Diet soft drinks may increase cardiovascular risk

A paper presented at the American College of Cardiology 2014 session says that diet soft drinks may play a role in increasing the risk of heart attacks and death in women. Dr. A. Vyas and his team did research on postmenopausal women who drank artificially sweetened soft drinks.

Previous studies have linked drinking beverages sweetened with artificial sweeteners to weight gain. They also increase the risk of developing metabolic syndrome. People with metabolic syndrome have a higher incidence of developing type II diabetes and cardiovascular diseases.

Sugar free via Shutterstock

Sugar free via Shutterstock

Research is ongoing to try to determine the mechanism that causes artificial sweeteners to cause weight gain, obesity, diabetes and other diseases. In animal studies, rats fed artificial sweeteners ate more than control animals. Artificial sweeteners may slow metabolism and cause fewer calories to be burned than normal. Artificial sweeteners may cause the body to lay down more belly fat. There are other hypothesis as well to attempt to explain this that are currently under investigation.

The study that Vyas, et al., did looked at data from about 60,000 women who were around 60 years old. These women were part of an observational study called the Women’s Health Initiative. They completed questionnaires that reported on their consumption of diet beverages. None of the women enrolled in the study had any previous history of cardiovascular disease.

The women were categorized into groups based on how many diet drinks they drank: 0-3 diet drinks per month, 1-4 diet beverages weekly, 5-7 diet drinks per week or 2 or more per day. Most of the women were in the 0-3 diet drinks per month range. Investigators looked to see how many or these women developed any of the following over time: heart attack, stroke, needed a revascularization surgery done, developed other cardiovascular disease, peripheral arterial disease, or death from a cardiovascular disease.

The women who drank two or more diet drinks per day had an increased incidence of cardiovascular disease compared with the women who drank less. But those women who did drink 2 or more diet drinks per day also tended to be overweight, smoke and have some other risk factors, as well.

Though drinking diet drinks could have contributed to their obesity and increased calorie intake. Comparing women who drank two or more diet sodas per day with those who rarely drank them, women who drank more had about a 30% increase in risk of having a cardiovascular event. This doesn’t conclusively say that drinking diet sodas will cause a heart attack or stroke. But, added to previous research showing that artificially sweetened beverages contribute to developing other diseases and increase health risks, it is something that bears watching and needs further research.

In a previous article, I wrote about the effects of added sugar in foods and beverages causing deleterious health effects. So, what should you drink? A few suggestions.

Water is always a good go-to beverage. It’s cheap and readily available. You can always add something to it like lemon juice or lemon or lime slices for a little flavor.

Alternatives include things like a sparkling water cocktail. 10 ounces of sparkling water with about 2 ounces of unsweetened juice (pineapple, apple, orange – all are naturally sweet enough to give this some flavor and sugar). Depending on the juice used, this is about a 60 calorie beverage. Unsweetened iced tea or iced coffee (or hot tea or coffee) are other alternatives.

Also, there are a number of beverages on the market that are made from juice combinations (lemon+apple, kiwi+papaya, and many other varieties) that don’t use any artificial sweeteners or added sugars. Check the label on the beverage to see how many calories are present.

With the possible risks from excessive added sugar and artificial sweeteners, this might be a good time to try some alternative beverages that could be more healthful in the long term. If you’d like to get an idea of how many calories are present in common beverages, you can take a look at this link.


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • emjayay

    Almost all diet soft drinks are sweetened with aspartame. A few, like Waist Watchers, are sweetened with sucralose. Maybe not the same effect. Also a lot of diet and regular soft drinks are colas, which have their own suspect health effects besides the caffeine. But it doesn’t seem that any of these studies have been able to separate the various other health factors. If I’m trying to cut calories way down having a diet soda helps and I have no urge to eat a Snickers afterwards.

    There is also some concern with the potassium phosphate or whatever it is in all sodas.

    But the soft drink/pop/coke map is more fun to think about.

  • emjayay

    Bleaach.

  • http://www.rebeccamorn.com/mind BeccaM

    That’s what I like to drink. My favorite is Rooibos, which also doesn’t have caffeine, so I can safely drink it well into the evening hours. There’s a very slight natural sweetness to it.

