an aluminum can of diet soda, non-sugar sweeteners, daily diet soda

Sugar-sweetened beverages have developed a very bad reputation over the past decade or so. They contribute empty calories without corresponding nutritional value. Sugary drinks have been linked to kidney damage as well as weight gain. As a result, many people have turned to diet soda as a more healthful alternative. Now, however, results from the Women’s Health Initiative have thrown cold water on that plan.

What Are the Risks of Diet Soda?

The Women’s Health Initiative is a huge study including more than 81,000 postmenopausal women. Researchers have been tracking their dietary habits, including beverage preferences, for the past 12 years. They have also kept tabs on the volunteers’ health status.

In a new publication in the journal Stroke, the scientists write that women who drank two or more cans of diet soda daily were 23 percent more likely to have a stroke during the study (Mossavar-Rahmani et al, Stroke, Feb. 14, 2019).  Nearly two-thirds of the women didn’t drink diet soda or drank it rarely. In comparison to them, women who drank at least two servings of diet soda a day were 30 percent more likely to have a stroke caused by a blood clot in the brain. They were also 29 percent more likely to develop heart disease and 16 percent more likely to die during the study. Heavy women were at particularly high risk.

Previous Danger Signal for Diet Soda:

Many people drink diet soda with the intention of staying slim and healthy–or at least not getting any fatter. But at least one earlier study suggested that this strategy could backfire (Fowler et al, Journal of the American Geriatrics Society, March 17, 2015).

SALSA Study in San Antonio:

In the bi-ethnic San Antonio Longitudinal Study of Aging (dubbed SALSA), 750 people 65 or above completed questionnaires about their diets every few years.

Bigger Bellies on Diet Soda Drinkers:

During the follow-up period of about nine years, people who drank diet soda every day added an extra 3 inches to their waistlines. By way of comparison, those who never drank diet pop added a little less than an inch during that time.

While this is an association and doesn’t prove causation, it is troubling. Extra fat around the middle is linked to a higher risk for diabetes, high blood pressure and heart disease.

What Should You Be Drinking?

The recent research from the Women’s Health Initiative established a correlation between diet soda consumption and the chance of a stroke or heart problem. It does not demonstrate that diet soda causes cardiovascular problems. However, if these beverages won’t help you lose weight or waistline, you may want to reconsider their use. Drinking water or unsweetened tea or coffee instead of artificially sweetened beverages might be a healthier choice.

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  1. Dr Richard
    West Palm Beach

    Are these research results relevant for men?
    The study info shared does not address men.

  2. Steven
    Atlanta, GA

    This does not make sense. I could throw flour in a drink and call it artificially sweetened. Could someone please distinguish which sweeteners they are discussing? Frustrating on all sides.

  3. John

    Why did you leave “Stevia” out of this, what with that being a ‘natural’ sweetener instead of an ‘artificial’ one? In baking I now use Stevia instead of ‘regular white’ and Truvia (mixture of Stevia & a bit of ‘regular’ brown sugar. Also, my wife (Type 2) now uses Stevia in her coffee – still working on getting her cut out all ‘pop’ (AKA, ‘soda’ if you don’t live in the Midwest).

  4. Naomi
    North Carolina

    Are the negative effects of drinking diet soda related specifically to any particular artificial sweeteners? I drink diet soda sweetened with stevia because it is a natural sweetener alternative. Does that also have the same adverse health effects?

  5. Solay

    Shouldn’t have too much caffeine in coffee; decaf is too processed. Too much tea causes kidney stones; juices are full of sugar; tap water has fluoride; bottled water has plastic nano particles, energy drinks have too much of everything; powdery water additives have artificial colors, flavors, sweeteners; and sodas are a no-no with a list of sugar, artificial sweeteners (now linked to strokes), chemicals, colors. Milk is linked to weigh gain, cancer, lactose intolerance, and allergies; non-milks have high sodium and a variety of flavorings and additives to make them palatable. Where do we go from here?

  6. Penelope

    How about unsweetened herbal teas? I make up a quart of hibiscus tea and have it hot in the morning and cold in the afternoon. Refreshing and healthy!

