Diet drinks containing sugar substitutes were found to be as effective as water for supporting weight loss in overweight or obese adults, according to a two-year randomized trial.
The study, led by the University of Liverpool, England, included 493 participants ranging from 18 to 65 years old, all of whom had a body mass index (BMI) between 27 and 35 (overweight or obese).
Half of them received 22.3 ounces of water each day, and the other half received the same amount of soda with non-nutritive sweeteners (about two cans) for a 104-week period.
The group assigned to NNS drinks could choose from a variety of diet sodas, low-calorie fruit drinks and flavored waters. The primary sweeteners used were aspartame, acesulfame potassium and sucralose.
After two years, people drinking diet beverages had lost about 10.6 pounds, while those drinking water lost about 8.2 pounds.
People in both groups kept off a meaningful amount of weight for two years, even during the last year when they no longer had regular weight-management support, the researchers stated.
Both groups lost inches around their waists and hips and reduced body fat, but there was no meaningful difference between people drinking diet beverages and those drinking water.
Additionally, total cholesterol remained within the healthy range in both groups.
The findings were published in the British Journal of Nutrition.
“The study does not show that diet beverages themselves caused the weight loss,” Alix Turoff, a registered dietitian in New York City, told Fox News Digital.
“Everyone in the study was participating in a structured weight-management program that included nutrition counseling, behavioral support and physical activity recommendations.”
Turoff, who was not involved in the study, noted that the main value of including diet beverages comes down to substitution, “not that these beverages have a magical metabolic effect.”
Notably, the study compared diet beverages with water — rather than with sugar-sweetened drinks — making it a test of whether the sugar substitutes themselves appeared to hinder weight loss efforts.
“If someone normally drinks 250 calories of regular soda and switches to zero-calorie soda, then they’re saving calories,” she added.
The dietitian emphasized that these findings don’t mean water and diet soda are nutritionally identical.
“The study did not find significant between-group differences in hunger or sugar intake at the end of the trial, which is relevant because one common concern is that artificial sweeteners may increase appetite or lead to compensatory eating,” Turoff said.
“I would still recommend water as the primary hydration choice, but I don’t think people need to be afraid of diet drinks because they think they will automatically prevent fat loss or cause weight gain.”
There were some limitations with the research, including that it was conducted at one location in England. Race and ethnicity data were not collected, which limits the generalizability of the findings.
Only 220 of the 493 participants who started treatment completed the 104-week assessment. The second-year extension was also voluntary, meaning those who continued may have been more motivated or more likely to stick with the program, Turoff noted.

Viola Davis is speaking out about the shocking diagnosis she received following her 2012 Academy Award nomination.
The 61-year-old star told People in an article published Oct. 8 about her past health struggle, including “debilitating pain” that severely impacted her well-being.
“I was a new mom. I had just adopted my daughter. I was riding off of my Oscar nomination after The Help. So I was working, working, working, running myself into the ground,” Davis said.
She and her husband, actor Julius Tennon, 72, adopted their only child, Genesis Tennon, in 2011.
“And then all of a sudden, I woke up with flu-like symptoms and an extraordinarily painful rash,” Davis recalled.
She continued, “I mean, I would put it at a nine out of 10. It started on my stomach, and it wrapped around to my back. It went away, and then it came back with three blisters on my upper back. I was surprised how much pain it was. Hard to lie down, hard to get up, hard to walk. Nerve pain, all of that.”
The painful, mysterious symptoms first made Davis suspect a poisonous spider had bitten her.
However, a doctor confirmed she was suffering from something much more common: shingles.
Shingles can affect anyone who has had chickenpox and, in rare cases, people who have taken the chickenpox vaccine, according to the Cleveland Clinic. It is most common in people over 50 and those with weakened immune systems.
Some experts have also suggested a link between shingles and heightened stress.
The virus causes a rash that often appears in a single stripe, with blisters that can be extremely painful.
Shingles can cause symptoms like fever and headache and lead to complications, including lingering nerve pain. The rash can take up to five weeks to disappear completely, although symptoms may calm down after a week.
Davis described the diagnosis as “the surprise of my life.”
“I felt that I sort of was immune to any disease at that point because I worked out, I ate right. I felt that I was healthy because I did all the right things. And then all of a sudden, I have shingles,” she said.
Adding, “I felt like I was a soldier, and the more that I could muster through, the stronger I was. I didn’t know that that’s not what strength is about. Strength is about sort of loving on your body and experiencing good health as you age.”
The experience inspired Davis to partner with GSK for their new “Shingles, Actually” campaign. The initiative aims to raise awareness of shingles and encourage people over 50 to talk with their doctors about preventive actions.
“I was there for my daughter. I was there for my husband, there for my employees, and I sort of put all of them on a level of importance higher than myself, you know? And I felt that that’s what defined me as a powerful modern-day woman, that I could sort of sacrifice my life for others,” Davis said.
Adding, “And that’s not the case for me anymore. I feel like I’m important enough and my body is important enough to listen to it and to honor it.”
