Diet Soda, Friend or Foe

I have always believed that diet sodas are fine. After all, they just contain sugar substitutes which have been around for decades plus there are no calories in every serving. It’s a weight loss bonanza that should cut down heart disease and stroke, right?

A new study from Stroke, 2019;50:555–562 followed women from the Women’s Health Initiative Study to discern whether or not diet sodas were harmful.

Women were assessed for a period of 3 months regarding their diet soda intake and were then followed for a period of 12 years. 82,000 women were studied between the ages of 55-79 and 64% had less than 1 diet soda per week as opposed 5.1% who had 2 diet soda or more a day.

After controlling for other variables, women who drank 2 or more diet sodas per week had a significantly greater number of strokes, heart disease and over all mortality.

In a previous Women’s Health Initiative (WHI) study, consumption of ≥2 servings of diet sodas a day was correlated with a 30% increase in a composite of cardiovascular events.

In the Framingham Offspring cohort, diet soda consumption, but not consumption of sugar-sweetened beverages, was associated with an increased risk for both stroke and dementia.

In the Nurses’ Health Study, just the opposite was seen; sweetened beverages, but not diet sodas were associated with coronary heart disease. 

Data from the Northern Manhattan Study supported an association of consumption of diet sodas with increased risk of cardiovascular events (stroke, myocardial infarction [MI], and vascular mortality).

Drs. Rx Is this definitely cause and effect? No. This is an observational study that shows an association. Since diet sodas do very little for weight reduction, it is prudent to consume less rather than more. These sodas probably increase the absorption of sugar by an unknown mechanism which leads to strokes and heart disease. The most prudent advice would be to limit the consumption of both sweetened beverages AND diet sodas as well. Stick with water or carbonated water. It’s boring but boring might buy you some years!


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