  • http://www.rebeccamorn.com/mind BeccaM

    Yeah! Doctors and scientists — what the frick do they know, what with their fancy PhDs and research and fancy-schmancy ‘scientific method’? There’s no bell-curve of expected outcomes and tabulated data, just unrelated examples that need no correlation, so there’s no point in not drinking, eating, and smoking to excess because one random commenter’s great-uncle happened to live a long time as a stinking, bloated walrus of a man. Individual anecdotes and exceptions are all the science we need, right?

  • Monophylos Fortikos

    I just love how idiotic responses like this of Eva’s practically write themselves. You could do the same for anything. “Drinking denatured alcohol is bad for you? What should people drink instead, regular alcohol and get whiskey dick? Too much of anything is bad for you anyway. And my grandpa’s second cousin, he drank denatured alcohol from the hardware store and smoked a crate of cigars every day and he lived to a ripe old age!”

  • ninjakiller

    I was going to say this. Just drink unsweetened iced tea. It’s Tea!

  • http://www.rebeccamorn.com/mind BeccaM

    Just my own theory, but I suspect we’ll find neurological and hormonal links between the consumption of low-calorie foods and drinks and obesity.

    Simple really: You drink a diet soda. It tastes sweet — that’s what your brain says. But your stomach and metabolic systems say, “There’s almost no energy here. Eat and drink more. Lots more.” In other words, the mechanism of appetite becomes skewed and eventually decoupled from caloric intake.

    Whereas someone with a normal appetite might, upon eating a burger and a plate of fries, have the natural feeling of being full and fully-fueled from the starches, fats, sugars, and protein, the person whose brain and metabolism have been screwed up with diet drinks and foods will have a body that’s been habituated to not trust the sensations of taste or of being ‘full.’ Because after all, it’s been trained to know that even though things taste sweet or fatty or whatever, a full stomach doesn’t necessarily mean energy has been provided.

  • EvaBrain

    Diet sodas increase the risk of heart disease in people? What people should do instead, drink regular soda and get diabetes? Maybe people should just drink water. But I have read that the consumption of too much water is bad for your health. Bottom line, most things can kill you if you consume too much of them. And the obsession many Americans seem to have with their health is a sign of narcissism. Worrying about your health can kill you, too. I have known several people who were obsessed with their health and they died young. My grandfather’s brother smoked three packs of unfiltered Camel cigarettes every day, drank too much, never exercised, was quite overweight and lived to be 93. Further you can read more at http://bit.ly/1hx8CTC

  • bejammin075

    You are right about correlation & causality, however, when observations match with what you expect based on having an understanding of the underlying mechanisms of how everything works, the two go well together. It is expected that diet soda would block the metabolism from burning fat (see one of my comments above), so then when you show that in the real world, diet soda drinkers are fatter, it strengthens the proper understanding.

  • bejammin075

    For literally hundreds of millions of years during our evolution, there were no artificial sweeteners. When an animal tastes something sweet in it’s mouth, there isn’t just a high probability, but a 100.00% guarantee that sugars will be going into the stomach within seconds. Think about how many times this process has been repeated in all the lifetimes that lead up to you being you. It’s clear from how our metabolism works that fat is burned when sugar is not around, and sugar is preferentially burned when sugar is around. It totally makes sense that tasting a super sweet beverage tells your body “If you were burning fat, STOP. If you were just about to start burning fat, DON’T”. It’s not perplexing at all, it totally makes sense from the correct frame of view.

  • bejammin075

    My personal observation is that I only ever see overweight & lethargic people with large spare-tire bellies drinking diet soda.

  • sck5

    I am no diet expert but there is an obvious statistical inference problem here. You are assuming that causality runs from artificial sweeteners to obesity. It is equally possible that obese people are the ones who choose to drink diet soft drinks. Correlation does not equal causality.

  • bkmn

    I’ve noticed for a long time that the people drinking multiple cans of diet soda tend to be overweight and their weight is carried in their midsection. I’ve also seen many of these same people downing a snickers bar with their diet soda, as though the calories saved by drinking a diet are immediately replaced by a very calorie dense product.

    These days I am avoiding most juices because it is still a big chunk of calories with little to no fiber to slow the absorption of the sugars. My first beverage of choice in the morning is sun brewed tea with no sugar. I don’t have any artificial sweetener in the house.

    I am also wary of any juice beverage that claims to be 100% juice but the majority of the juice is either white grape or apple. Again, little fiber but lots of sugar. The arsenic in apple juice is another reason to stay clear of that (Consumer Reports a little over a year ago).

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