Artifician Sweetned Beverages: Stroke and Dementia
Friday, April 28, 2017
Sugar and
artificially-sweetened beverage intake have been linked to
cardiometabolic risk factors, which increase the risk of cerebrovascular
disease and dementia.
A prospective cohort study published in Stroke
on April 24, 2017, analyzed data collected from 2,888 subjects for
incident stroke. The subjects were part of the community-based
Framingham Heart Study Offspring cohort, aged between 45 and 91 years,
with a mean age of 62 years. Forty five percent of the subjects were
men.
They
also analyzed data collected from 1,484 of the 2,888 Framingham Heart
Study participants over the age of 60 years for incident dementia, with a
mean age of 69. Forty six percent were men.
Beverage
intake was quantified using a food-frequency questionnaire at cohort
examinations between 1991 and 1995, 1995 and 1998, 1998 and 2001. They
quantified consumption and cumulative consumption by averaging across
examinations. Many of the subjects consumed one or more sugar or
artificially-sweetened soft drinks per day.
Surveillance for incident events commenced at last examination (2001) and continued for 10 years.
During
this 10 year period, 97 cases of incident stroke (82 ischemic) and 81
cases of incident dementia (63 consistent with Alzheimer’s disease) were
identified.
After
adjustments for age, sex, education (for analysis of dementia), caloric
intake, diet quality, physical activity and smoking, higher recent and
higher cumulative intake of artificially sweetened soft drinks were
associated with an increased risk of ischemic stroke, all-cause
dementia, and Alzheimer’s disease dementia.
Ischemic
stroke (strokes by blocked artery to the brain), dementia and
Alzheimer’s disease incidence were not associated with sugar-sweetened
beverages.
Conflicting data
The
Nurses’ Health Study and Health Professionals Follow-Up Study reported
that greater consumption of both sugar and artificially sweetened soft
drinks was each independently associated with a higher risk of incident
stroke over 29 years of follow-up for women and 22 years of follow-up
for men.
The
Northern Manhattan Study, a population-based multiethnic cohort
reported that daily consumption of artificially sweetened soft drink was
associated with a higher risk of combined cardiovascular events, but
not stroke when examined as an independent outcome.
Previous
studies linking artificially sweetened beverage consumption of negative
health consequences have been questioned based on concerns regarding
residual confounding and reverse causality (do sicker individuals
consume diet beverages as a means of negating a further deterioration in
health?).
One
of the study limitations we try to identify include the absence of
minorities and gender bias in study subject selection. In this study
case, the generalizabition of findings was investigator reported,
suggesting the subject selection was limited to populations of
non-European decent.
......
This
new study seems to be the first to report an association between daily
intake of artificially sweetened soft drinks, and an increased risk of
both all-cause dementia and dementia linked to Alzheimer’s disease.
The
conclusion suggests that further research is needed to replicate the
findings and to investigate the mechanisms underlying the reported
association.
Ellen Troyer with Spencer Thornton, MD, David Amess and the Biosyntrx staff
