (39). Another study reported that the high citrate and malate content of some diet sodas may help treat kidney stones, particularly in people with low urine pH and uric acid stones. However, more research and human studies are needed (40).

Diet Coke During Pregnancy: Potential Concerns

Drinking diet soda while pregnant has been linked to some negative outcomes, including preterm delivery and childhood obesity.

A Norwegian study in 60,761 pregnant women found that intake of artificially sweetened and sugar-containing drinks was associated with an 11% higher risk of preterm delivery (41). Earlier Danish research supports these findings. A study in almost 60,000 women found that women who consumed one serving of diet soda per day were 1.4 times more likely to deliver preterm than those who did not (42). However, recent research in 8,914 women in England did not find any association between diet cola and preterm delivery. However, the authors admitted that the study may not have been big enough and had been limited to diet cola (43).

It’s important to note that these studies were only observational and offer no explanation of exactly how diet soda may contribute to preterm birth. Furthermore, consuming artificially sweetened drinks while pregnant is significantly associated with an increased risk of childhood obesity (44). One study found that the daily consumption of diet drinks during pregnancy doubled the risk of a baby being overweight at 1 year of age (45).

Further research is needed to analyze the potential biological causes and long-term health risks for children exposed to artificially sweetened sodas in the womb.

Other Potential Health Effects

There are several other documented health effects of diet sodas, including:

May reduce fatty liver. Some studies have shown that replacing regular soda with diet soda can reduce fat around the liver. Other studies have found no effect (46, 47).
No increase in reflux. Despite anecdotal reports, carbonated drinks have not been found to make reflux or heartburn worse. However, the research is mixed, and more experimental studies are needed (3, 48).
No strong links to cancer. Most of the research on artificial sweeteners and diet soda has found no evidence it causes cancer. A slight increase in lymphoma and multiple myeloma in men was reported, but the results were weak (49, 50).
Changes to the gut microbiome. Artificial sweeteners may alter the gut flora, leading to reduced blood sugar control and potentially increasing the risk of type 2 diabetes. One study found all of the six tested artificial sweeteners damaged the gut microbiome in various ways. Another found the way people’s gut flora reacted to artificial sweeteners was highly individualized (51, 52, 53, 54).
Increased risk of osteoporosis. Diet and regular cola is associated with bone mineral density loss in women, but not in men. The caffeine and phosphorus in cola might interfere with normal calcium absorption (5).
Tooth decay. Like regular soda, diet soda is associated with dental erosion due to its acidic pH level. This comes from the addition of acids, such as malic, citric, or phosphoric acid, for flavor (5, 55).
Linked to depression. Observational studies have found higher rates of depression among those who drank four or more diet or regular sodas per day. However, experiments are needed to determine whether diet soda is a cause (56).

While some of these results are interesting, more experimental research is needed to determine whether diet soda causes these issues, or if the findings are due to chance or other factors.

The Conflicting Evidence and the Need for More Research

Research on diet soda has produced a lot of conflicting evidence. One explanation for this conflicting information is that most of the research is observational. This means it observes trends, but there’s a lack of information about whether diet soda intake is a cause or simply associated with the true cause.

Therefore, while some of the research sounds quite alarming, more high quality experimental studies are needed before concrete conclusions can be drawn about the health effects of diet soda.

Diet Coke and Electrolytes: An Insignificant Source

When it comes to electrolytes, Diet Coke offers very little. While it does contain a small amount of sodium (40mg per 12-ounce can), this is not a significant amount for electrolyte replenishment. Electrolytes are minerals that carry an electrical charge and are vital for bodily functions such as hydration, muscle contraction, nerve impulses, and maintaining fluid balance. Key electrolytes include sodium, potassium, magnesium, calcium, chloride, and phosphate.

Diet Coke is not formulated to be an electrolyte-rich beverage. Its primary purpose is to provide a sweet, low-calorie alternative to regular soda. Therefore, relying on Diet Coke for electrolyte replenishment is not advisable.

Better Alternatives for Hydration and Electrolyte Balance

If you're looking to hydrate and replenish electrolytes, there are much better options than Diet Coke:

Water: Plain water is essential for hydration and is the foundation of any healthy fluid intake strategy.
Electrolyte-rich drinks: Sports drinks, electrolyte tablets or powders mixed with water, and coconut water are designed to provide electrolytes in specific ratios.
Natural sources: Fruits and vegetables like bananas, oranges, spinach, and avocados are excellent sources of electrolytes.
Oral rehydration solutions (ORS): These are specifically formulated to treat dehydration, often containing precise amounts of sodium, potassium, and glucose.

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