Diet soda: Innocent until proven guilty?


Diet soda consumption has increased linearly in recent years, due to its image as a healthier alternative to regular soda. However, scientists have now shown that besides weight gain, daily consumption of diet soda may also lead to an increased risk in developing vascular events like heart attack and stroke.

Do you have soda with every meal of the day, including breakfast? Do you reach for diet soda instead of water when you are thirsty? Does the person who restocks the soda vending machine at work know you by name? If the answer to at least one of these questions is “yes”, then you, like so many others nowadays, may be addicted to soda.

Sugary drinks are the number one source of added sugar in the diets of Americans and increasingly the rest of world, today. Since it is well known that sugary drinks carry severe health risks and support the development of obesity and obesity related diseases, there is a need for healthier beverages. In recent years, diet drinks have been advertised and marketed as a healthier alternative to sugary soft drinks. This has led to a large number of people switching to diet versus sugary sodas. In fact, in 2009 and 2010, 20% of the U.S. population consumed at least one diet soft drink per day. From those individuals, at least 10% consumed more than 16 ounces of diet soda per day. In general, between 1999 and today the overall consumption of diet soda has showed a linear increase, reaching nearly 15% of worldwide and 25-30% of European and US consumption in 2014.

But is diet soda really a healthier alternative to regular soda?

Research carried out in recent years on this topic has hinted otherwise, linking diet sodas to obesity, but also to potentially increased vascular events like heart attacks and stroke, as shown in a study perfomed recently by Hannah Gardener and colleagues, at the University of Miami, Florida. More specifically, in this study, the scientists set out to examine the relationship between diet and regular soft drink consumption and the risk of developing diseases such as stroke, myocardial infarction (MI) and vascular death in a multi-ethnic population-based cohort.

In order to implement this study, researchers monitored the number of soft drinks, normal and diet, consumed by 2564 participants over a period of 10 years. They then examined the incidence of vascular events that occurred over this period of time, taking into account pre-existing vascular conditions such as high cholesterol and hypertension. Their results demonstrated that participants who drank diet soft drinks daily, had a 43% increased risk of vascular events compared to those who did not drink diet soft drinks. Participants that only consumed diet soft drinks infrequently did not show a significantly increased risk of vascular events, neither did those who chose to drink regular soft drinks.

So how does diet soda work to exert a potential negative effect on our health?

The health consequences resulting from regular soft drinks are well known and can be linked to the high caloric content of these drinks, glycemic load and a possible inflammatory response in the obese state. Furthermore, added sweeteners such as high fructose corn syrup may increase the risk of vascular events due to its influence on blood uric acid levels and triacylglycerol concentrations.

However, the mechanisms by which diet soft drinks could affect our health are less obvious. Consumption of artificially sweetened drinks has been associated with weight gain. In rats, it has been shown that the consumption of artificial sweeteners weakened the ability to anticipate the caloric contents of food. But, neither of these studies seems to provide a conclusive explanation for the observed findings. Taken together with previous reports suggesting a correlation between diet soda consumption and the development of type 2 diabetes and the metabolic syndrome, there is definitely a need for further research into whether diet sodas constitute healthy substitutes for regular sodas.

Does this mean we should give up diet soda?

There is definitely accumulating evidence that suggests diet soft drinks may be potentially as bad for our health as regular sodas. For sure, switching from regular soda to diet soda will save a great number of calories, especially for individuals that are addicted to these type of drinks. In fact, many diets out there today allow the consumption of diet sodas as an aid in weight loss. However, this may be counterproductive, seeing that it has been shown that diet soda can actually lead to weight gain. Taking into account that these drinks have also been linked to an increased risk in developing several health problems such as diabetes and cardiovascular disease, it may be wise to reduce diet soda consumption and replace it with healthier alternatives like water. Ofcourse, the choice is always up to each individual and it is not always an easy one to make...



U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2010. 7th ed. Washington, DC: U.S. Government Printing Office. 2010.

NCHS Data Brief, No 109,  2012.

Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89:1037–42.

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16:1894–900

Davidson TL, Swithers SE. A Pavlovian approach to the problem of obesity. Int J Obes Relat Metab Disord. 2004;28:933–5.

Image copyright: nitrub/thinkstock

Article last time updated on 03.12.2014.

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I believe that diet sodas also increase insulin levels, which stores our consumed fat immediately. So nothing worse than a burger combined with a diet soda!
#1 at 22.09.2014 from Guest
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