Two or more diet sodas a day increase risk of heart attach or stroke

daniwilford

Anyone have any thoughts on a new study from the American Heart Association and American Stroke Association that diet drinks are increasing your risk of heart disease.
The study had over 80,000 postmenopausal women take part. It found that women who drank 2 or more artificially sweetened beverages each day were 31% more likely to have a clot-based stroke, 29% were more likely to have heart disease, and 16% of women were more likely to die from any type of cause.

MikePTY

I think there is a ton of evidence out there that there are a host of negative effects associated with regular diet soda consumption and people should try to avoid it.

lkpducky

Beverage consumption was assessed by the study subjects' reports - they had to think back over the preceding 3 months and try to remember how much soda they were drinking. Not the most reliable method.
Also, this was an observational study, so they can't really tell cause and effect, only association.
Also, I'm curious what else these women were drinking or eating. They're not rats in cages all fed the same exact diet except for the soda.

MikePTY

lkpducky wrote: »

Beverage consumption was assessed by the study subjects' reports - they had to think back over the preceding 3 months and try to remember how much soda they were drinking. Not the most reliable method.
Also, this was an observational study, so they can't really tell cause and effect, only association.
Also, I'm curious what else these women were drinking or eating. They're not rats in cages all fed the same exact diet except for the soda.

There is sometimes a weird thing here where people try to discredit any sort of scientific study as if nothing means anything. This is not some low quality study put on by a questionable organization. It's a high quality study with a large sample size over a long period of time put on by a reputable organization. The study lasted for 12 years and the end results were CONTROLLED FOR LIFESTYLE FACTORS.

Yes, it is true that is is observational, but "correlation does not necessarily indicate causation" can only go so far. There is a whole host of research observing the link between diet soda consumption and a host of health issues. So either it's really super coincidental, or there is something there.

https://edition.cnn.com/2019/02/14/health/diet-soda-women-stroke-heart-attack/index.html

lkpducky

Not quite "nothing means anything" - and granted, correlation can point out a relationship. Indeed, this is a major study over a long period of time, which would be significant.
Still interested in knowing what else the women were consuming, though.
I'm looking at this part of the abstract: https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023100
"In women with no prior history of cardiovascular disease or diabetes mellitus, high consumption of artificially sweetened beverages (≥2 ASBs/day) was associated with more than a 2-fold increased risk of small artery occlusion ischemic stroke hazard ratio =2.44 (95% confidence interval, 1.47–4.04.) High consumption of ASBs was associated with significantly increased risk of ischemic stroke in women with body mass index ≥30; hazard ratio =2.03 (95% confidence interval, 1.38–2.98)."
Looks like the risks they mention here were both doubled. What were the risks in the folks with low consumption? Does this risk doubling mean a huge number more high consumers will have stroke?

lkpducky

Here's the link to the full article
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.118.023100
I see in Table 1 that a higher proportion of those drinking the most ASB were obese.

lkpducky

Also, look at the cautionary statements here https://caloriecontrol.org/statement-regarding-artificially-sweetened-beverages-and-stroke-coronary-heart-disease-and-all-cause-mortality-in-the-womens-health-initiative/

kimny72

lkpducky wrote: »

Here's the link to the full article
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.118.023100
I see in Table 1 that a higher proportion of those drinking the most ASB were obese.

And that is almost always one of the fatal flaws in "diet drink" surveys - people who are obese often drink a lot of soda, and are told that a great way to lose weight is to switch to diet soda. So they end up drinking a lot of diet soda and being obese. This leads to the correlation of diet soda with obesity, and the correlation of diet soda with the kind of diseases linked to obesity (like heart attack and stroke).

Each artificial sweetener is a different chemical compound. Why would these disparate compounds all have the same negative affects on the body, yet no one can determine why in a lab?

MikePTY

lkpducky wrote: »

Also, look at the cautionary statements here https://caloriecontrol.org/statement-regarding-artificially-sweetened-beverages-and-stroke-coronary-heart-disease-and-all-cause-mortality-in-the-womens-health-initiative/

Important to note that the organization putting out this cautionary statement is the lobbying organization for the diet soda industry.

zeejane03

kimny72 wrote: »

lkpducky wrote: »

Here's the link to the full article
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.118.023100
I see in Table 1 that a higher proportion of those drinking the most ASB were obese.

And that is almost always one of the fatal flaws in "diet drink" surveys - people who are obese often drink a lot of soda, and are told that a great way to lose weight is to switch to diet soda. So they end up drinking a lot of diet soda and being obese. This leads to the correlation of diet soda with obesity, and the correlation of diet soda with the kind of diseases linked to obesity (like heart attack and stroke).

