Two or More Diet Drinks Per Day Linked to Greater Risk of Stroke

MedicalResearch.com Interview with:

Yasmin Mossavar-Rahmani, Ph.D., RD Associate Professor Division of Health Promotion & Nutrition Research Dept. of Epidemiology & Population Health Albert Einstein College of Medicine Bronx, NY 10461

Dr. Mossavar-Rahmani

Yasmin Mossavar-Rahmani, Ph.D., RD
Associate Professor
Division of Health Promotion & Nutrition Research
Dept. of Epidemiology & Population Health
Albert Einstein College of Medicine
Bronx, NY 10461

MedicalResearch.com: What is the background for this study?

Response: This is the largest study of the effects of artificially sweetened beverages (ASB) in older women from the Women’s Health Initiative Observational Study which started in 1993 and still continues to follow the women. A prior paper indicated excess risk of cardiovascular disease with high consumption of ASBs, but cardiovascular disease was a composite endpoint combining stroke, coronary heart disease, heart failure, revascularization and peripheral arterial disease.  Our study focusses on stroke by itself and with different subtypes of stroke. We define high consumption as two or more 12 fl oz. of diet drinks (diet soda or fruit drinks) per day and low consumption as no or less than one drink per week.

MedicalResearch.com: What are the main findings? 

Response: Overall high consumers compared to low or no consumers of ASB were:

  • 23 percent more likely to have stroke (fatal and non-fatal)
  • 31 percent more likely to have the type of stroke from a clot in the brain or ischemic stroke
  • 29 percent more likely to develop heart disease (fatal or non-fatal)
  • 16 percent more likely to die from any cause

A novel finding of ours was the the risk of artificially sweetened beverages appears to be mostly for a particular subtype- small vessel occlusion.  We also found risk of ASBs with coronary heart disease and all-cause mortality. We do not know if this effect is found in younger women and of course our study did not include men.

Our study adds to the mounting evidence that artificially sweetened beverages may have adverse effects. 

MedicalResearch.com: What should readers take away from your report?

Response: That it is not a good idea to drink an excess of artificially sweetened beverages. On the other hand, women should not panic if they have an occasional diet soda. While the risk of stroke is higher in high consumers relative to non-consumers, the actual absolute risk is small. We found an incidence rate of about 2 per 1,000 people per year.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We need to understand the underlying mechanisms related to these results. These could be genetic, related to the gut microbiome or other factors that have yet to be investigated.

The senior author Dr. Sylvia Wassertheil-Smoller is the Principal Investigator of the New York City site of the Women’s Health Initiative

Citation: Yasmin Mossavar-Rahmani, Victor Kamensky, JoAnn E. Manson, Brian Silver, Stephen R. Rapp, Bernhard Haring, Shirley A.A. Beresford, Linda Snetselaar, Sylvia Wassertheil-Smoller, Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, Nancy Geller, Garnet Anderson, Ross Prentice, Andrea LaCroix, Charles Kooperberg, Barbara V. Howard, Marcia L. Stefanick, Rebecca Jackson, Cynthia A. Thomson, Jean Wactawski-Wende, Marian Limacher, Jennifer Robinson, Lewis Kuller, Sally Shumaker, Robert Brunner, Karen L. Margolis, Mark EspelandArtificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women’s Health Initiative.Stroke, 2019; DOI: 10.1161/STROKEAHA.118.023100 

Feb 21, 2019 @ 3:35 am

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1 thought on “Two or More Diet Drinks Per Day Linked to Greater Risk of Stroke

  1. According to the International Sweeteners Association, “[c]urrent evidence, including recent reviews commissioned by the World Health Organization (WHO), indicates that there is no evidence that low calorie sweeteners could cause or increase the risk of cardiovascular disease contrary to what the study published in Stroke suggests.” See full statement here: https://www.sweeteners.org/category/32/news/408/no-evidence-that-low-calorie-sweeteners-could-cause-or-increase-the-risk-of-cardiovascular-disease

    The fact is, low- and no-calorie sweeteners have been deemed safe by regulatory bodies around the world, and there is a substantial body of research that shows these sweeteners are a useful tool for helping people reduce sugar consumption. We support the WHO’s call for people to reduce sugar in their diets and we are doing our part by creating innovative beverages with less sugar or zero sugar, clear calorie labeling, responsible marketing practices and smaller package sizes.

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