Nancy Ferrari

Is there a link between diet soda and heart disease?

I’m a big fan of diet soda. I like the taste, and I love that it doesn’t have any calories. I can drink two or three diet sodas a day and not worry about gaining weight. But a new study has me wondering if enjoying the sweetness of soda without the sugar and calories is such a good thing after all.

University of Miami and Columbia University researchers followed roughly 2,500 New Yorkers for 10 years. All of the study volunteers were over age 40 and had never had a stroke. At the start of the study, each participant indicated her or his diet soda intake as “none” (less than 1 per month), “light” (1 diet soda a month to 6 diet sodas a week), or “daily” (1 or more a day). Each year, researchers contacted participants by phone to ask them about changes in risk factors and medications, as well as any health problems and hospitalizations that may have occurred.

At the end of 10 years, the daily diet soda drinkers were more likely to have had a stroke or heart attack, or to have died from vascular disease. The increased risk remained even after study investigators accounted for smoking, exercise, weight, sodium intake, high cholesterol, and other factors that could have contributed to the difference. The results were published online in the Journal of General Internal Medicine.

Both regular and diet soft drinks were linked with certain, but separate, cardiovascular disease risk factors. In this study, frequent diet soda drinkers were more likely to be former smokers and have higher blood sugar, high blood pressure, and, ironically, larger waistlines. They were also more likely to have metabolic syndrome. That’s the name for a cluster of risk factors—high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels—that occur together and increase the risk for heart disease, stroke, and type 2 diabetes. Folks who drank regular soda were more likely to smoke and eat more carbohydrates, but were less likely to have diabetes or high cholesterol.

A study such as this one can only hint at an association between diet soda and cardiovascular risk. It can’t pinpoint a cause and effect. But it’s not the first to implicate diet soda as a cardiovascular risk factor. A report from the Multi-Ethnic Study of Atherosclerosis, published in the journal Diabetes Care, found that people who drank diet soda every day had a 36% greater risk of developing metabolic syndrome and a 67% greater risk of developing diabetes. Both of these conditions greatly raise the odds of having a stroke or heart attack. It’s a little surprising that diet soda drinkers were more like to develop two particular components of metabolic syndrome: larger waistlines and higher fasting glucose levels (results consistent with the New York study results).

So far, research on diet soda’s relationship to cardiovascular disease raises more questions than it answers. For example, do people who drink a lot of diet soda have other behaviors or conditions that independently increase their risk of cardiovascular disease? We also don’t have a good understanding of the biological effects of artificial sweeteners (see this Harvard Health Letter article for more on this topic). Manufacturers use a variety of artificial sweeteners in soft drinks, and surely new ones will come on the market. So it is difficult to tease out the effects of a particular sweetener—or beverage for that matter, because a range of drinks come in sugar-free form, not just soda.

Sometimes making a healthful choice is a slam dunk. Quitting smoking and exercising more are very good for you. There’s no debate about that. Other times it’s a tougher call. Surely, no one needs to consume soft drinks of any kind. But is it a problem to do so?

My husband gently (but persistently) tells me there is nothing good about drinking diet soda, not even the taste I claim to enjoy so much. The evidence seems to back him up. For me, I have realized (time and again) that I just feel better when I don’t drink diet soda. When I make the effort, I’m reminded how much I enjoy other beverages such as carbonated water or iced tea.

Wish me luck as I once again try to get off diet soda.

Do you drink diet soft drinks? Do you notice any negative effects from doing so? If you’ve kicked the habit, let us know why and how you did it.

Comments:

  1. Paul

    I too am addicted to sodas. I have tried but failed to stop but I have not given up. I had a minor stroke in 2007 but nobody can tell if it was due to soda drinking. Thanks for your article.

  2. Build Discipline

    Discipline yourself not to drink soda all the time.
    It’s hard at first, but after two weeks and losing a lot of pounds you will feel better about it.

    At least I did.

  3. Aamir

    Very nice blog post. I certainly appreciate this site. Continue the good work!

