Soft Drinks: A Threat for A Healthy Life

Abstract

Background: Soft Drink is a non-alcoholic beverage, mainly composed of carbonated water and high amount of sugar. From the studies, it is concluded that people who consumed soft drinks frequently have more chances to develop different diseases.

Full text

Soft Drinks: A Threat for A Healthy Life
ISSN (Print): 2521-8514 ISSN (Online): 2521-8484
RADS J. Pharm. Pharm. Sci.
130
ORIGNAL A R T I C L E
Soft Drinks: A Threat for A Healthy Life
Amber Nawab1, Javeria Sheikh1,*, Faiza Muzaffar1, Huma Ali2
1Faculty of Pharmacy, Jinnah University for Women, Karachi, Pakistan
2Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
ABSTRACT
Authors’ Contributions
1 Conception & Study design, Data Analysis
and/or Interpretation, Critical Review.
2 & 3 Data Collection & Processing, Data
Analysis and/or Interpretation, Drafting of
Manuscript.
4 Conception & Study design, Critical Review.
Acknowledgement
We wish to pay our gratitude to all those
individual who took their precious time to spare
in this valuable research. For allowance and
encouraging our research at every point we
wish to pay our gratitude to our prestigious
organization Jinnah University for Women for
giving us such opportunities to excel in our
field.
Article info.
Received: November 20, 2020
Accepted: July 30, 2021
Funding Source: Nil
Conflict of Interest: Nil
Cite this article: Nawab A, Sheikh J, Muzaffar
F, Ali H. Soft Drinks: A Threat for A Healthy
Life. RADS J Pharm Pharm Sci. 2021;
9(2):130-139.
*Address of Correspondence Author:
javeria.sheikh91@gmail.com
Background: Soft Drink is a non-alcoholic beverage, mainly composed of
carbonated water and high amount of sugar. From the studies, it is concluded
that people who consumed soft drinks frequently have more chances to
develop different diseases.
Objectives: This research was designed to observe the consumption of soft
drinks in both genders, different age groups, and to gather information with
respect to its impact on wellbeing; to analyze the awareness level in general
public of Karachi, Pakistan.
Methodology: A cross-sectional survey based questionnaire was developed.
The relationship between various parameters of the data linking to age,
gender, occupation, consumption, effects and diseases were analyzed using
basic tools of statistics.
Results: From this study we have estimated that 85.79 % of the population
consumes soft drinks. Majority of the soft drinks’ consumers were teenagers
with age range from 15-25 years. It has been observed in study that females
who regularly consume soft drinks were more prevalent towards diabetes,
obesity and osteoporosis while males showed prevalence of heart diseases,
high cholesterol, obesity, diabetes, asthma and tooth decay.
Conclusion: Awareness campaigns should be conducted to educate people
followed by development of strategies against the consumption of soft drinks
especially in educational organizations.
Keywords: Soft drinks, Obesity, Diabetes, Awareness.
INTRO D U CTIO N
Soft drink is a non-alcoholic beverage, mostly
carbonated, contains natural or artificial sweetening
agent, edible acids, natural or artificial flavors, and
sometimes juice. Examples: Pepsi, Coca cola,
Marinda, Seven Up. The term soft drink was
originated to differentiate the flavored drinks from
hard liquor, or distilled spirits [1]. Joseph Priestly was
the first who created carbonated water in 1767. Since
then, many researchers began working on
carbonated water and in 1835 the first bottled liquid
soda was manufactured in the United States. In 1886,
Coca-cola was invented by John Pemberton.
Presently, it is the oldest top selling sugary soda drink
globally [2]. Soft drinks usually composed of
carbonated water, sugar syrup, caramel color,
caffeine, orthophosphoric acid, citric acid, natural or
artificial flavors, carbon dioxide, organic diol, and
Brominated oil, in addition to several other ingredients
[3].
Soft drinks are high in calories with no other nutrients.
The average can of soft drink and fruit drink provides
about 150 calories, majority from the added sugar. If
you consume soft drink every day without reducing
other calories, you can gain weight up to 5 pounds in

