A recent headline in the business papers reported that the cannabis constituent cannabidiol (CBD) may soon be an ingredient in popular beverages, a hot subject for investors given that cannabinoids have anti-inflammatory, immunomodulatory, analgesic, anti-nausea and anti-seizure properties.¹ This broad range of physiological effects is possible because plant cannabinoids resemble our own endogenous cannabinoids and act as chemical messengers to cell receptors all over the body.

Biotech companies are in fact rushing to produce a range of products from acne creams to sleep medicines which contain CBD, and it therefore makes sense that this promising substance could be administered on a broad scale to the ailing urban masses suffering chronic symptoms of metabolic syndrome. The strategy is to dispense CBD via bottled mineral waters, sweetened teas and the most obvious route, the ubiquitous soft drink, aka the sugar sweetened beverage (SSB).

Mind you, this is not a new idea considering SSBs were originally marketed in the 19^th century by pharmacists as health tonics because they contained stimulant and mood-elevating substances such as cocaine, caffeine, guarana and sugar. The cocaine has long since been removed from John Pemberton’s Coca-Cola and the claims muted, which poses the question: will these new pharmaceutical beverages be genuine medicines with rigorous trial evidence, or mere nutritional supplements that carry instead watered-down claims of the type that declares that they may ease symptoms, encourage wellness or even ‘add life’?

What is certain, however, is that at less than 0.3% THC content, they won’t induce a ‘high’ of the type associated with marijuana or hashish. These crude plant products are more appropriately associated with traditional herbal medicine and experimental psychiatry, the benefits of which, including appetite stimulation, anxiolytic activity, mood elevation, asthma relief and pain suppression, are perennially debated.

As for SSBs, there is a large sober evidence-base which could assist the reader in understanding this dilemma before even considering the additional medicinal activity of cannabis, guarana, stevia, vanilla or other herbs and their extracts. The research findings include the established relationship between the consumption of excess calories and obesity; caffeine and hyperactive psycho-stimulatory effects; the toxic effect of sucrose or high-fructose corn syrup on the pancreas and other organs; fatty liver in children; tooth decay; sensitivity reactions to food additives; and also the broad suite of side-effects relating to synthetic sweeteners in the ‘low’ or ‘diet’ category of SSBs which are, ironically, also linked to obesity and diabetes, as well as cancer.^2,3

If we just concentrate on the carbohydrate content of soft drinks, in particular high-fructose corn syrup, then there is enough research to create an impression that our wellness project is already in  difficulty. It seems that when this factory sugar is consumed in large amounts, as it is today in all manner of processed foods and bottled drinks, and there are concurrent nutrient deficiencies such as omega-3 and various minerals or vitamins, then the outcome is predictable: an epidemic of type 2 diabetes, fatty liver, obesity, hypertension and coronary artery disease.⁴

An example of the research available is a study from the Cesare Maltoni Cancer Research Centre published in 2006, relating to the ingestion of Coca-Cola by an experimental colony of rats. This is an interesting study not least because of the large number of rats kept under close observation until their ‘spontaneous’ death. All 1999 of the experimental animals were given a standard diet of rat chow, the control group was given only water to drink, while the experimental groups were given Coca-Cola ad libitum instead of water. The three experimental groups included breeding pairs, their offspring and a separate group of 7-week-old rats.

Rats provide an advantage in these kinds of clinical trials because they don’t voice opinions about their monotonous ‘chow’ or their environment, and they don’t live as long as humans. The  controlled study of human subjects therefore presents obvious ethical questions: potential obstacles to approval would arise with the intention to confine subjects to similarly restrictive apartment-like spaces; long-term feeding with a uniform factory-food diet; a lack of provision for adequate outdoor exercise; and the total substitution of natural water with a medicinal ‘treatment’ syrup.

The extensive investigation at autopsy in this trial would also be a cause for concern. This thorough histopathological investigation ‘was routinely performed on all macroscopically observed pathological lesions (with a margin of surrounding normal tissue) and on skin and subcutaneous tissue, the brain, pituitary gland, Zymbal glands, salivary glands, Harderian glands, cranium (with oral and nasal cavities and external and internal ear ducts, 5 levels), tongue, thyroid and parathyroid, pharynx, larynx, thymus and mediastinal lymph nodes, trachea, lung and mainstem bronchi, heart, diaphragm, liver, spleen, pancreas, kidneys and adrenal glands, esophagus, stomach (fore and glandular), intestine (4 levels), bladder, prostate, uterus, gonads, interscapular fat pad, subcutaneous and mesenteric lymph nodes, and any other organ or tissue with pathological lesions.’

As you would expect, such meticulous effort paid off: all treated animals gained weight; a significant increase was observed in mammary tumours in both breeders and offspring; a significant increase in pancreatic adenomas in male and female breeders and offspring was also apparent; and there was a non-significant increase in pancreatic islet cell carcinoma in females. The results prompted the scientists to recommend that the ‘excessive consumption of regular soft-drinks should be generally discouraged, in particular for children and adolescents.’⁵

For such stark findings it seems a rather overly cautious recommendation, of the type that leads to calls for a sugar tax, rather than the more severe prohibitions that could make a substantial difference to a whole nation’s health. Mind you, 28 countries have now legislated for a sugar tax, excluding Australia, where industry self-regulation and voluntary labelling such as the Health Star rating are the preferred health policy.

In the absence of strong prohibitive measures, the responsibility is then put squarely on the consumer to make healthy choices between classic SSBs and the new wellness drinks, and those containing CBD may at least ease some symptoms caused by the modern urban diet. This is despite the industry firmly rejecting any existing link between the classic SSB and obesity or diabetes.⁶ We may even anticipate a plateau in the figures for obesity which already reach beyond 60% if these initiatives are combined with other industry strategies designed to shift attention away from excess snack consumption, and promote exercise instead.⁷ Nevertheless, the Italian histopathological findings are an inauspicious outcome for the wellness project.

Articles on alternative wellness foods and drinks are available in the eBook Wholefoods And Common Medicinal Herbs.

References:

1. Lafaye G, Karila L, Blecha L, Benyamina A. Cannabis, cannabinoids, and health. Dialogues Clin Neurosci 2017;19:309–16.
2. Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2009;32:688–94.
3. Soffritti M, Padovani M, Tibaldi E, Falcioni L, Manservisi F, Belpoggi F. The carcinogenic effects of aspartame: The urgent need for regulatory re-evaluation. Am J Ind Med 2014;57:383–97.
4. Simopoulos AP. Dietary Omega-3 Fatty Acid Deficiency and High Fructose intake in the Development of Metabolic Syndrome Brain, Metabolic Abnormalities, and Non-Alcoholic Fatty Liver Disease. Nutrients 2013;5:2901–23.
5. Belpoggi F, Soffritti M, Tibaldi E, Falcioni L, Bua L, Trabucco F. Results of long-term carcinogenicity bioassays on Coca-Cola administered to Sprague-Dawley rats. Ann N Y Acad Sci 2006;1076:736–52.
6. Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, Martinez-Gonzalez MA. Financial Conflicts of Interest and Reporting Bias Regarding the Association between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews. PLOS Med 2013;10:e1001578.
7. Blair SN, Hand GA, Hill JO. Energy balance: a crucial issue for exercise and sports medicine. Br J Sports Med 2015;bjsports-2015-094592.