Consumption of Artificially Sweetened Beverages Increases Stroke Risk
By Matthew E. Fink, MD
Professor and Chairman, Department of Neurology, Weill Cornell Medical College; Neurologist-in-Chief, New York Presbyterian Hospital
Dr. Fink reports he is a retained consultant for Procter & Gamble and Pfizer.
SOURCE: Pase MP, Himali JJ, Beiser AS, et al. Sugar- and artificially sweetened beverages and the risks of incident stroke and dementia: A prospective cohort study. Stroke 2017;48:1139-1146.
Sugar-sweetened beverages have been associated with cardiometabolic diseases, including coronary heart disease, stroke, diabetes, and obesity. Artificially sweetened beverages have been heavily advertised as an alternative to reduce the cardiometabolic consequences of high sugar intake. To investigate the possible roles of both sugar-sweetened or artificially sweetened beverage consumption on risks of stroke and dementia, the Framingham Heart Study Offspring cohort was followed for a decade, with a specific focus on the effects of sweetened beverage consumption on the risk of stroke and dementia.
There were 2,888 participants aged > 45 years evaluated for incident stroke and 1,484 patients aged > 60 years evaluated for incident dementia. Beverage intake was quantified from a questionnaire over several time periods from 1991 until 2001, to determine cumulative consumption. Surveillance for events continued for 10 years. During that time, the investigators observed 97 cases of incident stroke and 81 cases of incident dementia. After adjustments for age, sex, education, caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks was associated with an increased risk of ischemic stroke (hazard ratio = 2.96) and Alzheimer’s disease (hazard ratio = 2.89). In a surprise finding, sugar-sweetened beverage consumption was not associated with stroke or dementia. As an observational study, causation cannot be inferred, and further investigation and further studies will be needed to confirm these findings.
Higher recent and higher cumulative intake of artificially sweetened soft drinks was associated with an increased risk of ischemic stroke and Alzheimer’s disease. However, sugar-sweetened beverage consumption was not associated with stroke or dementia.
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