Metabolic consequences of SSB consumption may result in part
due to their propensity to induce weight gain, but an independent
effect may also result from the large quantities of rapidly absorbable
carbohydrates such as sucrose or HFCS, used to flavor these beverages.
Rapid increases in blood glucose and insulin levels have been
observed following consumption of SSBs [85], which in conjunction
with the large volumes often consumed, contribute to a high dietary
glycemic load (GL). High GL diets have been shown to stimulate
appetite and induce weight gain and are associated with development
of both glucose intolerance and insulin resistance [86]. In addition,
high GL diets have been shown to dysregulate lipid profiles, which
taken together may explain how SSB consumption can lead to
increased risk of gallstone disease [70]. Higher dietary GL has also
been shown to increase levels of inflammatory biomarkers such as
C-reactive protein, a known marker of elevated T2DM and CVD risk
[19], and has been linked to the development of CHD in a relatively
short time-frame [87] since inflammation impacts the development
of atherosclerosis as well as plaque stability and thrombosis [63]. It
is also thought that the caramel coloring used in cola type beverages
may further increase insulin resistance and inflammation due to the
high amounts of advanced glycation end products, produced during
the process of caramelization [88].