  7. Sweet Pea
    Midwestern USA

    Not all diet soda is sweetened with the same artificial sweetener, and diet soda products in a bottle or can use a different artificial sweetener (generally aspartame) than fountain diet soda served in a restaurant, which generally uses sacharrin as the sweetener (to improve shelf life.) It would have been helpful if this article had been a little more detailed in that regard…plus, the amount of artificial sweetener varies among diet sodas. There is an interesting table of artificial sweeteners used in can/bottled diet sodas at

  8. Sam Grant

    Goodbye to diet sodas! I thought I was helping myself by drinking them. No more!

  9. Kathie

    Something else to think about if you can’t live without a cola every day: While working in a local hospital, I used to drink a Diet Coke ever day for lunch. Then a doctor warned me that the carbonation in Diet Coke (or other colas) was bad for your bones and would weaken them over time. “Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study.”

  10. Laura

    I drink water with Crystal Light or other water flavorings — what’s the information on this? Am I also harming myself?

  11. Pam

    I’ve been watching this stuff for years and I’m not convinced. First, they lump all artificial sweeteners into one bucket. Surely there are significant chemical differences between saccharin, sucralose (Splenda) and the rest, esp aspartame which is a derivative of aspartic acid and phenylalanine, the latter of the two occurring naturally in a wide array of food.

    By law, babies are tested at birth for lack of an enzyme to break down phenylalanine. If they lack that enzyme, all natural foods which contain it can cause a build up which can lead to mental retardation by as early as one year of age. They are called phenylkentonurics or as a disease it’s referred to as PKU. Every product that has aspartame added has to contain a warning to PKU sufferers. They can never eat anything containing phenylalanine safely their whole life. There is no cure or drug to counter this.

    We are all getting plenty it in our daily diet unless you eat very oddly. Parents of children with PKU are given a list of foods it occurs in naturally to avoid for life–they are high protein foods, such as milk, dairy products, meat, fish, chicken, eggs, beans, and nuts.

    So just once I would like to see all the various types of “artificial” sweeteners studied on their own and let’s see if they ALL behave the same. We know that even drugs that are in the same class can behave very differently in the human body. Even things that are just one molecule different (LSD and scopolamine for instance) can have very different effects.

    The other piece of poor science in all this: Does it not make sense that folks who are prone to put on weight easily and often do so starting at an early age are the ones most prone to drinking these diet drinks and very likely a lot of them?

    And those same folks who tend to be heavier– are they not also the ones most at risk for strokes and cardiovascular disease?

    I have yet to see a study where people of desirable weight who drink a lot of these are separated in the data from the people who start off as overweight or obese during the study period. If we saw the same outcomes exclusively in people of so-called normal weight or BMI, that would be interesting, and might suggest causation.

    As it is, all these studies just show association: people who by genetics or food consumption gain weight easily drink more diet soda in an effort to control their weight gain in my experience. They use it to fill up, assuage the hunger pains, just something to put in their stomachs to get a sensation of fullness rather that snacking all the time.

    Yes, I do see some very thin people obsessed with not putting on weight get a little over the top drinking diet sodas too, but over many years it’s been mainly already larger folks I see who use the diet drinks far more in an effort to combat more weight gain. So of course these folks have the frequently referred to larger belly or larger waist to hip ratio. But is the diet drink causing it or merely associated with it?
    If we can get some decent science on this topic, I’d like to see it. Start by tracking it by each individual sweetener, and then account for starting weights of study participants.

    Maybe the Graedons will have some well-reasoned response, but so far, all the studies and conclusions regarding artificial sweeteners are junk science as far as I’m concerned, starting with the panic attacks back in the 70’s over saccharin causing cancer in rats. Which it turned out, it did not.
    Sadly, people are all too willing to react very negatively to anything they consider not natural: a “chemical” or artificial, inc vaccines, but a lot of this stuff saves lives so it’s very important not to dismiss everything that didn’t get picked in your own garden as evil.

  12. Bryan

    I would like to know if the ‘abstainers’ practice healthy activities such as daily exercise, weight control and eating a healthy diet. I would imagine that the healthy practices are providing the beneficial results.

  13. Kassandra Pondmire

    The study doesn’t mention flavored, carbonated, unsweetened water. I wonder if that has the same negative effects as diet soda. In other words, what is it about the diet soda that increases the risk of stroke? If it’s the artificial sweetener, then flavored, carbonated water with no sweetener should be ok. I also wonder what effects carbonation has on any aspects of one’s health. I’d love to read an article about carbonation.