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one year. Furthermore, these sugary drinks can
increase the risk of type-II diabetes, heart diseases,
and other chronic diseases [4].
Numerous studies have found relationship between
soft drink and obesity. A twenty year study on
120,000 people found that those who increased the
consumption of soft beverage by one serving
everyday gained more weight than those that didn’t
change their consumption [5]. One meta-analysis of
88 studies showed that the effect seemed to be
stronger in women [6]. Another study found that for
every additional 12-ounce soda children consumed
every day, the chances of becoming obese increased
by 60% during 1½ years of follow-up [7]. Other
studies also found a link between sugary drink
consumption and weight gain in children [8]. A unique
study of 33,097 individuals concluded that among
people with a genetic predisposition for obesity, those
that drank sugary drinks were more likely to be obese
than those that didn't [9]. It suggests that genetic risk
for obesity doesn't become a reality if healthy habits,
like avoiding sugary drinks, are followed.
Alternatively, if we replace sugary drinks or fruit juices
with water then there is a less chance of long-term
weight gain [10].
People who consume 1 or 2 soft drinks everyday
have 25 % more chances of type-2 diabetes than
people who rarely consume drinks [11]. The Nurses’
Health Study explored the link between soft drinks
and diabetes by following the health of about 90,000
women for eight years. The nurses who consumed
one or more servings each day of a sugar-sweetened
beverage or punch were twice chances to developed
type 2 diabetes than those that rarely had these
beverages [12]. Another study watching 22–26 years’
worth of knowledge from quite 192,000 male and
female participating in three long-term studies found
that increasing total sugary beverage intake, including
both sugar sweetened beverages and 100% fruit
crush, by quite 4 ounces per day over a four-year
period was related to a 18% higher risk of type 2
diabetes. The study also found that drinking more
artificially sweetened beverages in situ of sugary
beverages didn't appear to reduce diabetes risk.
However, replacing daily serving of a sugary
beverage with water, coffee, or tea was linked with a
2–10% lower risk of diabetes [13].
In a study conducted on 40,000 men for time span of
almost two decades, explored that people who intake
averaged one can of a sugary beverage per day had
a 20% higher risk of having a congestive-heart-failure
or dying from congestive-heart-failure than men who
rarely consumed sugary drinks [14]. Similar study in
women which tracked the health of nearly 90,000
women over 20 years, found that women who drank
quite two servings of sugary beverage every day had
a 40 percent higher risk of heart attacks or death from
heart condition than women who rarely drank sugary
beverages [15]. Researchers investigate to find out
why and how intake of sweet beverages leads to
heart disease. An observational study examined
medical data of nearly 6,000 people that were
followed for a mean of 12.5 years. Researchers found
drinking quite 12 ounces per day of sugary beverages
was related to a 53% higher incidence of high
triglycerides and a 98% higher incidence of low good
cholesterol compared to those that drank but 12
ounces per month [16]. It is concluded that people
who drink soft drinks are at high risk of having heart
diseases.
A study found that ladies who intake quite three 12
ounce servings of cola each day had 2.3 to 5.1
percent lower bone mineral density in the hip
compared to women who intake one serving every
day [17].
A high content of orthophosphoric acid in soft drinks
has been assumed to be one among the mechanisms
linking soft beverages and fracture. Excessive intake
of orthophosphoric acid changes calcium/phosphorus
ratio and imbalance of not only the calcium and
phosphorus ratio but also the acid-base within the
body, leading to decreased bone density and even
osteoporosis and fractures
[18,19].
Consumption of two or more soda drinks daily was
related to an increased risk of chronic kidney
diseases thanks to high levels of orthophosphoric
acid within the body [20]. A study of over 3,000
women concluded consuming two servings or more of
artificially sweetened soft drinks each day was
significantly connected to more rapid renal function
decline in older women and doubled the danger of
kidney function decline [21].
There is a robust relationship between a high risk of
developing gout and drinking sweetened soda and
fructose [22]. A 22-year study of 80,000 women found
women who drank a soft drink can each day had a
75% higher risk of gout than women who rarely had
such drinks [23]. Researchers found a similar high
risk in men [24].