  4. Anonymous

    very good article, contains information that is essential for fans of soda. soda without sugar also has a bad risk to our health. The best is to consume plenty of water. thanks for sharing.

  5. Bea

    My applause to the University of Miami and Columbia University for conducting this study, even if it is raising more questions than answers. We all know one thing for sure: A too high percentage of people does not enjoy a high level of health. We definitively need to find out what are the causes. Unfortunately, I do know a lot of people who drink Diet Soda and think this is the healthy alternative to Soda with Sugar. Thanks to this study, it will at least raise some doubt and questions about these choices. I look forward to more of these kind of studies and their results.
    Bea

  6. brendan doyle

    These studies are interesting overviews of lifestyle patterns found in diet soda drinkers, but don’t prove diet soda increases our risk of heart disease at all. We know artificial sweeteners, like the ones found in diet soda, are broken down into their chemical constituents and purged from the body; these “pieces” are also found when digesting certain foods. As a Registered Dietitian and Certified Diabetes Educator, I frequently review the research on sweeteners. They have been proven safe to consume, including by the FDA, because they have no metabolic effects.

    I think we’re trying too hard to find an overly simplistic solution to our nation’s health crises. It’s most likely that diet soda drinkers have other lifestyle habits that increase their risk for metabolic syndrome and heart disease. As a nutrition expert and consultant to food and beverage companies like Coke, the first things I would evaluate are overall diet and exercise.

  7. haris

    Thank you, The information you provide is informative and helpful. You must show not only the absolute risk and relative risk.
    generally drinking soda is not good for health, had something to do with the heart.

  8. Health Coach

    It’s great to see that this information is finally hitting the mainstream, saw a story on 60 minutes about this recently.

  9. ideal protein diet

    In my opinion, if we have high blood pressure, we do not ever to drink soda, cause soda undirectly make blood pressure is higher, and it’s dangerous for our heart

  10. yoshino

    oh my gosh… diet soda..

    i shift drink water

    thanks your post

  11. Anonymous

    Drinking and smoking are very bad habits.Both are harmful for a perfect and healthful body.It is a good post. I like your post.Thanks for sharing this post.Try to eat home made dish.

  12. Soda

    I have been off soda for at least 3 years and watching my weight.

  13. William G. Murray

    I am 80 yrs old and have been drinking regular and diet coke since I quit alcoholic beverages some 20 or so yrs ago. I quit smoking about 25 or so yrs ago. I made chicken and fish the major portions of my eating about 25 years ago, although about 20 yrs ago I added red meat back in once or twice a week. I sleep about 7 hrs a night and read and watch TV almost all the rest of the time except a couple of hours driving, eating out and shopping. Shopping big stores eg Costco, Sams, Target, Walmart,etc. provides exercise. I’m wondering what else is there to give up. I haven’t read a reason yet to give up coke.

  14. Soyabean Oil

    It is the first time I am hearing about diet soda. Diet could be done by preferring healthy oil also which could make our health keep on going without any ailment and that would be the best part of our life.
    Being healthy I always goes with this oil

  15. Lance King

    Just posted my results from a diet where I first started reducing carbs and then isolated ketosis for two weeks. My results were 10X’s better in ketosis. My blog shows my progress. What do you think of these types of diets (ketosis). My results are proof it worked!

    thanks?

  16. Jason Smith

    Great article to read. And I agree with you.

  17. ROBERT J. NANTON

    i recently watched a fundraiser for our local pbs tv station. a doctor who wrote the book the blood sugar solution was the guest speaker. he stated that artifical sweeteners were not to used. i do not remember the reasoning. he was very big foods from the earth.

    thanks

  18. mma diet

    In general, people shouldn’t be drinking soda. Too much refined sugar and just overall bad. Just my opinion though, I’m not doctor.