While Meryl Streep ultimately took home the Oscar in 2012 for her role in The Iron Lady, Davis went on to win an Academy Award for her portrayal of Rose Maxson in Fences, opposite Denzel Washington.
The acclaimed star is a rare EGOT winner, meaning she has won Emmy, Grammy, Oscar, and Tony awards.
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You don’t have to be a pioneer on the Oregon Trail to catch the bug that causes dysentery.
Nowadays, the infection is spreading more through sex — and evolving into something that’s “close to untreatable,” one expert said.
Shigella bacteria infect nearly half a million people in the US every year — causing diarrhea with blood or mucus (the hallmark of a dysentery infection), stomach pain, cramps, fever and vomiting.
Scientists are learning more about why the disturbing disease is spreading so quickly, and why it’s developing a resistance to treatment.
Spreading through sex
Shigella is a nasty illness that causes more than uncomfortable doo-doos. It can become life-threatening by dehydrating and depleting bodily fluids including blood, causing bacterial and septic shock, neurological complications, and internal bleeding and infection.
The bacteria spreads through infected poop that gets into the mouth because of ill-washed hands, or swallowing tainted food or water. A minuscule amount — as few as 10 organisms — is enough to get you sick.
The population most likely to get infected are children under 5, who catch it at day care and schools from other kids who are just starting to learn about keeping themselves clean. Travelers to places where sanitation standards are lower, and people experiencing homelessness are also at higher risk.
But the population that’s experiencing one of the fastest rises in shigella infection are gay and bisexual men, and other men who have sex with men (GBMSM). Experts say shigella is “endemic” to these communities, meaning it’s constant and regularly present.
A study in July showed that the spread of the disease through sex grew 15% faster year-over-year between 2015 and 2020 compared to spread through travel, food, or nursery outbreaks.
Emerging evidence suggests that sex may even be the major route of transmission now, but it’s hard to tell when it’s not asked about when patients show up for medical care.
Experts say many people don’t realize Shigella can spread through sex — and that lack of awareness may be fueling infections.
“Many men who have sex with men are unaware of the serious and increasing risk posed by sexually transmitted Shigella,” said Cambridge geneticist Kate Baker, a lead author on the July study.
Becoming a superbug
As shigella spreads rapidly, it’s also becoming harder to manage. The CDC reports that drug-resistant strains of the infection skyrocketed from 0% in 2011 to 8.5% in 2023.
“This disease has gone from being relatively treatable with off-the-shelf drugs to being close to untreatable over the course of the last decade or so,” Baker said.
Why is this happening? Some experts believe “bystander resistance” might be at play. This happens when the wrong antibiotic is used for a pathogen, not only failing to kill the disease, but also accidentally giving the disease the opportunity to develop resistance to that antibiotic.
The CDC reports that most drug-resistant shigella cases affected adult men. The strains of shigella spread through sex are serious. Research shows that those who contracted shigella through sex were hospitalized for four to five days, on average.
“This isn’t just one form of sexually transmissible diarrhea,” Baker told Science Alert.
“This is multiple overlapping variants emerging that are all quickly becoming resistant to the drugs we use to treat them. It’s highly likely that if you contracted your Shigella through sex, you require different treatment to someone who contracted it through travel.”
Treating and preventing shigella
Many cases of shigella resolve on their own within a week, with the help of rest and fluids. But for serious infections, antibiotics might be used not only to shorten the illness but to reduce contagiousness, as well.
This is becoming harder as the strains become more resistant to antiobiotics. That’s why the CDC is urging more attention and development of prevention strategies.
They recommend:
Washing hands, genitals, and anus with soap and water before and after sexual activity. This applies to everyone having anal, oral, and vaginal sex — not just men who have sex with men.
Washing sex toys with soap and water
Using barriers like condoms and dental dams
The California Department of Public Health also adds simply, “don’t have sex with someone who has had diarrhea in the last two weeks.”

Each week, exclusively for Slate Plus members, Prudie discusses a new letter with a fellow Slate colleague. Have a question for Prudie? Submit it here.
Dear Prudence,
My husband has pretty severe anxiety/OCD, mostly concentrated on health and medical situations. Nothing can be a minor illness—it is a sign of something much more serious and sinister. He is on medication for it and he reports that it helps, but I do think he most likely needs a higher dosage or something for more support. He regularly (probably four times a year) becomes convinced he has an STI of some type due to relatively benign symptoms like a rashy dry skin patch or a bruise near his genitals. When this happens, he usually asks me a couple times if I think he could have (fill in the blank STI). I usually just ask if he’s had sex with anyone else or thinks I have, he says no, and I say “then I don’t see how you would have an STI” and refuse to answer him on it again (original advice of his doctor/counselor when starting OCD treatment).
But this last time has been different.
About one week after travelling for work, he asked again about what was definitely an eczema patch. I answered as I usually do, but a couple days later he told me he was really worried about it and was going to contact his doctor to order blood testing for STIs. I said I thought that was unnecessary. He got the tests done and everything was negative, so he went right back to his usual self.