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There is a high risk of cavity as many soft drinks
contain high levels of sucrose, carbohydrates, and
fructose sugars. Over consumption of sugary drinks
will cause dental problems due to sugar components
[25]. Also, phosphoric and citric acid present in soft
drinks weakened the enamel with long exposure time,
removing the protective layer (enamel) and exposing
the soft dentin. These circumstances cause cavity
and hypersensitivity [26].
The main objectives that were taken into
consideration for this study includes; To study the
consumption rate of soft drinks in both the genders in
the sample population, and the ratio of increasing
diseases that are occurring and prevailing among the
population along with Studying the degree of
awareness of usage and consequences followed by
the increasing use of these drinks.
METHO D O LOGY
Descriptive Research Design
The study is designed towards a scientific approach
to observe consumption of soft drinks in our localities,
as soft drinks are the most common and popular
beverages used and served in different events and
seen everywhere, we wish to collect data regarding it
effect on health and to know how much people in our
society are aware about it.
For this purpose we have designed a cross-sectional
survey based questionnaire, the questions designed
are on basic pattern for easy understanding including
basic question form like: who, what, why, and how, to
analyze the behavioral aspects, adaptation aspects,
and habitual aspects of different individuals living in a
society towards consumption of soft drinks. This also
studies the variations in all of these aspects in
individuals belonging to different societies or areas of
a particular region or city.
Sample size
The sample size selection, we applied Z-test with
85% of confidence interval with margin of error of 5%,
and keeping population proportion of 50%, the
population size used is 20 million as it is reported
population of city of Karachi, the sample size obtained
is 208.
Inclusion
The inclusion criterion is decided, using different
references from authentic research papers. Inclusion
criteria was Age (i.e. 5 to 55), Gender (i.e. Male and
female) and Occupation (including: students, Public
sector employed, private sector employed,
businessman and others).
Exclusion
The factors that were excluded in survey conduction
are, education status, residence or locality in which
individual lives, individual below 5 years and above
55 years.
Paper setting
The cross-sectional survey is designed using different
authentic research papers and studies from different
search engines like: Google scholar, PubMed,
Springer, Elsevier, ResearchGate, MEDLINE and
EMBASE. Using the data of different research papers
basic question were design, that were easy to
understand by local population of Karachi.
Set up
The setup of survey was completely based in Karachi,
locales selected were from different areas of Karachi.
The data was collected manually and online using
google forms. Different students from different
universities colleges and schools, along with friends,
family members, neighbors, random people in
shopping mall, markets, dispensaries, pharmacies,
and different societies participated in this study.
Statistical Analysis
The relationship between various parameters of the
data linking to age, gender, occupation, consumption,
effects and diseases were analyzed using basic tools
of statistics. The data was represented in
percentages and presented in tabular and graphical
form.
RESULT S
The study designed was cross-sectional survey
based, in which consumption of soft drinks in normal
population was identified along with complications
associated with it. For this purpose ad questionnaire
was designed which was conducted in normal
individuals, the results from the survey are
represented in terms of percentages in tables and
figures and analyzed by using suitable statistical tools
on MS excel 2016.
Table 1 shows demographic features of participants
in terms of percentage and the findings are as
follows: total respondents were 225 out of which 28%
were male and 72% were women. From the survey

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we have found that, 85.77 % of the people consume
soft drinks and 14.22% of the people do not like soft drinks. The participants belong to different age groups
ranging from 5 to 55 years.
Table 1. Demographics of individual participated in survey.
S NO.
FEATURES
N
PERCENATGE
1
GENDER
Female
162
72%
Male
63
28%
2
AGE
5-15
16
7.11%
15-25
145
64.44%
25-35
28
12.44%
35-45
17
7.55%
45-55
19
8.44%
3
OCCUPATION
Student
146
64.88%
Public
10
4.44%
Private
19
8.44%
Others
28
12.44%
Business
22
9.77%
4
SOFT DRINK CONSUMPTION
Yes
193
85.77%
No
32
14.22%
Table 2. Overall soft drinks consumption on regular basis.
HOW OFTEN INDIVIDUAL COMSUME SOFTDRINKS
N
%AGE
Few times a week
79
35.11%
More than one in a day
27
12%
Never
38
16.88%
Once in a month
57
25.33%
Only in special occasion
24
10.66%
Table 2 represents the overall consumption of soft
drinks in our society and the results showed that 12%
of the people consumed soft drinks more than once a
day, 35.11% consumed soft drinks few times a week,
25.333% consumed drinks once in a month, 10.66%
people consumed soft drinks only on special
occasions, and 16.88% never consumed soft drinks.

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Figure 1. comparative consumption of soft drinks in male and female.
Figure 1 shows that most of the people are
consuming soft drinks in their daily lives ranging from
few times a day to few times in a week. In this figure,
overall ratio also represents that men consume more
soft drinks than women.
Table 3 illustrates overall comparison of male and
female, in which 80.25% women and 96.90% men
consume soft drinks.
Table 3. Overall comparative consumption of soft drinks in both genders.
USE OF SOFT DRINKS
Female
Male
N
%AGE
N
%AGE
YES
130
80.25%
61
96.90%
NO
32
19.75%
2
3.10%
Figure 2. Consumption of soft drink consumption in different age groups.
Figure 2 shows comparative soft drink consumption
with respect to different age groups. This analysis
shows that a large percentage of soft drinks’
consumers are teenagers with age range from 15-25
years. 0% of women and 9.87% of men of 5-15 years,
89.5% of women and 16% of men of 15-25 years,
10.49% of women and 6.79% of men of 25-35 years,
0% women and 10.49% men of age group35-45 and
lastly 0% of women and 11.73% of men of age group
45-55 years consumes soft drink.
Table 4 shows almost 79.11 % of the locals are
aware of health issues caused by soft drinks while
only 20.88% are unaware.

