Diet drinks are often posed as the answer to helping us reduce weight but there is a new study suggesting they might pose a risk for post-menopausal women. A recent study published in Stroke, which is a journal of the American Heart Association is claiming that women over the age of 50 who are consuming an artificially sweetened drink every day are significantly lore likely to suffer a heart attack, stroke or even death.
The conclusion from such a study might seem staggering given that diet drinks are generally seen as a means by which we can be hydrated without piling on the pounds. Weight gain is a significant concern for many post-menopausal women and the use of diet drinks in this age group is very popular. The other benefits of diet sodas for some are that they help to maintain alertness and a feeling of energy. It seems though that in post-menopausal women at least the opposite situation might be the case. It is important not to lose perspective with such a study but it does pose some interesting findings. The women according to this study with the highest risk of stroke are actually those with no previous record or history of heart disease, the obese and are African-Americans.
The Study
In this study 81,714 women between the ages of 50 and 79 were assessed for nearly 12 years in this study which began in the mid to late 90’s. The study was part of the Women’s Health Initiative Observational Study. In this survey of health, a serving of diet drink was 355ml. The women in the study were assumed to be post-menopausal.
After three years into the study, the women were asked questions regarding the amount of diet drink consumed which included how much diet soda and fruit beverages were drunk, in the last three months. Based on the findings of that follow-up study, women who drank 2 or more artificially sweetened drinks per day had a 23% higher risk of having any type of stroke. There was also 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.
It has to be borne in mind about this type of study that all the women participating have been reporting their own information and relies heavily on how good their memory is. It also assumes that all women in the study are post-menopausal. We have no idea of the nature of the sweetened drinks so tea, coffee and even other products might be included. It would be difficult from this study to link a particular drink to a particular outcome like a stroke or a heart complaint.
The other aspect is that being an observational study, there is no control directly over the amounts of beverage consumed, the timings, the types of food consumed at the same time. Only associations can ever be established although there is sufficiently large numbers of women involved in the study to add statistical weight to various findings. It’s worth noting that they were only asked once about their drinking of diet products so there was no tracking over the twelve years. If there had been continued monitoring along with their health status over the twelve years, it might have generated a time-based assessment of heart health relative to diet.
What has to be born in mind at the outset is that this type of beverage is not the major reason or cause for heart disease. Just remember that other studies show that people who are obese and live off a poor diet tend to drink artificially sweetened drinks. We don’t know either if an association was made with diabetes although that should have been covered in the general survey, or if the women had undiagnosed diabetes. There could also be other underlying health conditions which have not been recognised.
Outcomes
Yasmin Mossavar-Rahmani, the lead author of the study and associate professor of clinical epidemiology and population health at the Albert EinsteinCollege of Medicine in the Bronx, New York, is quoted from the press release as saying:-
“Many well-meaning people, especially those who are overweight or obese, drink low-calorie sweetened drinks to cut calories in their diet.”
“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.”
There are was no assessment of the type of artificial sweeteners in the diet drinks but Dr Mossavar-Rahmani stated:-
“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.”
The American Heart Association has published some advisory information on drinking diet or low-calorie drinks. They highlight the fact that there is little or inadequate levels of scientific research to conclude that low-calorie sweetened beverages do or do not affect the risk of heart disease and stroke. From their point of view, water is the best choice compared to a no-calorie beverage.
Dr Rachel Johnson, the professor of nutrition emeritus at the University of Vermont and chairwoman of the writing group for the American Heart Association’s science advisory, Low-Calorie Sweetened Beverages And Cardiometabolic Health, said:
“Unfortunately, current research simply does not provide enough evidence to distinguish between the effects of different low-calorie sweeteners on heart and brain health.
“This study adds to the evidence that limiting use of diet beverages is the most prudent thing to do for your health.”
Whilst we should be cautious about how we interpret the evidence resented by this study it does raise interesting questions about the consumption of diet drinks by post-menopausal women and the health risks that may be associated with this.
Reference
Yasmin Mossavar-Rahmani, Victor Kamensky, JoAnn E. Manson, Brian Silver, Stephen R. Rapp, Bernhard Haring, Shirley A.A. Beresford, Linda Snetselaar, Sylvia Wassertheil-Smoller, Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, Nancy Geller, Garnet Anderson, Ross Prentice, Andrea LaCroix, Charles Kooperberg, Barbara V. Howard, Marcia L. Stefanick, Rebecca Jackson, Cynthia A. Thomson, Jean Wactawski-Wende, Marian Limacher, Jennifer Robinson, Lewis Kuller, Sally Shumaker, Robert Brunner, Karen L. Margolis, Mark Espeland. (2019) Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women’s Health Initiative. Stroke, (Article) DOI: 10.1161/STROKEAHA.118.023100
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