Having a social life is wonderful for us! Socializing often involves going out to eat or drink. Nevertheless, hanging out with friends whilst embracing a healthy lifestyle can make it a challenge sometimes. If you turn down alcoholic drinks and sugary mocktails, there are fewer options available! You can enjoy a cup of tea, a coffee, or even some sparkling water. OK, but they can get boring after a while… Diet soda might seem like a good choice on a hot day, but many sugar-free drinks come loaded with additives. What do they actually contain and are they a better option for us? Let’s explore!
What are the ingredients in sugar-free drinks?
Most sugar-free drinks contain very similar ingredients. Among these are fizzy water and artificial sweeteners. But not only that, you can find in them also coloring agents and flavor enhancers such as phosphoric or citric acid which help mimic the original soda taste. Additionally you will see caffeine in cola or energy drinks and of course preservatives such as potassium benzoate or sodium benzoate, which prevent bacteria and mold growth and increase shelf life. Let’s have a closer look at them.
With the regulation and manufacturing and storage standards differ so vastly in different countries or even within the same country, the amount of each ingredient can significantly vary, making it quite difficult to assess how much of which ingredient the drink contains. Making any informed decision about the health impact of the drinks can be tricky unless they are analyzed in the lab. This is amplified by uncertainty in how the drink was stored before we purchased it, and an incorrect storage (the presence of light and heat) can negatively alter some ingredients, as we will find out shortly.
Artificial sweeteners
There are multiple artificial sweeteners mimicking the taste of sugar used in our sugar-free drinks.
One of them is saccharin, which is the oldest sweetener discovered in the 19th century Currently it is less common in drinks due to its taste and a negative stigma based on some studies that linked it to cancer in mice. (1)
Aspartame, which followed saccharin almost a hundred years later, is a very popular sweetener present in Diet Coke or Pepsi Zero Sugar among others. Aspartame has been classified by IARC (International Agency for Research on Cancer) as possibly carcinogenic to humans (Group 2B)(2) if consumed in large quantities.
Another sweetener is acesulfame used in Coke Zero or Pepsi Max, and is also connected to a possible cancer risk in some very limited studies (3).
Other sweeteners, like sucralose present in some variations of Diet Pepsi. Sucralose is one of the very few sweeteners that has not been found as cancerous.
A good alternative to artificial sweeteners that doesn’t add calories would be sweeteners like Stevia or Monk Fruit, which are of natural origin and are comparatively minimally processed.
Additives to increase acidity or bitterness
Phosphoric or citric acid achieve just that. Both, when consumed frequently, could potentially negatively impact our kidney function and erode our tooth enamel, even though they are not a real concern when drinking sugar-free drinks.
Colorings
Colorings give our soda pop its signature appearance but can have a health impact; hence, their levels are regulated. Such examples are Caramel color (E150c/E150d) used in Coke or Pepsi in order to achieve that classic brown look, which can contain 4-MEI, again a possible carcinogen. (4)
Preservatives
Preservatives are added to sugar-free drinks as they are expected to sit around for a while and have an environment friendly to growth of bacteria. Such environment includes sweeteners, acids and flavorings. The three main preservatives used in sugar-free drinks are sodium benzoate, potassium benzoate, and sorbic acid (also known as potassium sorbate).
Sodium benzoate
It is a common ingredient in diet soda as it prevents mold and bacteria from growing and, in turn, increases shelf life. Frequent consumption can cause some health concerns as it can form carcinogenic benzene when combined with vitamin C under heat or light. This could happen during processing or storage, as many drinks can contain vitamin C; heat and light accelerate the reaction, and metal ions can act as catalysts in this process. (5)
Potassium Benzoate
Potassium Benzoate, also a salt of benzoic acid is an alternative to sodium benzoate. Even though potentially has similar effects as sodium benzoate, it is connected to slightly lower risk connected to manufacturing and storage. It is because it is slightly more soluble and so slightly less likely to accumulate in certain areas. Additionally it is also more effective as preservative in lower pH ranges which means less benzoate ion (which is prone to oxidation and creation of benzene) and more benzoic acid. Nevertheless just as sodium benzoate it can turn into benzene provided it is exposed to light and heat and it interacts with metal ions. Also here manufacturing and storage is important.
Sorbic acid (potassium sorbate)
Even though sorbic acid can cause mild irritation, it is fairly low-risk to the body.
