A 2005 study of overweight Latino children linked higher consumption of sugar and sugar-sweetened beverages with reduced beta-cell function. (Beta cells are pancreatic cells that make and secrete insulin.)¹ In other words, these overweight children were beginning to show signs of impaired pancreatic function, which means they are on their way to developing type 2 diabetes. The authors emphasized the need to reduce daily sugar intake, including drinking less sugar-sweetened beverages, to avert disease.

In adults, a 2006 study² linked higher consumption of sugar-sweetened soft drinks with a greater risk of weight gain, especially in people who are overweight. These two studies add to existing evidence^3,4,5 that sweetened drinks need to be curtailed, or even eliminated, to avert Diabesity^® -- that is, obesity and type 2 diabetes.

According to Popkin and colleagues,⁶ Americans are consuming an average of 150 to 300 extra (i.e., unnecessary) calories each day. This is equivalent to drinking one to two 12-ounce cans of cola daily. Every day, many young people often drink more sugary beverages⁷ than two cans of soda or other sweetened juice drinks. Many authorities believe that soda is contributing to the Diabesity^® epidemic in America.

Americans who lead a sedentary lifestyle are particularly at risk. Jacobs⁸ has advanced the Taylor Hypothesis that argues that (1) energy balance—in which the calories you burn equals the calories you eat—is promoted by high energy expenditure through physical activity and (2) energy imbalance that promotes obesity is due to a sedentary lifestyle marked by low energy expenditure (i.e., low levels of physical activity). In other words, your physiology and metabolism that ordinarily assures energy balance works less efficiently when your energy expenditure is low, so obesity develops more readily in people who are physically inactive. Conversely, energy balance is easier to maintain when you are highly active.

Alarmed by the growing epidemic of obesity and the high intake of sweetened beverages, Popkin⁶ urges that drinking water be used as the "preferred beverage" to fulfill daily water needs. Although we support Popkin’s position on water, we believe that many people will resist replacing all calorie-laden sweetened beverages with water, and many will turn to zero-calorie "diet" drinks instead.

Diet drinks are formulated to taste sweet but deliver zero calories. Paradoxically, several short-term studies, summarized by Tordoff and Alleva,⁹ suggest that sweet taste triggers a "metabolic reflex" that increases appetite. This might lead to an increase in body weight over the long run, but fortunately, long-term studies show that diet drinks do not cause weight gain. Rather, they appear to be useful in weight management. Three key long-term studies are summarized below:

Tordoff and Alleva⁹ gave one group of normal weight men and women conventional soda (530 calories per day) and a second group the same volume of diet soda (sweetened with aspartame). The researchers found that in the group drinking sugar-sweetened soda, total daily calories consumed and body weight increased, but in the group drinking aspartame-sweetened soda, calories consumed and body weight decreased. No safety problems were reported.

Raben and coworkers¹⁰ studied two groups of people for 10 weeks, to see how consuming two types of supplements would affect their daily calorie intake and body weight. The control group ate a diet that included supplemental drinks and foods containing sucrose (i.e., regular table sugar). The other group had similar drinks and foods that contained artificial sweeteners in place of sugar. Both groups were required to eat a minimum amount of the supplements each day, but the rest of their diet was not restricted. During the study, the sucrose group steadily gained weight while the artificial sweetener group steadily lost weight. The majority of the weight gain (1.6 kg or 3.5 pounds) in the sucrose group was primarily due to increased fat.

Blackburn and coworkers¹¹ carried out a very long-term study of obese female dieters. One group of women was instructed how to lose weight in a comprehensive program that included aspartame-containing beverages and foods. The control group of dieters received the same weight-loss instruction but was discouraged from using these products. The weight loss in the two groups was virtually identical for the first 19 weeks of the study. But three years later, the aspartame group regained significantly less weight and the conventionally-treated group regained all of their lost weight. The authors noted that despite other studies claiming to the contrary, the aspartame group did not report an increase in hunger at any time during the study. The 5% weight loss achieved in the aspartame group was considered to be clinically significant, and no significant health problems were reported.

