The average Australian drinks almost 60 litres of soft drink a year. Many people see diet soft drinks as a “healthier” choice than regular ones, and when it comes to sugar, that’s true.

For example, a 375 millilitre can of Coca-Cola contains about seven teaspoons of added sugar (almost to 40 grams). That’s close to the World Health Organization’s (WHO) daily recommended limit for added sugars of 50g.

In comparison, the Diet Coke version is sweetened with artificial sweeteners such as aspartame and does not contain sugar.

So if you reach for diet soft drinks, is that so bad? Or is it worth giving them up too?

Are diet soft drinks really that bad?

Diet soft drinks provide few nutrients. They often contain artificial sweeteners and caffeine, and while they’re low in energy (kilojoules), they aren’t filling.

People who regularly drink diet soft drinks may have a higher risk of developing conditions such as heart disease and type 2 diabetes.

But this doesn’t necessarily mean the drinks cause these conditions. People who already have health concerns or are trying to manage their weight may be more likely to choose diet drinks, which might make this evidence a little misleading.

How about artificial sweeteners?

In 2023, the WHO classified aspartame (a common sweetener found in many diet soft drinks) as “possibly carcinogenic to humans”. This means the evidence linking aspartame to cancer is currently limited and not conclusive.

The WHO also emphasised that the public generally consumes safe levels of aspartame and only has evidence for concern if people drink the equivalent to 14 cans of soft drink a day.

There is also emerging evidence some artificial sweeteners might irritate the gut or alter the balance of gut bacteria. These effects are still being investigated. But they’ve added to concerns about the health impacts of drinking diet soft drinks over a long period of time.

Can I get used to the sweetness?

An occasional diet drink isn’t likely to fuel an addiction to sweet foods, but cutting back is still a good idea if this has become a daily habit.

After people cut back on very sweet foods or drinks, some research suggests they start noticing sweetness more easily and find very sweet things taste too sweet.

So if you’re trying to enjoy less-sweet drinks, give it time. Within a few weeks you might actually prefer the less-sweet taste.

Here are three evidence-based strategies to help you adjust.

1. Water it down

A gentle first step is to dilute your soft drink. Start by pouring less soft drink into a glass and topping it up with water or soda water, then gradually adjust the ratio over time.

It may taste less sweet at first, but your taste buds will adapt. This slow, steady approach can make change feel easier and more sustainable than quitting abruptly.

2. Make smarter swaps

Try replacing diet soft drink with a healthier alternative that still delivers flavour or fizz. Sparkling water or soda water with a squeeze of lime or lemon and a few mint leaves gives you the same bubbly refreshment with a natural and refreshing flavour. Add ice if it is a hot day, or to provide some crunch.

If you prefer plain water but it feels boring, infuse it with slices of fruit, cucumber, berries or herbs.

You could also try unsweetened iced tea, such as black, green or herbal tea. These offer a mild caffeine lift without the added sweeteners and can be served cold with ice and lemon.

Coconut water can also be a healthier alternative as it is low in sugar while providing some additional electrolytes, which help balance fluid in the body.

3. Know your triggers

If you often reach for a soft drink out of habit, boredom or an afternoon energy slump, paying attention to these moments can help. Once you spot your triggers, you can plan a different response. Take a short walk, call a friend or make a cup of tea instead.

Keeping a chilled, reusable water bottle nearby also helps. If your drink is always within reach, you’re less likely to grab a diet soft drink when you’re out and about.

If you drink diet soft drinks because you’re hungry, reach for something nourishing instead, such as a handful of nuts, a yoghurt or a piece of fruit. These foods will satisfy you for longer than a can of diet soft drink because they have nutrients, such as fibre, to keep you fuller for longer.

The bottom line

You don’t have to give up diet soft drinks altogether. But being mindful of how much soft drink you drink, and how often, can help you make choices that better support your long-term health.

Start small, be consistent and let your taste buds adjust. Over time, you might find what once tasted “flat” now feels refreshingly natural.

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland; Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University, and Mackenzie Derry, Nutritionist, Dietitian & PhD Candidate, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Outbreaks of bacterial meningococcal disease in England and recent cases in students in New Zealand have raised awareness of this serious and life-threatening disease.

The disease is caused by the bacterium Neisseria meningitidis and presents as meningitis or blood poisoning (septicaemia).

