Elsevier

Drug and Alcohol Dependence

Volume 157, 1 December 2015, Pages 197-199
Drug and Alcohol Dependence

Short communication
Effects of artificial sweeteners on breath alcohol concentrations in male and female social drinkers

https://doi.org/10.1016/j.drugalcdep.2015.10.015Get rights and content

Highlights

  • Lab study examined breath alcohol concentrations for alcohol with mixers.

  • For both alcohol doses, diet (vs. sweetened) mixers resulted in higher breath alcohol contentration (BrAC) levels.

  • Risks of higher BrAC levels may outweigh the benefits of reduced caloric intake.

Abstract

Background

Alcohol is often mixed with various nonalcoholic beverages. While consumption of food with alcohol will decrease peak breath alcohol concentrations (BrAC), recent evidence has suggested that mixing alcohol with diet beverages can result in higher BrAC when compared with mixing the same amount of alcohol with sweetened beverages. The purpose of this study was to examine this phenomenon using two different moderate alcohol doses.

Methods

Twenty participants (10 males) attended five sessions where they received 1 of 5 doses (0.91 ml/kg vodka + 3.64 ml/kg of diet soda, 0.91 ml/kg vodka + 3.64 of regular soda, 1.82 ml/kg vodka + 7.28 ml/kg diet soda, 1.82 ml/kg vodka + 7.28 ml/kg regular soda, and a placebo beverage). BrAC was recorded repeatedly up to 180 min after dose administration.

Results

Participants had significantly higher BrAC when the mixer was diet as compared to regular for both alcohol dose conditions. No gender differences were observed.

Conclusions

Mixing alcohol with diet beverages can result in higher BrAC when compared to the same amount of alcohol administered with a similar sweetened beverage. Individuals who consume diet mixers with alcohol may reduce caloric intake but increase the harms associated with higher BrACs.

Introduction

Alcohol contains calories and consumers often limit added calories to alcohol via caloric mixers. However, limited evidence suggests that mixing alcohol with diet beverages results in higher breath and blood alcohol concentrations (BrAC) when compared with the same dose of alcohol mixed with a sweetened mixer (e.g., Marczinski and Stamates, 2013, Rossheim and Thombs, 2011, Wu et al., 2006). The difference can be noticeable with one study reporting an 18% higher BrAC when the carbonated soda mixer was diet versus caloric (Marczinski and Stamates, 2013). However, this previous study had limited generalizability in that drinks were prepared to best study pharmacokinetics around intoxicating levels (i.e., peak BrAC of .08 g%). Previous work has incorporated limited amounts of mixer since it is thought that sugar-sweetened mixers delays gastric emptying time when compared to non-caloric mixers (Wu et al., 2006). Despite concerns about the generalizability of current laboratory-based studies, this observation has also been found in a field study in bar patrons who self-selected their mixers (Rossheim and Thombs, 2011). Further, preliminary survey research has determined that almost half of college student female drinkers report the use of diet mixers with alcohol and consumption of alcohol with diet mixers was associated with greater alcohol-related harms even when the amount of alcohol consumed is controlled (Stamates et al., 2015). Given the limited findings that consumption of alcohol with diet mixers may pose as a risk factor for greater BrACs which can result in heightened risks to brain and liver health, additional research is needed to test the reliability of this effect for low to moderate alcohol doses using drinks prepared for optimal taste (i.e., with a greater mixer to alcohol ratio).

For this study, participants attended five sessions where they received 1 of 5 doses (0.91 ml/kg vodka + 3.64 ml/kg of diet soda, 0.91 ml/kg vodka + 3.64 of regular soda, 1.82 ml/kg vodka + 7.28 ml/kg diet soda, 1.82 ml/kg vodka + 7.28 ml/kg regular soda, and a placebo beverage). BrAC was recorded repeatedly up to 180 min after dose administration. We predicted that the alcohol + diet beverage would result in higher BrAC compared to the alcohol + regular beverage for both alcohol doses.

Section snippets

Participants

Twenty adults (10 men) between the ages of 21 and 30 (M = 22.65, SD = 2.56) participated in this study. The sample included 19 Caucasians and 1 African American, who were recruited using established procedures reported elsewhere (Marczinski and Stamates, 2013). The Northern Kentucky University Institutional Review Board approved this study. All participants provided informed consent prior to participation. Participants received $160 upon completion of the study.

Measures

The Personal Drinking Habits

Drinking characteristics

From the PDHQ, the sample reported a mean (SD) weekly alcohol drinking frequency of 1.10 (0.73), with a mean (SD) number of standard drinks per occasion of 3.48 (1.65) over a mean (SD) duration of 3.33 (1.15) h. The sample self-reported a mean (SD) typical alcohol dose of 0.84 g/kg (0.45) per occasion. No gender differences were observed, ps > 0.26.

Breath alcohol concentrations

0.91 ml/kg alcohol dose BrAC. Results of the 2 × 3 × 2 ANOVA revealed a main effect of Mixer, F(1,18) = 14.66, p = 0.001, η2 = 0.449, and a main effect of Time, F

Discussion

The purpose of this study was to determine if there are BrAC differences when alcohol is mixed with a diet versus sweetened mixer. The results from both alcohol doses indicated that BrAC was elevated at every time point when a diet mixer was used as compared to a sweetened mixer. The difference in BrAC was not only statistically significant but also practically significant. For the 0.91 ml/kg dose of alcohol, the mixer type resulted in a 22% difference in BrAC (when measured at 40 min after dose

Role of funding source

This research was funded by NIH grants AA019795 and GM103436, awarded to CA Marczinski. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the NIH. The NIH had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Contributors

All authors (Marczinski, Stamates & Maloney) contributed fully to the study design, data analysis, writing the manuscript, and the decision to submit the paper for publication. Data collection was completed by AL Stamates and SF Maloney.

Conflict of interest statement

No conflict declared.

References (8)

There are more references available in the full text version of this article.

Cited by (10)

  • Nature versus intensity of intoxication: Co-ingestion of alcohol and energy drinks and the effect on objective and subjective intoxication

    2017, Drug and Alcohol Dependence
    Citation Excerpt :

    Gastric emptying is impacted by the contents of the intestinal system via a feedback loop from the small intestine (Chaikomin et al., 2006), with some substances slowing emptying rate relative to their energy density (Hunt et al., 1985). Previous research has shown increased alcohol absorption and reductions in peak BrAC with consumption of naturally- versus artificially-sweetened mixers with alcohol (Marczinski and Stamates, 2013; Stamates et al., 2015; Wu et al., 2006). Indeed, the current study did not record any meaningful difference in BrAC between the AmED and other treatment conditions containing sugar and alcohol (i.e., ‘Caffeine + Sugar’ and ‘Cola’ in Study 1, and ‘Sugar-only’ in Study 2) at those time points when ED reductions in BrAC were observed.

  • Mixing alcohol with artificially sweetened beverages: Prevalence and correlates among college students

    2016, Addictive Behaviors
    Citation Excerpt :

    Mixing alcohol with artificial sweeteners (i.e., diet beverages) has been linked to greater objective levels of intoxication, such as higher breath alcohol concentrations (BrACs; Irwin, Shum, Desbrow, & Leveritt, 2014; Marczinski & Stamates, 2013; Stamates, Maloney, & Marczinski, 2015) and blood alcohol concentrations (BACs; Wu et al., 2006).

  • Acute tolerance to the analgesic effects of alcohol

    2021, Journal of Studies on Alcohol and Drugs
View all citing articles on Scopus
View full text