Each artificial sweetener is a different chemical compound. Why would these disparate compounds all have the same negative affects on the body, yet no one can determine why in a lab?

Yep this.

I didn't start using artificial sweeteners/diet soda until I started my active weight loss phase. At that point my health markers were trash/just diagnosed with pre-diabetes. 6ish months later all my health markers had greatly improved, including normalized glucose numbers. I could attribute the health improvements to the diet soda/artificial sweeteners. Or it could be the 50lbs I lost.

Now several years into maintenance I continue to get twice a year blood work done/health markers assessed. They consistently come back good-my heart health markers are excellent, glucose numbers in the 80s etc. I could attribute the continued better health to the 2 cans of diet soda I drink every day or the artificial sweeteners I use in my coffee (which is a different kind of a.s. than what's used in the soda). Or it could be from the lower body weight that I maintain at.

lkpducky

MikePTY wrote: »

lkpducky wrote: »

Also, look at the cautionary statements here https://caloriecontrol.org/statement-regarding-artificially-sweetened-beverages-and-stroke-coronary-heart-disease-and-all-cause-mortality-in-the-womens-health-initiative/

Important to note that the organization putting out this cautionary statement is the lobbying organization for the diet soda industry.

Those limitations were also in the original article itself, so listed by the study authors.

sijomial

As usual these studies are mildly interesting but raise more questions than answers.

• What is the mechanism at play here?
• All diet drinks or is there a stronger correlation between certain sweeteners but not others? (If it's the same for all then that would suggest the actual ingredients not being the cause.)
• Same risk correlation with pre-menopausal women? If not, why not? How about men?
• Dosage? Is one perfectly OK or is one half as risky as two? Is four twice as risky as two or the same as two?
• How about a comparison of risk profiles between drinking two sugar sweetened drinks and two diet drinks?

etc. etc.

It's really important to keep in mind that reporting an unexplained statistical higher risk for a sub-section of the population is very different to stating "two or more diet sodas a day increase risk of heart attack or stroke" - that should be left to the Daily Mail.

RunsWithBees

When it comes to heart health, diet isn’t everything. It would have been enormously helpful to know if any of these women exercised. But of course, they didn’t keep track of that

squirley13

The debate is only of denying logic. Most everyone knows and I know from personal experience that strokes and heart attacks are sequential in the outcome of being dehydrated and that is what causes the blood clotting. Yes, there are other factors but anyone who has a bloodclot had days without drinking enough water. The research of diet sodas being dehydrating as it takes more water to flush the chemicals out of the body has been done since the late 1980’s!!! The fact that people ignore logic is why this study had to prove that drinking diet toxic sodas will cause strokes and heart attacks. Now what could also be made public is that diet sodas cause brain damage and seizures. I had a boss that had her first seizure at work and then found out it was from drinking diet pop consistently! It makes perfect since since the brain is mostly water. https://www.thedailymeal.com/healthy-eating/scary-facts-diet-soda-gallery/slide-15

ladyreva78

squirley13 wrote: »

The debate is only of denying logic. Most everyone knows and I know from personal experience that strokes and heart attacks are sequential in the outcome of being dehydrated and that is what causes the blood clotting. Yes, there are other factors but anyone who has a bloodclot had days without drinking enough water. The research of diet sodas being dehydrating as it takes more water to flush the chemicals out of the body has been done since the late 1980’s!!! The fact that people ignore logic is why this study had to prove that drinking diet toxic sodas will cause strokes and heart attacks. Now what could also be made public is that diet sodas cause brain damage and seizures. I had a boss that had her first seizure at work and then found out it was from drinking diet pop consistently! It makes perfect since since the brain is mostly water. https://www.thedailymeal.com/healthy-eating/scary-facts-diet-soda-gallery/slide-15

:huh:

That's the first time I hear of dehydration being the leading cause of strokes.

I guess you should contact all those med schools teaching doctors something else (there's a long list I trust a whole lot more at the mayo clinic then whatever blog you've dug up) to tell them they're wrong...