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Table 4. General awareness of soft drink consumption and health issues associated with it.
1
AFFECT HEALTH OR NOT
N
%AGE
Yes
178
79.11%
No
47
20.88%
2
AFFECT TEETH OR NOT
Yes
132
58.66%
No
93
41.33%
3
DIET DRINK HEALTHIER THAN USUAL DRINK OR NOT
Yes
75
33.33%
No
150
66.66%
4
CAN ARTIFICAL SWEETNER CAUSE DIFFERENT DISEASES OR NOT
Asthma
12
5.33%
Cancer
40
17.77%
Diabetes
114
50.66%
Heart disease
30
13.33%
Metabolic acidosis
29
12.88%
5
INCREASES WEIGHT OR NOT
Yes
141
62.66%
No
84
37.33%
6
AFFECT BONE & CALCIUM OR NOT
Yes
178
79.11%
No
47
20.88%
7
CAUSE DEHYDRATION OR NOT
Yes
141
62.66%
No
84
37.33%
8
DISEASE OCCURANCE THROUGH SOFT DRINK CONSUMPTION
Yes
178
79.11%
No
47
20.88%
9
HEALTH PROBLEM APPEARS OR NOT
Yes
111
49.33%
No
114
50.66%
10
CAUSE JOINT PAIN OR NOT
Yes
80
35.55%
No
145
64.44%
11
MAY SUFFERING FROM FOLLOWING DISEASE(S)
Acidity
38
16.88%
Diabetes
50
22.22%
High cholesterol
24
10.66%
Obesity
58
25.77%
Osteoporosis
47
20.88%
None of the above
8
3.55%
12
INCREASES OBESITY & CHLOESTROL OR NOT
Yes
127
56.44%
No
98
43.55%

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Figure 3. Awareness regarding health issues due to soft drinks consumption in male and females:
Figure 3 shows that both males and females are
aware of the health issues related to soft drinks.
Females have knowledge about soft drink
consumption may cause acidity, diabetes, high
cholesterol and obesity and males knows that the
consumption cause obesity and osteoporosis.
Figure 4. Prevalence of different health issues due to soft drink consumption in both gender:
Figure 4 indicates that majority of the population is
affected by the use of soft drinks. Women show
prevalence of diabetes48.4%, osteoporosis 50.66%,
weight gain 34.66%, cholesterol 28.44%, dehydration
20.88%, asthma 5.33%, and teeth problem 4.89%.
Whereas men show high cholesterol 27.55%, obesity
27.55%, diabetes 27.55%, teeth decay 27.55%, heart
diseases 13.33% and dehydration 28%.
DISCU S S ION
Soft drinks are one of the most popular drinks that are
consumed globally on large scale. In recent years the
consumption of soft drinks has increased extensively
all around the world. Alone in USA almost 86% of
individual consumes soft drinks on daily basis.
European countries also shows high percentage of
soft drink consumption, averagely 90 liters per capita
is consumption of soft drinks per day in different
western countries [27]. In 2019 it has reported that
Mexico showed highest consumption of soft drinks
followed by USA on second position, while Pakistan
was ranked on 8th position in consumption of soft
drinks in 2019 [28]. The consumption has increased
in many regions around the world due to many
reasons.

