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Two or more diet beverages a day linked to high risk of stroke, heart attacks

60 points| koolba | 7 years ago |www-m.cnn.com | reply

63 comments

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[+] floathub|7 years ago|reply
It is entirely unclear how any controls were implemented. They say "after controlling for lifestyle factors" but do not say which factors nor how they controlled for them. It is entirely possible, perhaps even likely, that diet beverages are simply a proxy for some other factor. Maybe even just weight. To wit:

    "This association may also be contributed 
    to by rising blood pressure and sugars 
    that were not yet diagnosed as hypertension 
    or diabetes but warranted weight loss," 
    thus leading the women in the study to take 
    up diet beverages, said Dr. Keri Peterson, 
    medical advisor for the Calorie Research Council, an
    international association representing the low- and
    reduced-calorie food and beverage industry.
This possibility makes the implication that there is some causal relationship pretty tenuous. This question:

    "What is it about these diet drinks?" asked 
     lead study author Yasmin Mossavar-Rahmani ...
might well be answered with, "nothing at all actually".

(edited for quotes because I keep forgetting this is not markdown)

[+] toasterlovin|7 years ago|reply
Welcome to all of nutrition science. As a field it is characterized by a dearth of studies which are actually capable of demonstrating causation. Almost every study is simply a measurement of correlation. And then you get these moronic interpretations of the studies, sometimes by the study authors themselves.
[+] jillesvangurp|7 years ago|reply
I concluded a some time ago that soda drinks weren't adding a lot of value for me at all. And I heard some people claim that the artificial sugars actually are not that great for you. 1) they teach your body that sweet stuff has no nutrition, which then becomes a problem when you actually eat sweet stuff 2) sweeteners like aspartame build up in your liver and fat deposits, which may or may not have long term impact. 3) artificial sweeteners can cause issues with your gut bacteria/cause some irritation. All of that may or may not be true and I never really experienced any of that.

I used to just order a cola light/zero/diet in restaurants but it was more of a habit than something I actually particularly enjoyed. These days I usually go for water, tea, or coffee. Small change, probably a lot healthier, and I actually enjoy drinking it.

[+] drankula3|7 years ago|reply
On 2 and 3: aspartame metabolizes into the amino acid phenylalanine, a precursor to dopamine and epinephrine[0]. In normal people, breakdown of the upstream neurotransmitters increase when phenylalanine increases, meaning there are no negative effects from it's consumption. It does not store in the liver.

There are some diseases that involve a malfunction in phenylalanine processing, like phenylketonuria[1] and hyperphenylalaninemia[2]. It would not surprise me a bit if people with subclinical forms of hyperphenylalaninemia self-medicate with diet soda to feel better, particularly energy drinks that come with other things that aid in dopamine synthesis. Disfunction in dopamine synthesis often affects other things like NO synthesis, affecting blood pressure and inflammation.

[0] https://en.wikipedia.org/wiki/Aspartame?wprov=sfla1

[1] https://en.wikipedia.org/wiki/Phenylketonuria?wprov=sfla1

[2] https://en.wikipedia.org/wiki/Hyperphenylalaninemia?wprov=sf...

Edit: changed serotonin to epinephrine, as phenylalanine is not a precursor to serotonin.

[+] Reason077|7 years ago|reply
In the UK, most carbonated beverages now contain a blend of sugar and artificial sweeteners, in order to stay under the 5g per 100ml threshold for the "sugar tax".

Coca-cola "classic"/"original taste" is still available with only sugar, but typically at a higher price than other options.

[+] bluedino|7 years ago|reply
I’ve never seen a skinny person regularly drink Diet Coke/Pepsi

Diet carbonated drinks just make me gassy. I’d rather have the sugar from a regular Coke and just not drink one every day, or multiple ones per day. I have co-workers that drink 6-8 per day.

I find the “tiny” cans which are only 7.5 are about the perfect size. 3-4 drinks, only 80 cslories, a small bump of sugar...if I drink a 20oz bottle I usually can’t finish it as it’s way too sweet. Turns out the original size of a bottle of Coke was 6.5 ounces.

[+] AnIdiotOnTheNet|7 years ago|reply
I drink Coke Zero all the time, and I have been described as skinny by at least one ultrasound technician. I think you might just not be noticing when non-fat people drink it.
[+] zzzcpan|7 years ago|reply
> I’d rather have the sugar from a regular Coke

I guess this is what the article tries to achieve. Just PR to steer you to more unhealthy consumption.

Safe choice here was always to simply avoid sweet beverages altogether, and not just Coke, all the juices too.

[+] adrianmonk|7 years ago|reply
I drink a whole lot of diet soda, and I'm skinny. (If I lost 10 pounds, I'd have an "underweight" BMI.)

Of course, I also drank diet soda when I was overweight. And it's fair to say that when I switched from regular soda to diet, I was hoping it would help me lose weight.

Diet sodas appeal to people who are looking for an easy answer to the problem of losing weight. It just so happens in my case I eventually found and committed to a not-easy answer.

I still drink diet sodas for two reasons. One is that I enjoy the variety. At times I have drunk just tea and water, but I get bored with that. The other is I do feel like they make it marginally easier for me to maintain a healthy weight. Without them, I'd probably indulge in non-diet sodas from time to time.

