Greater Diet Drink Consumption Heightens Stroke Risk in Postmenopausal Women

While diet soft drinks may seem like a healthier option, the effects of the drinks given the amount of artificial sugar and flavorings haven’t yet been fully studied. Researchers recently sought to evaluate the association between self-reported consumption of artificially sweetened beverages (ASBs) with stroke and its subtypes, coronary heart disease, and all-cause mortality in postmenopausal US women.

The study enrolled more than 81,000 women from the Women’s Health Initiative. Participants were enrolled from 1993 to 1998 and were aged 50 to 79 years at baseline. Three years into the study, women answered questions about how many diet drinks—including low-calorie sodas and fruit beverages that contain artificial sweeteners—that they had consumed within the past 3 months.

The study had a mean follow up duration of 11.9 years. After the follow-up visit, the study authors found that women who drank 2 or more artificially sweetened drinks per day had a 23% higher risk of having any type of stroke, and a 31% increased risk of having a stroke due to clotting in brain blood vessels, compared with women who reported drinking fewer than 1 beverage per week.

In general, most participants (64.1%) infrequently consumed (never or less than 1 beverage per week) ASBs, with only 5.1% consuming ≥2 ASB/day. For women who did consume 2 or more ASBs per day, the risk of all stroke was 1.23 (95% CI, 1.02-1.47), 1.31 (1.06-1.63) for ischemic stroke; 1.29 (1.11-1.51) for coronary heart disease; and 1.16 (1.07-1.47) for all-cause mortality.

Importantly, even in women with no prior history of cardiovascular disease or diabetes, a greater consumption of ASB was associated with a more than 2-fold increased risk of small artery occlusion ischemic stroke (hazard ratio, 2.44 [95% CI, 1.47-4.04).]) This increased risk is worrisome in particular, because these strokes were in smaller blood vessels in the brain where repeated events have been shown in previous studies to have potential to lead to dementia.

"Our research and other observational studies have shown that artificially sweetened beverages may not be harmless and high consumption is associated with a higher risk of stroke and heart disease,” Yasmin Mossavar-Rahmani, PhD, lead author of the study and associate professor of clinical epidemiology and population health at the Albert Einstein College of Medicine, said in a statement.

The study authors concluded that future studies should be completed in order to identify which artificial sweeteners might be more or less associated with stroke; however, these new findings add to the potentially harmful association of consuming high quantities of ASB with poor health outcomes.

“We don’t know specifically what types of artificially sweetened beverages they were consuming, so we don’t know which artificial sweeteners may be harmful and which may be harmless,” Mossavar-Rahmani explained.

Reference

Mossavar-Rahmani Y, Kamensky V, Manson JE, et al. Artificially sweetened beverages and stroke, coronoary heart disease, and all-cause mortality in the Women’s Health Initiative [Published online February 14, 2019]. Stroke. doi.org/10.1161/STROKEAHA.118.023100.