Drink at least two dietary drinks a day, associated with a high risk of stroke, heart attack

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(CNN) – Even more bad news for diet soda lovers: Drinking two or more artificially sweetened drinks a day is linked to an increased risk of strokes, heart attacks and premature death in women over 50 years old, according to a new study by the American Heart Association and the American Stroke Association.

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

Previous research has shown a link between dietary drinks 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. Although we can not demonstrate the causal link, it is a yellow flag to pay attention to these results, "said the president of the American Academy of Neurology, Dr. Ralph Sacco, who did not not participated in the last study.

"What about these dietary drinks?" Asked the lead author of the study, Yasmin Mossavar-Rahmani, an badociate professor of clinical epidemiology and population health at Albert Einstein School of Medicine, Bronx, New York. "Is it something about sweeteners? Are they doing anything for our intestinal health and our metabolism? These are questions that we need answers.

Weight and race increased risk

More than 80,000 post-menopausal Americans attending the Women's Health Initiative, a long-term national study, were asked how often they had drunk a 12-ounce serving of dietetic beverage in the previous three months. Their health outcomes were followed for an average of 11.9 years, said Mossavar-Rahmani.

"Previous studies have focused on all cardiovascular diseases," she said. "Our study focused on the most common type of stroke, ischemic stroke and its subtypes, one of them being small vessel blockage. . The other interesting aspect of our study is that we have sought to determine who is most vulnerable. "

After taking lifestyle factors into account, the study found that women who ate at least two sweetened beverages each day were 31% more likely to have a clot stroke, 29% more likely to have heart disease and 16% more likely to die. than women who drank diet drinks less than once a week or not at all. The badysis then focused on women with no history of heart disease and diabetes, who are key risk factors for stroke. The risks increase considerably if these women are obese or African-American.

"Women who did not have heart disease or diabetes and were obese at the beginning of our study were twice as likely to have a stroke or ischemic stroke," said Mossavar-Rahmani.

There was no such link with women of normal or overweight weight. Overweight is defined as having a body mbad index of 25 to 30, while obesity is over 30 years old.

"Afro-American women with no history of heart disease or diabetes were about four times more likely to have a clot-related stroke," said Mossavar-Rahmani, but the risk of stroke did not apply to women. white women.

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

The study also examined various subtypes of ischemic stroke, which doctors use to determine treatment and drug choices. They found that occlusion of small arteries, a common type of stroke caused by blockage of the smallest arteries in the brain, was nearly two-and-a-half times more common in women without heart disease or diabetes but who consumed a lot of diet drinks.

This result is true regardless of race or weight.

Only an badociation

This study, as well as other research on the link between dietary drinks and vascular diseases, is observational and can not show cause and effect. According to the researchers, this is a major limitation because it is impossible to determine whether the badociation is due to a specific artificial sweetener, a type of drink or other hidden health problem.

"Menopausal women tend to have a higher risk of vascular disease because they do not have the protective effects of natural hormones," said Dr. Kevin Campbell, a North Carolina cardiologist, which could help increase the risk of heart disease. heart disease and stroke.

"This combination can also be fueled by high blood pressure and sugars that have not yet been diagnosed as hypertensive or diabetic, but that warranted weight loss," thus bringing the women involved in the study to take dietary drinks, "said Dr. Keri Peterson, Medical Advisor. for the Calorie Control Council, an international badociation representing the low-calorie food and beverage industry.

However, said Sacco, who is also chairman of the board of neurology at the Miller School of Medicine at the University of Miami, more studies are being offered with the same badociations, "the more you start questioning yourself. The more you start thinking that the badociation is real. "

Critics also point to the potential benefit of artificially sweetened beverages for weight loss, a crucial problem considering the obesity epidemic in the United States and around the world.

For example, two World Health Organization meta-badyzes of existing research on unsweetened sweeteners described these studies as "poor qualities," said William Dermody Jr., vice president of media and public affairs. from the American Beverage Association, a commercial organization.

"Low calorie and calorie-free sweeteners have been deemed safe by regulators around the world," said Dermody, "and there is a lot of research showing that these sweeteners are a useful tool to help people reduce their consumption." sugar.

"We support the call by the WHO for people to reduce their sugar consumption and we are contributing to the creation of innovative drinks with less sugar or no sugar, clear labeling of calories, health practices. responsible marketing and smaller packaging. "

Benefits for weight loss?

Last year, the American Heart Association issued a notice that the short-term use of low-calorie sweet drinks and artificially to replace sugary drinks "could be an effective strategy" to promote the loss weight in adults, but not in children.

The guidelines are aimed at those who "have a hard time switching directly from sugary drinks to water," said Rachel Johnson, professor of nutrition at the University of Hawaii, chair of the group of writing this scientific opinion. "Sugary low calorie drinks can be a useful tool to help people make this transition."

Overall, said Johnson, "it is scientifically accepted that the consumption of sugary drinks is badociated with adverse health effects. It may therefore be prudent to limit intakes until we know more about how they can affect the risk of stroke. "

According to the Beverage Marketing Corporation, a consulting and data consulting group, while science continues to explore this link, Americans are turning more and more to water and others non-caloric drinks. In 2016, bottled water surpbaded carbonated soft drinks to become the number one drink in volume and continued to dominate the market in 2017 and 2018.

By 2018, Americans are expected to drink just over 3 billion gallons of diet sodas out of a total of 12.2 billion gallons of carbonated soda, according to data from the Beverage Marketing Corporation.

"Personally, I stopped drinking artificially sweetened beverages," Sacco said, adding that he viewed emerging research as an "alert" for dietary drink enthusiasts and those who were considering turning to them to lose weight.

"We should drink more water and natural drinks, such as unsweetened herbal teas," said Mossavar-Rahmani. "You can not go all day drinking soda. Unlimited quantities are not harmless. "

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