[+] nikk1|7 years ago|reply
Caffeine, sugar, (and alcohol) aren't necessarily bad for you. Joe Rogan repeats a phrase on his podcast all the time that I quite like, "keep all things in moderation, including moderation itself"
[+] orzig|7 years ago|reply
Positive: The article links to a study

Positive: The study is open access!

Negative: The study is, to the best of my few minutes of ToC reading and Ctrl-F-ing, _entirely_ unrelated to soft drinks or sweeteners

Am I missing something? In either event, 2 out of 3 ain't bad, I suppose

[+] lolc|7 years ago|reply
I wonder whether even if there is a causal link, the diet version will still be healthier (for low values of healthy) than the sugary version. I tend to think so.

I would assume the people most likely to drink diet beverages do so to wean themselves off of sugary drinks. That's one of the first steps in getting towards a healthier lifestyle. The article notes this too.

A mystery to me is why they haven't asked about consumption of sugary drinks at the same time. That would have allowed to get much more interesting correlations.

[+] zzzcpan|7 years ago|reply
> A mystery to me is why they haven't asked about consumption of sugary drinks at the same time.

Obviously because sugary drinks manufacturers are paying for the article and the "study".

[+] deegles|7 years ago|reply
I had a coworker who insisted diet sodas were worse for you than regular sodas. I just don't understand how people reach that kind of conclusion.
[+] yoz-y|7 years ago|reply
> A mystery to me is why they haven't asked about consumption of sugary drinks at the same time. That would have allowed to get much more interesting correlations.

I suppose because there already is a consensus that sugary drinks are bad for people and cause all the mentioned problems. Now the eye turns on the sugarless ones. However a comparison would be indeed welcome.

[+] Waterluvian|7 years ago|reply
"...16% more likely to die from any cause than women who drank diet beverages less than once a week or not at all."

Doesn't this suggest that they actually failed to control for lifestyle effects?

[+] mattkrause|7 years ago|reply
All-cause mortality is a pretty common way to look at “side-effects”, especially when it is not clear exactly what they might be.

These do need to be interpreted carefully though, lest you end up concluding that a drug increases your odds of getting into a car crash or something. There could be a causal link—maybe the drug causes drowsiness or affects vision—but it could also be noise....5% of the time happens 5% of the time, after all!

[+] S_A_P|7 years ago|reply
The problem is that diet sodas are seen as a cheat that allows a person to eat more calories than they should. This usually is linked to people with poor nutrition habits. Those same people are probably more likely to stroke out or have a heart attack.
[+] lucozade|7 years ago|reply
That's unlikely to be the basis for this result as they controlled for weight.

In fact, of their cohort, if the person was obese and drank high quantities of diet drinks, their risk of strokes shot up even further.

[+] njitram|7 years ago|reply
The article states that the research was done only for women above 50, and that it is observational, does not show cause and effect, so not sure how to interpret this.
[+] C1sc0cat|7 years ago|reply
Coke and similar drinks are q problem for patients with renal failure its the phosphor.

You normally take phosphor binders (Renagel) as well as giving up coke - god only knows what costs in the states it cost the nhs about £1000 for 2 months supply for me.

[+] dilap|7 years ago|reply
I dunno, 1.23 increase in risk is tiny; seems likely that it's just lifestyle stuff (which you can try to control for a bit, but you can't know every single choice a diet soda drinker is making -- quite likely an overall less healthy lifestyle).

Compare this to e.g. 20x lung cancer incidence for smokers, where even w/ observational data, you can be pretty sure there's a causal relationship.

Maybe do some RCTs giving diet soda to animals or something and see what happens. And look into the chemistry to see what the mechanism might be...

(That said, probably prudent not to go too crazy with diet soda, or any other novel ingredients.)

[+] twistedanimator|7 years ago|reply
I didn't RTFA, but I'm going to chime in anyways.

I think if you're drinking 2 or more diet beverages a day, you probably have a "fuck it" attitude when it comes to your health. And that attitude probably pervades the rest of your decisions you make in your life.

Even the people I know who couldn't care less about their health all talk about not wanting to get cancer from drinking diet sodas, especially those containing aspartame.

[+] aledthemathguy|7 years ago|reply

[deleted]

[+] PavlikPaja|7 years ago|reply
It's the phosphoric acid, which binds and prevents the absorption of other micronutrients.
[+] TeMPOraL|7 years ago|reply
TL;DR: it's an association, not a causal relationship.

It may as well be that people more prone to stroke or heart attacks pick up diet beverages.

[+] lowken10|7 years ago|reply
I think I'll go grab a diet coke.
[+] lolc|7 years ago|reply
Why not get the one with the sugar? The data on that one are clear. No worrying about whether it's bad for you.
[+] joebluemoon|7 years ago|reply
Why do westerners treat everything as a cause and effect machine? Its such an amateur view. This is a great illustratin of "intellect" vs "intelligence". The entire western societies are based on "intellect". Also, don't consume fake anything ;)
[+] joebluemoon|7 years ago|reply
I noticed a pattern on sites where the userbase is more "science savvy" types, concencus os always to discredit anything against manmade like gmo and now this. Also, the entire perception on food in the west is so upside down its like the darkages here in that regard. Its fascinating to witness.