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Soft drinks offer wide variety in terms of flavors, size,
packaging and formats (low-calorie, diet and low-
sugar). The attractive advertisement of soft drinks has
become a global trend. It is cheap, readily available
everywhere like bakeries, fast food restaurants,
hotels, even in school canteens. Easy access to such
drinks has increased the consumption drastically.
Although consumption of soft drink is directly
proportional to many harmful effects and may lead to
many health problems like obesity, diabetes,
cardiovascular diseases, tooth decay, bones
problems and many more [29]. It has been reported
that due to high consumption of soft drinks obesity
has increased up to 11.2% in USA; dental caries in
children and teenagers increases every year by 14%
in UK; bone associated problems have raised in many
countries like USA, India, Pakistan, UK, Australia;
Diabetes type II has also shown rise in many region
around the globe.
Pakistan in 2019 ranked in top ten on consumption of
soft drinks. In recent years consumption of soft drinks
has increased almost 10%, it has become a house
hold beverage; found in every house and at every
occasion [30]. Students, teenagers, office workers are
one of the main consumers of soft drinks all over
Pakistan, as they are main consumers of fast foods,
and are more engaged in commercials of soft drinks
[31].
We have designed a cross-sectional survey to find
out the statistics of consumption of soft drinks along
with awareness among people about harmful effects
associated with it, in locals of city of Karachi. Karachi
is the largest and most densely populated city of
Pakistan, the trend of fast food is found most common
in Karachi among all cities of Pakistan. For this
evaluation the designed survey mainly focuses on
following certain, age wise consumption, gender wise
consumption of soft drinks and what health issues
they are facing and are they aware about it or not.
From the survey we have found that, 85.77 % of the
people consume soft drinks and 14.22% of the people
do not like soft drinks (Table 1). Second part of the
study was to perform a Comparative analysis of soft
drink consumption with respect to different genders.
The results showed that 12% of the people consumed
soft drinks more than once a day, 35.11% consumed
soft drinks few times a week, 25.333% consumed
drinks once in a month, 10.66% people consumed
soft drinks only on special occasions, and 16.88%
never consumed soft drinks (Table 2). High
consumption indicates that how soft drinks are
attracting the people by their taste, flavors and colors.
It was also found that 80.25% women and 96.90%
men consumes soft drinks and are consuming soft
drinks in their daily lives ranging from few times a day
to few times in a week (Table 3 and Figure 1). This
increasingly large consumption is due to the charming
advertisements, enhanced flavors, promotions and
discount offers by the manufacturer [8].
Third part of the study was the comparative soft drink
consumption with respect to different age groups.
This analysis shows that a large percentage of soft
drinks’ consumers are teenagers with age range from
15-25 years (Figure 2). They usually consume soft
drinks that are easily available in cafeterias and
canteens of schools, colleges and universities.
The study also focused on identifying awareness
about harmful effects of soft drinks on our health in
general population. Through findings of survey report
in Table 4, almost 79.11 % of the locals are aware of
health issues caused by soft drinks while only 20.88%
are unaware in many ways. Although many
individuals are aware of health problems associated
with soft drinks still the consumption of soft drinks is
pretty high according to our survey as well as global
report [12]. Figure 4 represents the outcome of this
analysis and indicates that majority of the population
is affected by the use of soft drinks. Women show
prevalence of diabetes48.4%, osteoporosis 50%,
weight gain 34.66%, cholesterol 28.44%, dehydration
20.88%, asthma 5.33%, and teeth problem 4.89%.
Whereas men show high cholesterol 27.55%, obesity
27.55%, diabetes 27.55%, teeth decay 27.55%, heart
diseases 13.33% and dehydration 28%.The survey
findings show that in 79.111% individuals tooth decay
problem is commonly observed, 62.666% people
have complained about weight gain due to soft drinks
consumption, 79.111% showed bones issues, joint
pain problem but still in such conditions 35.555% of
the people are still consuming it, 62.666% people
know soft drink’s consumption can cause
dehydration, but still consumption is high as people
feel fresh and energize after consuming soft drinks
[22].
Survey findings also show a misconception about the
use of diet soft drinks. 33.333% people think that the
diet soft drinks are healthier than the usual drinks and
66.666% people think that diet soft drinks are not
healthier than the usual drinks, out of which 56.444%
consider that diet Coke can increased belly fat, leads

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to high cholesterol and CVD [12-13].
It is surprising to see a large percentage of affected
people associated with the increased use of soft
drinks; still the people are in the habit of using them
regularly with meals and snacks at any time of the
day without realizing that the usage still can cause
extremely negative effects on the individual body
system.
In the light of this study it has shown, soft drinks have
become very popular recently among people of
Karachi where men consumption is higher than
women and teenagers show most consumption of soft
drinks. It has become an essential need in household,
basic need in different events and nutritional need in
different canteens of offices and educational
institutes. The consumption has risen to a threatening
level that it is affecting our health, decreasing quality
of our life and slowly leading us to different diseases
[18, 20, 30].
CONCL U S ION
In this research study it has been concluded that, the
consumptions of soft drinks are increasing day by
day. Due to the attractive advertisement people
change their consumptions patterns they prefer soft
drinks over juices and a huge population of Pakistan
prefer soft drinks, especially teenagers and young
adult, as it is in easy access to them. The study
shows that soft drink does have adverse effects on
heath and not many locals are aware of it.
Furthermore, individuals being aware of harmful
effects still consumes soft drinks on either regular
basis or occasionally. Strict strategies should be
made against consumption of soft drinks especially in
educational organizations and we should promote use
of health drinks, milk in societal level, along with it
should create an awareness forum to educate people
more regarding it.
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