Over the past 30 years, the consumption of sugar-sweetened drinks has increased dramatically in both children and adults. This is concerning not only because of the effect on an individual level, but also because it has been linked to a range of issues on a population level, including poor diet quality, weight gain, obesity, and type 2 diabetes (1)Â (2).

When we see these trends, it is important to look at which products have led these changes in eating and drinking Â patterns. It is impossible to overlook Coca-Cola. Coca-Cola is the most popular soft drink in the history of soft drinks.

Coca Cola Nutrition Facts and Ingredients

Letâ€™s take a look at the nutritional information for different Coca-Cola products. Below is regular Coke:

In one 12 oz. can of Coke, there are 140 calories (kcal), all of which come from sugar. Those 140 calories are equal to 39 grams, or almost 10 teaspoons of sugar.

The American Heart Association recommends a maximum of 9 teaspoons of added sugar a day for men and 6 teaspoons of added sugar a day for women (3). That means that just with one can of Coke, both men and women have surpassed their daily limit of sugar.

Besides sugar, it doesnâ€™t provide any nutrients. This is the definition of â€œempty caloriesâ€

If you take a look at the ingredients, sugar doesnâ€™t appear on the list. That is because rather than cane sugar, the US formula for Coca-Cola uses High Fructose Corn Syrup as a sweetener.

High fructose corn syrup:

It is produced from corn syrup, that is then processed to increase the fructose process and then mixed with glucose (both fructose and glucose are simple sugars, naturally found to some extent in fruits and vegetables, but added to processed foods in high concentrations) (4). Fructose has been directly implicated in the epidemics of obesity and type 2 diabetes (4).

Caramel color

Â The next ingredient on the list is the caramel color. Researchers at the Johns Hopkins Bloomberg School of Public Health found that some kinds of caramel color, like those sometimes used in sodas, are made with 4-methylimidazole (4-MEI). 4-MEI is a possible human carcinogen formed during the manufacturing process. In other words, over-consumption could increase your risk of cancer (5).

Phosphoric Acid

Researchers have found that there is a connection between the risk of osteoporosis and soda drinking. While it may be because of replacing healthy liquids in the diet with less-healthy liquids, some experts believe it is related to the amount of phosphoric acid in Colas. It is a component that is in cola drinks, but not other sodas so it is believed phosphoric acid could contribute to bone loss when it is found in higher concentration in the blood than calcium (6).

Additionally, phosphoric acid makes Coca-Cola taste less sweet, keeping you from feeling nauseous when you drink it.

Caffeine

CaffeineÂ may interfere with calcium absorption as well, contributing to osteoporosis (6). Caffeine leads to addiction, alterations in sleep patterns, increased blood pressure, and a rapid heartbeat. While coffee has five times more caffeine than cola, if you drink coffee as well or if you drink many cans of Coca-Cola a day, it contributes to your daily fix of caffeine. Remember not to consume more than 500 mg of coffee to avoid health issues.

Below is the nutritional information for Diet Coke:

If you look at the nutritional information for Diet Coke, it looks like it doesnâ€™t have anything in it. It provides a little bit of sodium and provides more caffeine than regular Coke, but besides that it has no calories or sugar. This is because, in addition to the ingredients found in regular Coca-Cola, it is sweetened with aspartame.

Aspartame

Aspartame has received a lot of bad press over the tears as one of the worst artificial sweeteners. It was originally said to cause cancer, but it was then refuted saying that

is was true only when consuming ridiculous amounts of aspartame â€“ something that is unrealistic for humans when consumed in things like Coca Cola.

However, a newer study wanted to see the effects of consuming aspartame regularly over a lifespan. In rats, it was administered over a lifespan in amounts realistic for humans, and it was found to be a â€œmultipotential carcinogenic agentâ€ (7), meaning there are multiple pathways by which it can cause cancer.

Additionally, the consumption of aspartame with carbohydrates is connected to brain or functional changes (8).

The reason you will find the warning â€œphenylketonuria: contains aspartameâ€ is because phenylketonuria, or PKU, is a disorder that cannot process a certain protein building block, called phenylalanine, like most of us can. Phenylalanine is a protein found in aspartame, as well as naturally in plenty of foods. As a result, babies with PKU can develop severe mental dysfunction (11).

For most people, however, this warning is not relevant.

Potassium Benzoate and Citric Acid

Potassium Benzoate and citric acid are preservatives added to many foods. Because some of its components, when isolated, have been found to have carcinogenic effects, some specialists have worried about their potential carcinogenic effects. Studies that examine their direct effects, however, are less clear. Most studies cannot show any carcinogenic effects of potassium benzoate beyond animal models (9), (10).

Other Ingredients:

They arenâ€™t listed on the ingredients list, but you can imagine that you canâ€™t make Coca-Cola at home using just the ingredients listed. While, of course, Coca-Cola has a secret formula that wonâ€™t be revealed, the taste includes vanilla, citrus fruits, and spices.