But now I’m convinced he cheated on me on his work trip. Since starting his medication, he has never needed more than a verbal confirmation that he wouldn’t have an STI. I have never thought he would cheat on me, but he did go out with people one night, and I know they all drank quite a lot. When he travels, he normally calls me either before bed or in the morning while I’m getting ready for work and he didn’t this time, instead texting that he was out and then around lunchtime the next day saying it had been a rough night/morning. What would you recommend as the best way to approach him on this? I’m worried he’s going to just explain it away as his OCD being more severe this time and needing more reassurance, but I also think this is a reasonable reaction on my part. I feel like I’m always supporting him through the things he struggles with and the one time I have a concern (that actually has some evidence to it!), it’s just going to get brushed off.
—Now I’m Anxious
Jenée Desmond-Harris: I don’t know why I initially misread this as being about her brother (I truly pulled that out of nowhere) and I was so happy to say “You don’t have to worry about this! It’s not your business.” Now that I have my facts right, things have become a lot heavier. Yeah, this is totally her business.
Lizzie O’Leary: I am kind of stunned by the lack of trust here. And maybe that’s not fair, but it’s wild to be repeatedly asking your spouse if they have had sex with other people, even if most of that is coming from a place of mental illness! I think that is the place these two need to start.
Jenée: Right, if you’re going to have ideas about STIs that don’t have a basis in reality, you may as well take the irrational thinking all the way and imagine that you got them from a toilet seat or something.
I agree with you that the lack of trust is a big problem. And actually, it would be helpful for the letter writer to strip away all the mental health history and ideas about what kind of support she’s owed and how her husband will receive her concerns and focus on the core issue: She thinks her he cheated! And that he’ll lie about it! So maybe the goal is not to get him to take that concern seriously, but to decide what it means for whether she wants to be in this marriage.
Do you think a digital snooping investigation is warranted here? Because I know nobody wants to get divorced based on a weird feeling alone.
Lizzie: I think some counseling is warranted. Digital snooping is so messy, and even if she finds some proof of affair, getting it that way is horrible and upsetting. And puts her on the back foot. I think she needs to tell her spouse how she feels, AND that she is so turned around by all of this that she doesn’t know whether to trust him. It sucks, but I don’t think there is a way to be like “hmm yeah I think you may still be lying though,” without really probing what that means about the marriage.
Jenée: Well, I’m glad there’s one reasonable and mature person in this chat. I’m not sure why I suggested the 19-year-old approach. Counseling would be great because maybe things could be repaired (I know an Esther Perel or Dr. Orna wouldn’t see it as a dealbreaker even if the cheating allegations were confirmed—maybe there’s a better relationship on the other side of this!) and if not, it would be nice to have someone to guide the couple through wrapping things up. Oh, and maybe the therapist would suggest more individual work for the husband, which could lead to a medication adjustment, which could lead to STI worries no longer playing such a big role in this relationship.
Lizzie: Yeah, at the bare minimum, repeated allegations of cheating over random rashes are not a great way to live! Jenée, maybe if I see Dr. Orna in the neighborhood walking her little dog, I should ask her? Obviously I will not, because I am a New Yorker and we mind our own business. But still. LW, this is not about this one-time accusation, it’s about the fact that your marriage needs more support! Dealing with mental illness can be incredibly difficult in a relationship, but I don’t think it’s impossible. You two just need to be able to trust each other. And right now you can’t.
Jenée: Yes, please. Dr. Orna and her dog have enough couples to deal with.
Anyway, letter writer, sorry to pass the buck to a therapist here, but it really is the best way forward. Pretend you never heard me mention snooping. I wish you a future with more trust and fewer suspect rashes.

Generally speaking, people with ADHD tend to have trouble sleeping. But new research suggests that sleep problems might not merely be a symptom of the condition but at the root of what’s causing it, reports the Washington Post. A perspective paper (not a clinical trial) in Frontiers in Psychiatry sees a strong correlation between ADHD and people with dysfunctional circadian rhythms, which govern when we sleep and wake. Physician Brandon Luu and co-author Nicholas Fabiano pull together “convergent” evidence that people with ADHD often run on a significantly later internal schedule: up to 78% show delayed sleep timing, with melatonin kicking in much later than is normal.
“In other words, some people with ADHD may not simply be ‘bad at going to bed,'” observes a post at Proactive Psychiatry. “Their internal clock may actually be shifted later.” The researchers urge clinicians to routinely screen for circadian disruption and use sleep tracking as a cheap, low-risk tool for ADHD. The wider field is moving that way, too: Psychiatrists are probing whether misaligned body clocks underlie conditions from depression to schizophrenia, and testing fixes like morning light therapy, structured wake times, and timed exercise to “phase shift” patients closer to society’s demands, notes the Post. The thinking is that in at least some cases, recalibrating the clock could ease the mind.
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