I also wouldn't trust a blog specialized in recipes for information on as serious a medical condition as strokes. They can cook. They should stay the *kitten* away from trying to spread misinformation on such a serious level.

edit: typos...

pinuplove

ladyreva78 wrote: »

squirley13 wrote: »

The debate is only of denying logic. Most everyone knows and I know from personal experience that strokes and heart attacks are sequential in the outcome of being dehydrated and that is what causes the blood clotting. Yes, there are other factors but anyone who has a bloodclot had days without drinking enough water. The research of diet sodas being dehydrating as it takes more water to flush the chemicals out of the body has been done since the late 1980’s!!! The fact that people ignore logic is why this study had to prove that drinking diet toxic sodas will cause strokes and heart attacks. Now what could also be made public is that diet sodas cause brain damage and seizures. I had a boss that had her first seizure at work and then found out it was from drinking diet pop consistently! It makes perfect since since the brain is mostly water. https://www.thedailymeal.com/healthy-eating/scary-facts-diet-soda-gallery/slide-15

:blink:

That's the first time I hear of dehydration being the leading cause of strokes.

I guess you should contact all those med schools teaching doctors something else (there's a long list I trust a whole lot more at the mayo clinic then whatever blog you've dug up) to tell them they're wrong...


I also wouldn't trust a blog specialized in recipes for information on as serious a medical condition as strokes. They can cook. They should stay the *kitten* away from trying to spread misinformation on such a serious level.

I'll be sure to tell everyone in my immediate family who has suffered a blood clot (genetic disorder) that if only they'd have drunk more water, they'd be fine!

I find the study in the original post intriguing, but that particular post is almost insultingly wrong to anyone who has been personally affected by a blood clot or stroke.

whatalazyidiot

I think anything consumed in excess could lead to negative health consequences, but I'm not a doctor or a scientist. I'm still going to drink Diet Soda because it keeps me from eating my weight in donuts and fries.

magnusthenerd

MikePTY wrote: »

lkpducky wrote: »

Beverage consumption was assessed by the study subjects' reports - they had to think back over the preceding 3 months and try to remember how much soda they were drinking. Not the most reliable method.
Also, this was an observational study, so they can't really tell cause and effect, only association.
Also, I'm curious what else these women were drinking or eating. They're not rats in cages all fed the same exact diet except for the soda.

There is sometimes a weird thing here where people try to discredit any sort of scientific study as if nothing means anything. This is not some low quality study put on by a questionable organization. It's a high quality study with a large sample size over a long period of time put on by a reputable organization. The study lasted for 12 years and the end results were CONTROLLED FOR LIFESTYLE FACTORS.

Yes, it is true that is is observational, but "correlation does not necessarily indicate causation" can only go so far. There is a whole host of research observing the link between diet soda consumption and a host of health issues. So either it's really super coincidental, or there is something there.

https://edition.cnn.com/2019/02/14/health/diet-soda-women-stroke-heart-attack/index.html

There's a huge limitation on any epidemiology study as to what conclusions can be drawn.
Just consider, epidemiology studies will strongly suggest human metabolism is wildly varying as obese individuals report eating and moving similar to their lighter peers. Particularly when using individual recall data.

InsertFunnyUsernameHere

correlation =/= causation

I didn't see anything in the study that showed which artificial sweeteners were being blamed, nor what chemical processes were suspected in making stroke risk more heightened.

lkpducky

And artificial sweetener use was captured only if it was from sodas or fruit drinks, not when added to tea or coffee.
Interesting that only 5% of the group was in the highest consuming group.
"Frequency was described in 9 categories: never or less than once per month (reference), 1 to 3 per month, 1 per week, 2 to 4 per week, 5 to 6 per week, 1 per day, 2 to 3 per day, 4 to 5 per day, ≥6 per day."
How are you going to remember how much you drank when thinking back over 3 months? and consumption data were only available for that 3-month period (the year 3 questionnaire), not for all the years of the study. A lot could have happened in the rest of the follow-up period.

mph323

One of the problems with this type of hype is that it's one study. Even if it was conducted to rigorous standards (it's not, the methodology is deeply flawed), it would require other rigorously conducted corroborative studies to pose a serious challenge to 50 years of artificial sweetener research. Particularly, as @sijomial pointed out, since diet soda contains numerous different types of sweeteners, and any other sweetener use outside of diet soda was not included.

It's similar to a study I saw awhile back where eating an ounce of walnuts mid-morning had a positive effect on appetite and corrolated with weight loss. Never mind that nothing but walnuts was used in the study (do almonds have the same effect? Would eating the equivalent amount of avocado work? Would eating anything mid-afternoon instead of morning make a difference?) The study was well-controlled, and the weight-loss appeared legit over the short period of time the study was conducted, but by limiting the snack to nothing but walnuts, it's obvious the study was conducted to persuade people to eat more walnuts.

In the same way, the diet soda study was obviously designed to persuade people to drink less diet soda.