What happens to your body when you drink Coca Cola?

From the moment you see Coca-Cola, your body starts experiencing radical changes.

When you see a Coca-Cola, hear the classic sound of the air escaping as you open the can, and hear the ice clinking in the glass as it is served, you start salivating. This is a classic neural response to food.

Your body starts to secrete gastric juices to prepare the body for absorbing the substances Coca-Cola provides.

Only minutes after you drink it, the 10 teaspoons of sugar hit your system (165% of the recommended intake for women, and 111% of the recommended intake for men). If you try to eat 10 teaspoons of sugar or high fructose corn syrup in one sitting, you would normally feel nauseous and throw up.

The phosphoric acid reduces the sweet taste, allowing you to keep it down.Â At the same time, your pancreas starts secreting insulin to absorb the large quantities of sugar.

After about 20 minutes of drinking Coke, you start absorbing it in your small intestine, making your blood sugar spike. Your pancreas produces more insulin to transport the sugar, as glucose, into your cells. The sugar that isnâ€™t needed as energy is stored, first as glycogen, a reserve, and if there is still more energy available, as fat.

At about 45 minutes, you finish absorbing the caffeine. This is when your blood pressure rises and, combined with the sugar, you get an energy rush.

At about 50 minutes, the caffeine then increases the opioid receptors and stimulates the pleasure centers of your brain, making you want more (12)

A few minutes later, the phosphoric acid binds to minerals in your intestine, which boosts your energy even more.

The diuretic effects kick in and you have to go to the bathroom.

Once all of the sugar and caffeine has been absorbed, your blood glucose falls dramatically, potentially causing changes in mood and irritability. This is what many people call a â€œsugar crash,â€ which takes place between an hour and three hours after consumption.

Long-term Effects of Drinking too Much Coca-Cola and Other Soft Drinks

There is a range of effects associated with drinking sweetened beverages such as Coca-Cola. Keep in mind that this article doesnâ€™t imply that drinking Coca-Cola, specifically, automatically results in these effects. Of course, it is about overall lifestyle choices that lead to many of these negative effects. In general, people who drink too many soft drinks over a long period of time also have other unhealthy eating and exercise behaviors that lead to these effects.

Additionally, avoiding Coca-Cola doesnâ€™t mean that you are safe from these chronic diseases. The studies carried out, group together all sweetened beverages, and, as mentioned above, are a reflection of overall lifestyle choices, not specific foods or drinks.

Obesity:

One of the most prevalent effects of drinking too much coca cola over a long period of time is weight-gain, and eventually, obesity. The Institute of Medicine found that the rising consumption of carbonated beverages is a major contributor to the obesityÂ epidemic.

The Â American Heart Association recommends that consume a maximum of 450 kilocalories (kcal) of sugar-sweetened drinks, per week. However, the average male consumes 178 kcal of sugar-sweetened beverages per day, while the average female consumes 103 kcal of sugar-sweetened beverages per day (5).

The population that consumes most for both males and females is the 12-19 age group, a key period of physical and emotional development (5).

Type 2 Diabetes:

A meta-analysis looked at the many studies that have examined the correlation between drinking soft drinks (or sugar-sweetened beverages) and the risk of developing type 2 diabetes and metabolic syndrome. It found that people who drank 1-2 servings a day had a 26% greater risk of developing diabetes than those that didnâ€™t drink any or less than 1 serving a month (13).

Heart Disease

Longitudinal studies found that men who drank at least a can of sugary drinks a day had a 20% higher risk of having a heart attack that men who rarely consumed those drinks (14). Another study found that the risk was similar for women, even after controlling for other lifestyle factors (15).

Gout

GoutÂ is a disease in which uric acid cannot be metabolized properly, and it causes arthritis and acute episodes of pain.

A study carried out over 22 years with 80,000 women found that those who consumed at least a can of sugary drinks daily had a 75% higher risk of developing gout than women who rarely drank them (16). Other studies with men found similar results (17)

Osteoporosis

A bone mineral density study was carried out in Framingham, Massachusetts that examined the effect of drinking colas, specifically, which contain phosphoric acid, at its effect on bone density.

The preliminary findings suggested that consuming cola drinks, such as Coca-Cola, Pepsi, and other cola beverages is associated with a low bone mineral density, particularly in older women (18).

Bottom Line

If you are a regular Coca-Cola drinker, or if you drink other sweetened beverages, it’s time to reduce consumption. Not only do sugar-sweetened beverages spike your blood sugar unnecessarily, drinking them regularly over a long period of time has serious adverse effects on your health.

Because of the caffeine content, and the specific taste of Coca-Cola, Coca-Cola can be addictive. If you are worried about being addicted, it is important to seek professional help.

Additionally, if you feel that you need to make lifestyle changes regarding diet and exercise to lower your risk of chronic diseases, it is important to seek support from a registered dietician to get you on a realistic and healthy diet and exercise regimen.