Overall found impact of sugar-free drinks
Even though there is much more understanding needed in how sugar-free drinks impact our health, according to a research of multiple studies, the main impact of drinking sugar-free drinks has been found in following areas among others (6):
- Mental health issues, such as depression and eating disorders like bulimia
- it can slow down the development of their child’s brain and nervous system when exposed during pregnancy
- Changes to the heart’s structure can include the heart’s chambers becoming larger or the walls of the heart thickening, which can affect how well it works
- Diabetics may experience worsening eye problems as well as increased blood sugar levels.
- Women may experience more frequent or uncomfortable urinary problems, such as difficulty or pain while urinating.
- Higher likelihood of developing end-stage kidney disease
- There is a small connection between consuming certain substances and an increased risk of developing specific types of cancers in men, like non-Hodgkin’s lymphoma and multiple myeloma.
- Some women may have a slightly increased chance of developing rheumatoid arthritis, a condition that causes joint pain and swelling.
- Postmenopausal women may face a higher chance of breaking a hip due to weaker bones.
Guilt-free alternatives to sugary drinks
- Coffee with a dash of low fat milk or milk alternative and a vanilla extract
- Black tea with orange and cinnamon
- Hot water infused with turmeric and lemon
- Coffee with a dash of low fat milk or milk alternative and a vanilla extract
- Green tea infused with mint and lemon
- Cold sparkling water infused with orange slices
- Cold sparkling water infused with berries
- Green tea infused with mint and lemon
- Cold sparkling water infused with cucumber, lemon and mint
- Hot water infused with apple slices and cinnamon
Diet soda might seem like a smart swap for sugary drinks as it can help manage calorie intake or blood sugar levels. Nevertheless it comes with potential downsides. While science is still piecing together the full picture, one thing is clear, moderation is key. Best is to limit such drinks and swap them for healthy alternatives such as water, herbal teas, or naturally flavored drinks as often as possible. Simple drinks without various additives will always be the best bet for feeling your best!
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DISCLAIMER: This article and any associated social media is created for entertainment and informational purposes only. They do not constitute medical advice or professional services specific to you or your medical condition.
Resources:
(1) Carcinogenicity of saccharin., Environ Health Perspect, . 1978 Aug;25:173–200. doi: 10.1289/ehp.7825173, , M D Reuber, PMCID: PMC1637197 PMID: 363408, downloaded from the web 05/05/2025 https://pmc.ncbi.nlm.nih.gov/articles/PMC1637197/, Carcinogenicity of saccharin – PMC
(2) Aspartame hazard and risk assessment results released, 14 July 2023, Joint News Release, downloaded from the web 04/05/2025, https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released, Aspartame hazard and risk assessment results released
(3) Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study, Charlotte Debras, Eloi Chazelas, Bernard Srour, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Rebecca Lutchia, Stéphane Gigandet, Inge Huybrechts, Chantal Julia, Emmanuelle Kesse-Guyot, Benjamin Allès, Valentina A Andreeva, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier,DOI: 10.1371/journal.pmed.1003950, PMID: 35324894, PMCID: PMC8946744, downloaded from the web 05/05/2025, https://pubmed.ncbi.nlm.nih.gov/35324894/, Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study – PubMed
(4) Caramel Color in Soft Drinks and Exposure to 4-Methylimidazole: A Quantitative Risk Assessment
Tyler J. S. Smith, Julia A. Wolfson, Ding Jiao, Michael J. Crupain, Urvashi Rangan, Amir Sapkota, Sara N. Bleich, Keeve E. Nachman
Published: February 18, 2015, https://doi.org/10.1371/journal.pone.0118138, Caramel Color in Soft Drinks and Exposure to 4-Methylimidazole: A Quantitative Risk Assessment, https://doi.org/10.1371/journal.pone.0118138
(5) Sodium benzoate in non-alcoholic carbonated (soft) drinks: Exposure and health risks, S.L. Azuma, N.K-A. Quartey, I.W. Ofosu, Food Systems Chemistry and Risks Studies, Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, downloaded from the web 05/05/2025, https://doi.org/10.1016/j.sciaf.2020.e00611, https://doi.org/10.1016/j.sciaf.2020.e00611
(6) Artificially Sweetened Beverages Beyond the Metabolic Risks: A Systematic Review of the Literature, Tomas Escobar Gil, Juanita Laverde Gil, Editors: Alexander Muacevic, John R Adler, PMCID: PMC9891650 PMID: 36741610, 2023 Jan 1;15(1):e33231. doi: 10.7759/cureus.33231, downoaded from the web 19/04/2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9891650/, Artificially Sweetened Beverages Beyond the Metabolic Risks: A Systematic Review of the Literature – PMC
