You probably stopped drinking sugary soft drinks years ago. But if you switched to artificially sweetened drinks instead, it might be time to give LaCroix or Perrier a try.

A study of 80,000 women age 50 to 79 found a link between drinking artificially sweetened beverages and higher risk of stroke, heart disease, and mortality. 

The Women’s Health Initiative study is noteworthy because it studied a large number of women from locations around the United States for a long period of time. It included more than 20 times the number of participants as another study examining diet drinks and health risks.

Also, it sheds new light on the links between these beverages and health risks for older women. It is one of the first studies to examine the connection between diet drinks and the risks of certain types of stroke in a large, racially diverse pool of post-menopausal women.

It compared women who reported drinking two or more 12-ounce artificially sweetened drinks per day to those who drank none or less than one a week. 

It found the twice-or-more-a-day drinkers were: 

  • 23% more likely to have a stroke and 31% more likely to have a stroke caused by a blood clot
  • 29% more likely to develop heart disease
  • 16% more likely to die from any cause

The risks were even higher in obese and African American women. The study adjusted for risk factors such as age, high blood pressure, and smoking. 

“These women are already in the years when their risk for heart disease starts to increase.”
Nieca Goldberg, medical director
Joan H. Tisch Center for Women’s Health, New York University Langone Medical Center

Nieca Goldberg, medical director of the Joan H. Tisch Center for Women’s Health at the New York University Langone Medical Center, says that diet drinks may add to the risks that older women are already facing. 

“These women are already in the years when their risk for heart disease starts to increase,” she says. “As you transition through menopause you see increases in blood pressure, bad cholesterol, and triglycerides that raise your cardiovascular risk.”

It’s important to note that this study identifies a link between diet drinks and health risks. It doesn’t prove that diet drinks cause these increases in stroke, heart disease, and mortality. 

“The bottom line is that we need more research. Our study shows an association—this does not imply causation,” says Yasmin Mossavar-Rahmani, the study’s lead researcher.

The study didn’t specifically ask which beverages or artificial sweeteners the women consumed, just how often they drank them. “So, we don’t know which artificial sweeteners may be harmful and which may be harmless,” says Mossavar-Rahmani.

This study adds to the evidence that limiting diet beverages might be a smart choice.

What to drink instead

Last year the American Heart Association published a science advisory recommending that people replace sweet drinks with plain, carbonated, or unsweetened flavored water. 

The advisory included drinks sweetened with saccharin, aspartame, acesulfame-K, sucralose, neotame, advantame, steviol glycosides, and extracts obtained from luo han guo or monk fruit.

The advisory’s authors acknowledge that there isn’t a lot of research on diet drinks and health problems, and says that switching to water is the best advice the AHA has to offer now, based on the evidence that’s available.

“It seems sensible to assume that these [artificially sweetened] drinks are not harmless and so not to have endless amounts. We need more research on sweeteners and other ingredients in the drinks and how they impact our metabolism,” Mossavar-Rahmani says.

Researchers recognize that some people use diet drinks in place of sugary beverages. They recommend using them to make the switch from sugary beverages to water and other healthier choices, not as a permanent replacement for sugary beverages. 

Need more convincing? A 2017 study also found a link between stroke risk and diet drinks, and found a link between dementia and diet drinks as well.