Posted on Feb 18, 2019, 8 p.m.
An observational study women who had reported drinking more than one diet soda or other kind of artificially sweetened drink were found to have a higher risk of strokes caused by a blood clot; this association was even stronger in obese women and in African-American women, as published in Stroke.
The association between drinking artificially sweetened beverages and risk of specific types of stroke in a large racially diverse group of postmenopausal women were examined in this study; an association between diet drinks and strokes was identified, but as it is an observational study it does not prove cause and effect.
Women who drank two or more artificially sweetened beverages a day were 23% more likely to have a stroke; 31% more likely to have a clot caused stroke; 29% more likely to develop heart disease/fatal or non-fatal heart attack; and 16% more likely to die from any cause than those who drank diet drinks less than once a week or not at all.
Risks were higher for certain women such as a heavy intake of diet drinks, and drinking 2+ drinks a day which more than doubled stroke risks in: those without previous diabetes or heart disease were 2.44 times as likely to have a common type of stroke caused by artery blockage; obese women without previous diabetes or heart disease were 2.03 times as likely to have a clot caused stroke; and African-American women without previous diabetes or heart disease were 3.93 times as likely to have a clot caused clot.
Well meaning to do people often drink low calorie sweetened drinks in an attempt to cut calories, however this research and others have shown that these artificially sweetened beverages may not be harmless and high consumption is associated with higher risk of stroke and heart disease, according to Yasmin Mossavar-Rahmani, Ph.D.
Data from 81,714 postmenopausal women aged 50-79 who participated in the Women’s Health Initiative study tracking health outcomes for on average 11.9 years was analyzed, in which participants reported how much diet drinks, sodas, low calorie, artificially sweetened colas/soda/pop, and fruit drinks they had consumed.
Results may not be generalizable to men or younger women; adjustments were made for various stroke risk factors such as smoking, age, and high blood pressure to obtain the results which are for postmenopausal women. The study was also limited by data on specific artificial sweeteners in drinks not being provided, and the women self reporting drink intake.
A science advisory was issued by the American Heart Association finding that there was inadequate research to conclude that low calorie sweetened beverages do or do not alter risk factors for heart disease and stroke in adults, teens, and children; they recognize diet drinks may help replace high calorie sugary beverages but recommend plain water including carbonated and unsweetened flavored water as the best choices for no calorie drinks.
As long term clinical trial data is not available on the effects of low calorie sweetened drinks and cardiovascular health the best course may be to avoid and limit prolonged use due to their lack of nutritional value and results of observational studies such as this showing association of harm and increased risks.
Materials provided by American Heart Association.
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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 Espeland. Artificially 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