Soda and strokes linked

Having at least one diet drink a day increased the risk compared to consuming less than one diet drink a week the study found

As a result of the burgeoning war on sugar, more people are turning to artificially sweetened foods and drinks as "healthful" alternatives.

"After adjustments for age, sex, education (for analysis of dementia), calorific intake, diet quality, physical activity and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischaemic stroke, all-cause dementia and Alzheimer's disease dementia", the co-authors write.

However, experts and health charities warned against reading too much into the new findings reported in Stroke.

The latest data from the Framingham Heart Study suggests that people who frequently drink sodas and fruit juices are more likely to have poorer memory as well as smaller overall brain volumes.

"Because our study was observational, we are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to consume diet beverages", Pase said. Many individuals trying to manage their obesity and diabetes often include foods and beverages containing no- and low-calorie sweeteners in their diets as a way to manage their condition.

4,000 Framingham residents 30 or older were monitored for the study.

Researchers analyzed the self-reported diets of two sets of people participating in the Framingham Heart Study, the longest-running heart study in the US, funded by the National Heart, Lung, and Blood Institute and run in partnership with Boston University.

The researchers identified 97 cases of stroke. "Dementia is rare in people under the age of 60 and so we focused only on those aged over 60 years for dementia".

The researchers point out that both sugar and artificially-sweetened drink consumption has been linked, in previous research, to "cardiometabolic risk factors", such as high blood pressure, high blood sugar, and abnormal cholesterol - all of which increase the risk of stroke and dementia.

Drinking one sugar-free fizzy drink a day has been linked to a threefold increased risk of stroke and dementia, compared with people who drank one diet fizzy drink a week or less.

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"Even if someone is three times as likely to develop stroke or dementia", Pase said, "it is by no means a certain fate".

They also found people who drank at least one artificially-sweetened beverage a day were nearly three times as likely to have an ischemic stroke (the most common type), and 2.9 times as likely to develop Alzheimer's disease dementia.

"Although we did not find an association between stroke or dementia and the consumption of sugary drinks, this certainly does not mean they are a healthy option".

The American Beverage Association concurred.

"Rather than focusing on results from observational studies, which can not establish cause and effect, individuals should talk to their health care team to address known risks for stroke and dementia", he said. For example, people who more frequently consumed diet soda were also more likely to be diabetic, which is thought to increase the risk of dementia. "America's beverage companies support and encourage balanced lifestyles by providing people with a range of beverage choices - with and without calories and sugar - so they can choose the beverage that is right for them".

Excess sugar is known to have adverse effects on health.

Pase noted the findings complement their sister study, published in Alzheimer's & Dementia, that found higher consumption of both sugary and diet beverages was associated with smaller brain volumes, a marker of accelerated brain aging.

"When the authors controlled for hypertension and diabetes and obesity the effects diminish, which implies that some of the effects of artificially sweetened beverages could still be going through a vascular pathway", he said about the new study. A more thorough examination would have included all well-established risk factors for stroke and dementia such as socioeconomic status, body mass index, drug use, alcohol intake, family history, and depression. "So, I believe the mechanisms may be through vascular disease, though we can't prove it".

The study is observational, and while it can suggest a potential association, the study cannot be used to assess causation; therefore, these results should not cause alarm. The study found 81 cases of dementia, or 5 percent of the participants in the dementia arm of the study. "Swapping out sugary drinks and foods for those containing no- and low-calorie sweeteners remains a valuable tool for people looking to cut calories in order to reach their weight loss goals". "This study adds strength to that, and also says they may not be great for your brain, specifically", she said.

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