  19. Steve

    There is mounting evidence that diet and sugar-free sodas actually lead to fat gain – which is the exact opposite result required.Numerous studies have found that obesity occurs when too much insulin is released into the blood to deal with the consumed sugar. Because there is no sugar for the insulin to convert it simply waits around until it can be used – in the process, it starts shutting down the receptors which would normally be required to process the sugar. The brain apparently goes into ‘feast or famine’ mode because it is getting the wrong message about the sugar and starts storing all food consumed as fat in order to protect the organs.
    This is a very simplistic interpretation of just one of the reasons not to drink or eat diet or sugar-free foods and sodas.

  20. SDW

    My daughter, age 31, gets a bad headache with even small amounts of aspartame so the diet Coke is out for her. I solved the soda dilemma for myself by eliminating all sodas completely. Scientific studies cannot determine what every individual should or should not eat, but can give generalities for the population at large. As the previous comment stated, “If it is not good for health, then avoid it.” About a year ago I increased fruits and vegetables, reduced substantially refined grains and sugar, now eat whole grains in moderation, and increased the good fats. I lost 20 pounds and my energy levels are constant. I now love what I eat and eat all I want. I don’t miss the sodas.

  21. Tonmoy

    As it is not good for our health we should avoid it. Clinical research has shown that eating much fruits and vegetables reduces the risk of heart attack and diseases and it is also a great source of vitamins and proper nutrition. Eating a 2 servings of fruits and 5 servings of vegetables a day is mandatory for our better health.

  22. Beth

    You should show absolute risk and not just relative risk – it is much more informative. this is an observational study and these relative risks stated here are very, very small. While I don’t drink much diet soda, this kind of report is not nearly enough to make me stop drinking the 3 or 4 i have a week.

  23. Anonymous

    The way you define here related to diet soda and heart disease is quite informative and helpful and while following such thing which explain here you can know more about diet soda and heart.

  24. Fran

    I normally have low blood pressure and low blood sugar. Smoking brings my blood pressure up to normal, as does sugar. Before going to the doctor I usually smoke, eat lots of sugar and fat. So long as I am not taking medicine that raises my blood pressure or increases my blood sugar the tests usually come out normal. I don’t like sugar substitutes because of the after taste. I don’t have a cluster of risk factors but sometimes a swollen abdomen because of high acidic foods or eating too much in one meal. Is there a way to quit smoking and elevate blood pressure while feeling more energetic without sugar and caffeine?

  25. mitch

    As a Phys Ed teacher I should have known better. I got drawn into drinking diet coke in my early twenties. At my worst drank 5 litres a day. Tried many times to give up, suffered headaches, dizziness, the worst feeling of going to throw up, and the shakes. Addicted. After nearly 10 years I worry what it has done to me. Have problems controlling my weight and waist line through self discipline in my diet, and plenty of exercise. Not touched a diet coke for just over 11 years now, nor any other POP drink. My kids only drink water, milk, juices and cordial drinks.
    I drink too much coffee instead. Trying to drink more tea, at least 1green tea a day.
    For me, studies or not, diet coke was not good for me, and I do not want my. Kids to touch it.

  26. Coffee Lover

    I am convinced it is the aspartame. I can drink coffee all day long and while overdoing the caffeine is pronbably not so good, I don’t feel ill effects.

    However, I have two diet sodas and I feel dizzy and ill. Evil stuff.

  27. Jonathan

    I drank diet ginger ale for ages but then read about increased stroke risk so switched to naturally flavored and no calorie no sodium soda seltzer/ soda water called Ice

  28. Mike McDermott

    If it’s cardiovascular, then it’s about kidneys. Kidney damage/diseaese is both the cause and result of hypertension, particularly true with minorities. Tell everyone you know.

  29. Dana

    I was a diet coke addict. I probably drank 4-6 cans of it a day for many many years. I kicked the habit cold turkey a little over a month ago because I was having very strange dizzy spells about once or twice a day. My mother was convinced it was the diet pop. I of course was reluctant to give it up. Here’s what happened.

    – In the first week I lost 7 pounds. Yes. After kicking DIET pop out of my life. Sure, it was probably water weight because I was drinking more water as I quit, but still, I will take a 7 lb loss any week of the year!