  14. Jim

    Although I do not drink diet soda I am curious as to why the study did not differentiate between the various types of sweeteners used in these drinks. I would think this would be a critical variable in this study.

  15. donald I


    This is not a double blind study. there is no control group, of people gaining weight, who are given a diet drink without a sugar substitute. there is also no control group of non weight gainers forced to drink diet soda.

    The people in this study are all self selected to drink diet soda, probably because they are gaining weight and can’t do anything to stop it. Drinking diet soda at least slows the weight gain down. If these self selected weight gainers didn’t drink diet soda, they would probably still have their health problems.

    The people in this study are also self selected NOT to drink diet soda, probably because they are not gaining weight and DON’T need to do anything about it. There is no control group of non-weight gainers, forced to drink diet soda, to see what happens to them. The non-weight gainers would probably have no health problems, even if they were forced to drink diet soda.

  16. Gigi

    This is so scary! If I drink more than one can of diet soda a day I get a horrible migraine. This article has convinced me to stay away from them!

    Do the researchers know what ingredient in the diet soda’s causes the strokes?

  17. Rose J

    Yes, association/correlation is not causation. I am very skeptical of these kind of study pronouncements. They are not scientific method studies. One could find all kinds of correlations in these studies of you just went looking – want to see if blondes eating mushrooms twice a week links to higher cancer risk? We, the public, have been subjected to these dubious health alarms for too long. A few years from now we may be told that diet soda delays dementia. The best advice is moderation in all things. I have dietary alarm fatigue which is sad because I may actually dismiss something serious.

  18. Sylvia
    Waco, TX

    I would like to know the body weights of the diet soda drinkers compared to the weights of the no-diet-soda group . Many overweight people drink diet soda, thinking they will at least avoid the sugar in regular sodas. The no-diet-soda group may be doing lots of other health enhancing things, such as maintaining a healthy weight, eating healthy foods, and exercising. Something besides diet soda consumption may be measured in this study. The study appears to show a correlation between diet soda and an increased number of strokes. I’m interested in the possibility of the largest correlation being between overweight people and/or lack of exercise and increased strokes. I guess what I wish is that diet sodas, which I like, were okay to drink, but I do think the other comparisons and information would be most helpful.

  19. Vince
    Vero beach FL

    I have been using saccharin and saccharin products like Sweet and Low for
    70 years. Sugar was not available during WW2 when I was a kid, I am 78 yrs old. I have no problems, guess I am the exception.

    V Pucci

  20. william

    Studies show that people who live in expensive houses earn more money than those who are homeless.So using that factual observation it suggests that if you want to get a raise you should
    buy an expensive house. This is using correlation to prove causation. It is not science. It is sociology.

  21. Markeeta
    Santa Fe

    I wish that they had further divided the study into those that drank mainstream diet sodas (sweetened with sucralose or aspartame) and the ones sweetened with stevia.

  22. Anita Faulkner

    “Women who drank at least two servings of diet soda a day were 30 percent more likely to have a stroke caused by a blood clot in the brain. They were also 29 percent more likely to develop heart disease and 16 percent more likely to die during the study. Heavy women were at particularly high risk.” What was not said is that women who drink diet soda are already obese, diabetic, have hypertension, or have metabolic syndrome. That is what puts them in the stroke/heart disease/early death category. Giving up diet soda cures none of this and this type if scare reporting does nothing to address the underlying health issues. No where in the study is the rest of the diet of the participants looked at. There is not enough emphasis put on the real conclusion which is that cause and effect are not determined. I am disappointed that People’s Pharmacy is furthering this very flawed study.

    • Joann

      How many people did die during this study?

    • Jane

      I am 80 years old, a type 1 diabetic, who walks at least 5 miles a day, am not overweight, my A – 1c is below 7, and drink diet sodas as well as beverages sweetened with Splenda. I also participate in the women’s health initiative. I get annoyed by assumptions made about diabetics.

  23. Carol

    So, if it is the artificial sweetener that is the culprit, should this warning not also include diet tea? I wonder if stevia is also suspect.

  24. Karen
    Elma, NY

    Is the stroke correlation similar when drinking diet flavored powdered drink mixes, such as Crystal Light?

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