Taken together, these studies agree with earlier careful work by Porikos and colleagues^12,13 who showed that both lean and obese subjects living in a metabolic ward consumed fewer calories when the researchers covertly substituted aspartame for all the sucrose in their diets. It is clear that the long-term use of artificial sweeteners does NOT stimulate hunger, was not associated with safety problems, and can be useful for achieving weight loss in a dieting population. Zero-calorie sugar substitutes are an easy way to reduce or eliminate sugar-sweetened beverages that are increasingly being linked to Diabesity^®. They may be useful not just for dieting, but also for preventing weight gain in a normal weight population.

Bottom Line: Although the data are not ironclad, studies in humans increasingly point to the dangers of consuming sugary soft drinks and the need to moderate sugar intake to avert obesity and disease. Long-term studies in humans support the use of artificially-sweetened beverages in managing weight. Although water is our preferred beverage choice, artificially-sweetened drinks are a better choice than sugar-sweetened beverages. We support the call to reduce sugar intake, especially sugar-sweetened beverages.

The triceps muscles are used in a pushing movement, usually along with the chest and shoulder muscles. The triceps were briefly mentioned in the September 2005 Shape Up America! newsletter article on push ups. (You can find that article in the newsletter archives at shapeup.org.) This month we are going to look at several variations of a movement that specifically works the triceps muscles – bench dips.

To perform bench dips, all you will need is a bench that is placed directly against a wall so that it won’t slip while you perform the exercise. I have also used a chair for this exercise, but since my chair is too narrow to allow me to sit on the edge and at the same time grip the front edge of the chair, I put two chairs together as shown in the illustration below. So don’t hesitate to grab a second chair if a bench is not available.

For safety’s sake, position the bench or chairs right next to each other, and back them up against a wall to ensure they will not slip or move as you perform this exercise.

There are two variations of this exercise, one with your legs bent (which is the beginner position) and another with your legs straight (which is more difficult). To start this movement, you will need to sit (or more accurately, "perch") on the very edge of the bench, or chairs, and place both hands on the front edge on either side of your body. Place your hands so your entire palms are on the bench and your fingers are gripping it firmly. Next, place your feet together in front of you so that your knees are bent and your feet are flat on the ground. Now you are ready to start the movement.

Slide your rear end off the bench so now only your arms are holding you up. With your elbows pointing backwards, slowly bend your arms and lower your bottom towards the ground – just far enough so that a right angle forms at your elbow joint. Stop at that point and reverse the movement, pushing your hands into the bench and straightening out your arms. When you reach the top of the movement, stop just before you lock your elbows; this will keep your triceps working for the entire movement.

Now take a breath and repeat until you reach your rep goal. This goal will vary depending on your fitness level. (See table below). You only need to do it once a week.

Goal Level	Sets/Reps	Comments
Beginner	1 set, 10-12 reps	When you move from one skill level to the next, you may have difficulty reaching your rep goal. That’s OK. Go as far as you can and try to add one or two more reps each workout.
Intermediate	2 sets, 10-12 reps
Advanced	3 sets, 10-12 reps

This movement is simple, but very effective. To make it more difficult, straighten your legs and stretch them out before you, so that only your heels are touching the ground.

Next month we will complete upper arm training with a movement that strengthens the biceps.

Shape Up America! has a RMR calculator that you can use to estimate your resting calorie needs for the day. For more information on metabolism, see Step 7 of the Shape Up & Drop 10™ program)

INGREDIENTS:

• 10 1/2 oz. fresh, trimmed or frozen, cut asparagus
• 1/4 tsp. garlic powder
• 2 tsp. lime juice (lemon juice may be substituted)
• 2 Tbsp. canned green chili peppers, drained, chopped
• 1 Tbsp. onion, chopped
• 2 tsp. tomato paste
• 1/8 tsp. salt
• 1/4 tsp. ground cumin
• 1/8 tsp. white pepper

DIRECTIONS:

1. Cook asparagus. Drain well, pat dry with paper towels.
2. Place asparagus in blender. Add remaining ingredients. Blend until smooth. Dip will become less thick upon standing and will need to be stirred.

Nutrition Information Per Serving: 25 calories, 0 grams fat, 0 milligrams cholesterol, 2 grams fiber, 142 milligrams sodium

Source: 5 A Day recipe, http://www.cdc.gov/nccdphp/dnpa/5aday/recipes