    – I never had another dizzy spell

    – I’m sleeping like a champ

    -I’m a ton more focused at work

    – and most importantly, I haven’t felt this good in years.

    When I say cold turkey I mean I even gave up caffeine. Which is tough because when you drink this much pop, the withdrawal is nothing to laugh at. Be prepared for a headache. Get yourself through this headache (mine lasted 2 days of migraine like pain. Ow) and you will wake up a new person. I promise.

    If I can do it, anyone can. Hmm… I wonder if coke is still in business since I haven’t been paying their bills lately…. ;)

    Good luck!

  30. Peggy Fowler

    I find this article both disturbing and interesting. My husband and I are AVID Diet Coke drinkers. We neither smoke or drink alcohol. We get moderate exercise both retired and he is 63, I am 61. We have been drinking Diet Coke for over 30 years daily. We have nit as yet observed any adverse effects. As I read this article I understood this study was over a 10 year period and with people who did not drink Diet Coke regularly. I feel this is a study looking for something to squawk about. The past has been eggs, bacon, red meat, and Lord knows what else. It seems evey time you turn around some “fresh-out-of-college” newbie decides to get their study funded at the expense of others. I think maybe more study needs to be done and possibly millions more of tax payees money spent to get Americans to second guess what they need to eat or drink! If these studies are going to be done let’s publish ALL facts. Tell the difference between the control group, the constant, and how you varied the study to get a clear result. This seems more like your hypothesis than a result. I really get disturbed when studies are performed fir college doctorate thesis and then published and used as scare tactics on the public. Please keep your college project in in context with what they are; college projects, until definate proof results are secured.

    Peggy Fowler EDS
    Average American

  31. Dr. Dani

    Hi Nancy,

    I love your honest and helpful blog about diet soda–it is an interesting topic with relation to the health effects. I advise my patients to try to choose soda water with lemon, or add some chopped fruit or citrus to water to get some more flavor instead of choosing diet sodas. Tea is also a good option and you can ice it and add some stevia for a naturally sweet and low cal option with a bit of caffeine too!

    Thank you for sharing, look forward to reading more of your posts!

    Yours in Health,

    Dr. Dani
    MD, CCFP, Family Physician, Holistic Medicine Specialist and Health Coach

  32. Elizabeth Patton

    These studies are interesting overviews of lifestyle patterns found in diet soda drinkers, but don’t prove diet soda increases our risk of heart disease at all. We know artificial sweeteners, like the ones found in diet soda, are broken down into their chemical constituents and purged from the body; these “pieces” are also found when digesting certain foods. As a Registered Dietitian and Certified Diabetes Educator, I frequently review the research on sweeteners. They have been proven safe to consume, including by the FDA, because they have no metabolic effects.

    I think we’re trying too hard to find an overly simplistic solution to our nation’s health crises. It’s most likely that diet soda drinkers have other lifestyle habits that increase their risk for metabolic syndrome and heart disease. As a nutrition expert and consultant to food and beverage companies like Coke, the first things I would evaluate are overall diet and exercise.

    Elizabeth Patton MS, RD, LD, CDE

  33. Barbara W. Kaplowitz

    Perhaps metabolic syndrome causes the increased use of diet sodas, and not the other way around? As an insulin-dependent diabetic for 45+ years, diet sodas used to be a staple in my daily life. The only other healthy choice for me was water. Juices raised my blood sugar too much. I finally swore off diet sodas and other diet drink mixes when it became clear that the “Blue” and “Yellow” sweeteners were problematic–causing headaches, upper lip tingle, & other side effects. Oddly enough, “Pink” sweetener doesn’t cause the same issues, nor did the now-banned-in-the-U.S. and unfairly-vilified cyclamate. For now, I stick to water, plain seltzer, and fresh-brewed decaf tea. I usually regret it when I “cheat” and order a diet soda.

  34. michael simon

    Do not Drink anymore(bier) and do mo smoke. I drink diet soda in the summer to get in the habit of drinking water. If the diet soda temp is elevated it changes the chemical make up etc.