Has your competent? doctor and hospital managed to remove ALL soda from the hospital? Not just diet soda?
Frequent Diet Soda Intake Linked to Fourfold Increased Dementia Risk
Frequent consumption of diet soda has been tied to an increased risk for dementia, although the association may be mediated by certain physical conditions.
New findings from the Northern Manhattan Study (NOMAS) showed a fourfold increased dementia risk among dementia-free individuals who consumed more than one diet soda per day. In addition, the increased risk was found in individuals who were White or Black but not Hispanic.
However, after excluding participants with either diabetes or obesity, this association was no longer significant.
“I think the takeaway message for clinicians is that we need more research to better understand the association of soda consumption with neurological health,” corresponding author Hannah Gardener, ScD, Department of Neurology, University of Miami Miller School of Medicine, Miami, told Medscape Medical News.
Still, she added that the study adds to previous research showing that drinking diet soda “is not very healthy, and consuming more of it is not an effective way to decrease cardiometabolic risk,” Gardener said.
The findings were published online on January 6 in the Journal of Alzheimer’s Disease.
The History of the Soda-Dementia Link
Soda consumption is linked to vascular risk, but little is known about its potential association with dementia.
A prospective 2017 study published in Stroke showed an increased incidence of both stroke and dementia among participants who consumed artificially sweetened beverages, including diet soda — but not among those who consumed sugar-sweetened beverages.
On the other hand, a meta-analysis published in 2022 showed a link between cognitive disorders and sugar-sweetened beverages — but not with artificially sweetened beverages.
The investigators wanted to assess these associations in a population-based cohort, deciding to analyze data from the longitudinal NOMAS project.
The analysis included 947 adults without dementia at baseline. Participants at the start of the study had a mean age of 64 years; 59% were women, 64% Hispanic, 18% Black, and 16% White.
A variation of the Block-National Cancer Center Institute food-frequency questionnaire was used to determine consumption of both regular and diet soda. Among participants, 4.8% consumed regular soda more than once per day, and 2.3% consumed diet soda more than once per day.
Dementia was diagnosed using neuropsychological and functional testing, with 20% of participants developing the condition over the follow-up period.
Reverse Causation?
Diet soda consumption was linked to a significantly increased risk for dementia, with an adjusted incidence rate ratio (aIRR) of 1.39 per soda per day after accounting for demographic and vascular risk factors.
Those who consumed more than one diet soda per day had an even greater risk for dementia than those who drank one or fewer diet sodas per day (aIRR, 4.15; P = .001).
Diet soft drink consumption was also associated with a greater risk for dementia in non-Hispanic White and Black individuals but not in Hispanic individuals.
Although the investigators had hypothesized that regular soda consumption would also be linked to increased risk for dementia, they found no significant association. Still, they did observe a “nonstatistically significant trend” (unadjusted P = .07).
Interestingly, sensitivity analyses showed that the link between higher consumption of diet soda and increased dementia risk “was not apparent after excluding those with obesity or diabetes, highlighting a potential for reverse causation,” the researchers reported.
“Further study is needed into the impacts of obesity and diabetes,” they added.
Gardener noted that the study did not assess how long the participants had been drinking soft drinks, or whether or when they switched from regular sodas to diet versions.
“Were they increasing their consumption of diet sodas in an effort to control their metabolic risk factors — to consume fewer calories or to control their blood sugar? We really need more research to better understand if this association that we and other researchers have seen is causal,” she said.
No Definitive Answer
Commenting for Medscape Medical News, Matthew P. Pase, PhD, a professor of neurology in the School of Psychological Sciences at Monash University in Melbourne, Australia, said it was notable that the current findings closely resembled those from his 2017 Stroke paper, one of the first major studies to examine these associations, despite being conducted nearly nine years ago.
He also pointed out similar limitations in both papers, including the fact that consumption data were collected at the same timepoint and that it was difficult to tease out whether physical conditions, such as obesity and diabetes, may play a role in the diet soda-dementia association.
“It’s just a quick snapshot. We don’t know what these people were doing 5 or 10 or 30 years ago. It’s difficult to [assess] that, but I think that’s what’s needed in order to be able to really tease out the ‘chicken or the egg’ question,” he said.
Pase added that it makes one wonder whether the association was only there because the individuals who drank diet drinks were already unhealthy
Overall, “I actually don’t think there’s a strong message yet for clinicians,” he said.
If a patient raises the topic, “it might be best to say that the science is a bit mixed currently, and it makes it hard to make a conclusion one way or the other,” Pase said.
Partial results were presented previously at the 2024 Alzheimer's Association International Conference in Philadelphia, Pennsylvania
NOMAS was funded by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging. One investigator reported receiving royalties from Wolters Kluwer, Inc. for a writing project on vascular dementia. Gardener, Pase, and the other investigators reported no relevant financial relationships.
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