Meningitis is an inflammation of the membranes that cover the brain and spinal cord (meninges), while septicaemia affects the whole body through the presence of bacteria in the blood stream.

Both can be also be caused by other infectious agents, but bacterial meningococcal disease is the most severe form.

Infants, children and young adults are at higher risk. While the disease is largely preventable through vaccination, only one vaccine is currently on the national immunisation schedule in Aotearoa New Zealand.

As part of ongoing research to explain the recent cases, we compared the meningococcal strains involved in both countries and explored the significance of people who carry the bacterium but don’t develop symptoms or disease.

There are several strains of Neisseria meningitidis and most belong to six groups (named A, B, C, W, X and Y). All have an extraordinary ability to swap genetic material between them and switch genes on and off through a process known as phase variation.

This can change the surface of the bacterium, enabling it to escape the body’s immune system.

The strains responsible for both the UK and recent Dunedin cases belong to Group B meningococci. However, the similarity ends there. The UK outbreak strain is known as ST485, while the Dunedin cases were caused by different strains. They differ from the UK strain as well as from each other, suggesting more than one chain of transmission was involved.

The Bexsero vaccine is used to protect people against bacterial meningitis caused by group B strains. It was designed to recognise components in the outer membrane and on the surface of the bacteria.

The strain that caused the UK outbreak is likely covered by the Bexero vaccine because it matches exactly one of the protein antigen sequences used in the vaccine.

But genomic sequencing of the bacteria responsible for one of the Dunedin cases is still pending, while the other case did not yield a bacterial culture.

The importance of genome sequencing

Although meningococcal disease can appear as scattered and apparently unrelated cases, these can occasionally build into larger outbreaks.

Strain typing and genome sequencing can help to determine if an apparent outbreak is due to the emergence of a particular strain or a cluster of cases that are genetically unrelated.

Both scenarios can occur if cases share a common risk factor, such as increased close contact and mixing in educational settings such as schools and universities.

Past genomic surveillance in New Zealand has shown the emergence of outbreak strains and helped identify likely resistance to antibiotics. For example, a W group strain variant caused rising numbers of meningococcal disease between 2016 and 2019 in New Zealand and an outbreak in Northland in 2018.

Genome sequencing showed this strain was different from the W strain causing disease in Europe at the time, and the specific 2015 variant also has increased resistance to penicillin.

Healthy people can be carriers

Despite its ability to cause severe disease, the bacterium causing meningococcal disease is often found in people’s throat, without causing symptoms.

About 5% to 30% of the global population are carriers, and most don’t experience any symptoms or disease. We don’t yet fully understand the factors that determine whether disease develops.

Genome sequencing has shown that some highly virulent strains which are associated with outbreaks are rarely identified in samples from healthy carriers. But as yet, attempts to find genomic explanations for differences in bacteria found in outbreaks and healthy carriers remain inconclusive.

The likelihood whether people carry the bacterium is age dependent. It is low in younger children and older people, but high in teenagers and young adults.

The high carriage rate in young adults makes university students a high-risk group for developing the disease. Crowded living conditions also contribute to the high carriage rate, exacerbating the risk.

In New Zealand, both the Bexsero (against group B) and MenQuadfi (against ACWY) vaccines are available to young people moving into boarding school or university halls the first time. In contrast, only one vaccine (against ACWY) is currently funded for university students in England.

Both vaccines are needed to have maximum protection. Conjugate ACWY vaccines may reduce carriage and therefore transmission. Bexsero does not reduce carriage but protects against development of the disease.

Impact of COVID measures on transmission

Lockdowns and border controls introduced during the COVID pandemic reduced transmission of the SARS-CoV2 virus. But they also had a major effect on other diseases, including influenza and other respiratory viruses.

Cases of meningococcal disease were also dramatically reduced during the COVID response, most likely due to reduced contact between individuals and because fewer infected people entered the country.

The rebound in cases following relaxation of these strict measures was expected.

This highlights how important it is to be aware of the risks associated with large gatherings, particularly of young people, and the need to vaccinate with the Bexsero vaccine as part of the immunisation schedule as well as MenQuadfi for high-risk groups.

