Too many diet drinks may spell heart trouble for older women


March 31, 2014
Health

Largest study of its kind looks at diet drinks and cardiovascular outcomes, mortality

It appears healthy postmenopausal women who drink two or more diet drinks a day may be more likely to have a heart attack, stroke or other cardiovascular problems, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.

In fact, compared to women who never or only rarely consume diet drinks, those who consumed two or more a day were 30 percent more likely to suffer a cardiovascular event and 50 percent more likely to die from related disease. Researchers analyzed diet drink intake and cardiovascular risk factors from 59,614 participants in the Women’s Health Initiative Observational Study, making this the largest study to look at the relationship between diet drink consumption, cardiac events and death.

“Our findings are in line with and extend data from previous studies showing an association between diet drinks and metabolic syndrome,” said Ankur Vyas, M.D., fellow, Cardiovascular Diseases, University of Iowa Hospitals and Clinics, and the lead investigator of the study. “We were interested in this research because there was a relative lack of data about diet drinks and cardiovascular outcomes and mortality.”

Information on women’s consumption of diet drinks was obtained through a questionnaire that asked them to report their diet drink consumption habits over the previous three months. This information was assessed at follow-up year three of the Women’s Health Initiative Observational Study. Each drink was defined as the equivalent of a 12-ounce beverage and included both diet sodas and diet fruit drinks. For the purposes of the analysis, researchers divided the women into four consumption groups: two or more diet drinks a day, five to seven diet drinks per week, one to four diet drinks per week, and zero to three diet drinks per month.

After an average follow-up of 8.7 years, the primary outcome – a composite of incident coronary heart disease, congestive heart failure, heart attack, coronary revascularization procedure, ischemic stroke, peripheral arterial disease and cardiovascular death – occurred in 8.5 percent of the women consuming two or more diet drinks a day compared to 6.9 percent in the five-to-seven diet drinks per week group; 6.8 percent in the one-to-four drinks per week group; and 7.2 percent in the zero-to-three per month group.

The association persisted even after researchers adjusted the data to account for demographic characteristics and other cardiovascular risk factors and comorbidities, including body mass index, smoking, hormone therapy use, physical activity, energy intake, salt intake, diabetes, hypertension, high cholesterol and sugar-sweetened beverage intake. Women who consumed two or more diet drinks a day were younger, more likely to be smokers, and had a higher prevalence of diabetes, hypertension and higher body mass index.

But Vyas says the association between diet drinks and cardiovascular problems raises more questions than it answers, and should stimulate further research.

“We only found an association, so we can’t say that diet drinks cause these problems,” Vyas said, adding that there may be other factors about people who drink more diet drinks that could explain the connection.

“It’s too soon to tell people to change their behavior based on this study; however, based on these and other findings we have a responsibility to do more research to see what is going on and further define the relationship, if one truly exists,” he adds. “This could have major public health implications.”

About one in five people in the U.S. consume diet drinks on a given day, according to data from the National Health and Nutrition Examination Survey (2009-2010). But Vyas cautions that this particular study only applies to postmenopausal women. The average age in the study was 62.8. To be included in this analysis, women had to have no history of cardiovascular disease and be alive 60 or more days from time of data collection.

Previous studies have found artificially sweetened drinks to be associated with weight gain in adults and teens, and seem to increase the risk of metabolic syndrome, which makes both diabetes and heart disease more likely.

Vyas says future research could include clinical studies, animal models and even molecular and pharmacologic analyses to begin to explain what, if any, direct role diet drinks play in heart health.


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4 Responses to Too many diet drinks may spell heart trouble for older women

  1. Obadiah , 14008247 April 29, 2014 at 1:19 am #

    In my opinion, anything in excess cannot be good for you. In the study above, perhaps other factors, such as smoking, also play a role in inflicting heart disease in a person, however, that does not necessary rid off the potential of diet drinks also having a role in causing heart disease in woman or increasing the likelihood of heart disease. Further research, will definitely be beneficial for society

  2. Obadiah March 31, 2014 at 7:46 pm #

    In my opinion, anything in excess cannot be good for you. In the study above, perhaps other factors, such as smoking, also play a role in inflicting heart disease in a person, however, that does not necessary rid off the potential of diet drinks also having a role in causing heart disease in woman or increasing the likelihood of heart disease. Further research, will definitely be beneficial for society.

  3. Maureen Beach March 31, 2014 at 12:50 pm #

    To the Editor:

    Your recent blog (“Too many diet drinks may spell heart trouble for older women,” March 31) on diet beverages warrants clarification for your readers.

    Neither the body of science nor the abstract recently presented at the American College of Cardiology meeting supports that drinking diet beverages causes cardiovascular events among women – or any other population for that matter. In fact, the research your paper reported on was an observational study which cannot show causation, as noted by one of the abstract’s authors. Furthermore, it is important for your readers to know that the women in this study who had the greatest risk of cardiovascular events also had higher incidences of smoking, diabetes, hypertension and overweight – all known risk factors for heart disease. Importantly, when it comes to being overweight, numerous studies have repeatedly demonstrated that diet beverage consumption helps with weight loss as part of an overall weight management plan by helping to reduce calorie intake.

    Sincerely,

    Maureen Beach
    Director, Communications
    American Beverage Association

  4. Lené March 31, 2014 at 7:54 am #

    I think diet drinks as a whole is bad for your health. I know that diet sodas and diet juice contains sodium benzonate that has a negative impact on your lungs. It cause your lungs to rapidly excrete mucus, that on the long term can be fatal for people struggling with a lung decease.

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