Drinking Two Or More Diet Beverages A Day Linked To High Risk Of Stroke, Heart Attacks

The risks were highest for women with no history of heart disease or diabetes and women who were obese or African-American.

Nearly half of US adults have cardiovascular disease, study says.

Previous research has shown a link between diet beverages and stroke, dementia, Type 2 diabetes, obesity and metabolic syndrome, which can lead to heart disease and diabetes.

"This is another confirmatory study showing a relationship between artificially sweetened beverages and vascular risks. While we cannot show causation, this is a yellow flag to pay attention to these findings," said American Academy of Neurology President Dr. Ralph Sacco, who was not involved in the latest study.

"What is it about these diet drinks?" asked lead study author Yasmin Mossavar-Rahmani, an associate professor of clinical epidemiology and population health at the Albert Einstein College of Medicine in the Bronx, New York. "Is it something about the sweeteners? Are they doing something to our gut health and metabolism? These are questions we need answered."

Weight and race increased risk

More than 80,000 postmenopausal US women participating in the Women's Health Initiative, a long-term national study, were asked how often they drank one 12-fluid-ounce serving of diet beverage over the previous three months. Their health outcomes were tracked for an average of 11.9 years, Mossavar-Rahmani said.

"Previous studies have focused on the bigger picture of cardiovascular disease," she said. "Our study focused on the most common type of stroke, ischemic stroke and its subtypes, one of which was small-vessel blockage. The other interesting thing about our study is that we looked at who is more vulnerable."
After controlling for lifestyle factors, the study found that women who consumed two or more artificially sweetened beverages each day were 31% more likely to have a clot-based stroke, 29% more likely to have heart disease and 16% more likely to die from any cause than women who drank diet beverages less than once a week or not at all.

The analysis then looked at women with no history of heart disease and diabetes, which are key risk factors for stroke. The risks rose dramatically if those women were obese or African-American.

"Women who, at the onset of our study, didn't have any heart disease or diabetes and were obese, were twice as likely to have a clot-based or ischemic stroke," Mossavar-Rahmani said.

There was no such stroke linkage to women who were of normal weight or overweight. Overweight is defined as having a body mass index of 25 to 30, while obesity is over 30.

"African-American women without a previous history of heart or diabetes were about four times as likely to have a clot-based stroke," Mossavar-Rahmani said, but that stroke risk didn't apply to white women.

"In white women, the risks were different," she said. "They were 1.3 times as likely to have coronary heart disease."

The study also looked at various subtypes of ischemic stroke, which doctors use to determine treatment and medication choices. They found that small-artery occlusion, a common type of stroke caused by blockage of the smallest arteries inside the brain, was nearly 2½ times more common in women who had no heart disease or diabetes but were heavy consumers of diet drinks.

This result held true regardless of race or weight.

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