Una Ren, Senior Scientist in Genomics, New Zealand Institute for Public Health and Forensic Science; Nigel French, Distinguished Professor of Infectious Disease Epidemiology and Public Health, Te Kunenga ki Pūrehuroa – Massey University, and Sarah Hannah, Doctoral Candidate in Epidemiology, Te Kunenga ki Pūrehuroa – Massey University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As we enter the festive season it’s a good time to think about what all those celebratory alcoholic drinks can do to your gut.

Alcohol can interfere with the time it takes for food to go through your gut (also known as the “transit time”). In particular, it can affect the muscles of the stomach and the small bowel (also known as the small intestine).

So, how and why does alcohol make your poos goes weird? Here’s what you need to know.

Diarrhoea and the ‘transit time’

Alcohol’s effect on stomach transit time depends on the alcohol concentration.

In general, alcoholic beverages such as whisky and vodka with high alcohol concentrations (above 15%) slow down the movement of food in the stomach.

Beverages with comparatively low alcohol concentrations (such as wine and beer) speed up the movement of food in the stomach.

These changes in gut transit explain why some people can get a sensation of fullness and abdominal discomfort when they drink vodka or whisky.

How long someone has been drinking a lot of alcohol can affect small bowel transit.

We know from experiments with rats that chronic use of alcohol accelerates the transit of food through the stomach and small bowel.

This shortened transit time through the small bowel also happens when humans drink a lot of alcohol, and is linked to diarrhoea.

Alcohol can also reduce the absorption of carbohydrates, proteins and fats in the duodenum (the first part of the small bowel).

Alcohol can lead to reduced absorption of xylose (a type of sugar). This means diarrhoea is more likely to occur in drinkers who also consume a lot of sugary foods such as sweets and sweetened juices.

Chronic alcohol use is also linked to:

• lactose intolerance
• overgrowth of small bowel bacteria and
• reduced absorption of fats from the pancreas not producing enough digestive enzymes.

This means chronic alcohol use may lead to diarrhoea and loose stools.

How might a night of heavy drinking affect your poos?

When rats are exposed to high doses of alcohol over a short period of time, it results in small bowel transit delay.

This suggests acute alcohol intake (such as an episode of binge drinking) is more likely to lead to constipation than diarrhoea.

This is backed up by recent research studying the effects of alcohol in 507 university students.

These students had their stools collected and analysed, and were asked to fill out a stool form questionnaire known as the Bristol Stool Chart.

The research found a heavy drinking episode was associated with harder, firm bowel motions.

In particular, those who consumed more alcohol had more Type 1 stools, which are separate hard lumps that look or feel a bit like nuts.

The researchers believed this acute alcohol intake results in small bowel transit delay; the food stayed for longer in the intestines, meaning more water was absorbed from the stool back into the body. This led to drier, harder stools.

Interestingly, the researchers also found there was more of a type of bacteria known as “Actinobacteria” in heavy drinkers than in non-drinkers.

This suggests bacteria may have a role to play in stool consistency.

But binge drinking doesn’t always lead to constipation. Binge drinking in patients with irritable bowel syndrom (IBS), for example, clearly leads to diarrhoea, nausea and abdominal pain.

What can I do about all this?

If you’re suffering from unwanted bowel motion changes after drinking, the most effective way to address this is to limit your alcohol intake.

Some alcoholic beverages may affect your bowel motions more than others. If you notice a pattern of troubling poos after drinking certain drinks, it may be sensible to cut back on those beverages.

If you tend to get diarrhoea after drinking, avoid mixing alcohol with caffeinated drinks. Caffeine is known to stimulate contractions of the colon and so could worsen diarrhoea.

If constipation after drinking is the problem, then staying hydrated is important. Drinking plenty of water before drinking alcohol (and having water in between drinks and after the party is over) can help reduce dehydration and constipation.

You should also eat before drinking alcohol, particularly protein and fibre-rich foods.

Food in the stomach can slow the absorption of alcohol and may help protect against the negative effects of alcohol on the gut lining.

Is it anything to worry about?

Changes in bowel motions after drinking are usually short term and, for the most part, resolve themselves pretty efficiently.

But if symptoms such as diarrhoea persist beyond a couple of days after stopping alcohol, it may signify other concerning issues such as an underlying gut disorder like inflammatory bowel disease.

Researchers have also linked alcohol consumption to the development of irritable bowel syndrome.

If problems persist or if there are alarming symptoms such as blood in your stool, seek medical advice from a general practitioner.

Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.