Frequently consuming artificially sweetened beverages (ASBs) is associated with an increased risk for stroke, coronary heart disease, and all-cause mortality in women, according to study results published in Stroke.

The study included participants from the Women’s Health Initiative Observational Study: postmenopausal women age 50 to 79 at baseline who enrolled between 1993 and 1998 (N=81,714). Mean follow-up was 11.9 years. The study’s primary outcome was the association between self-reported consumption of ASB and stroke, coronary heart disease, and all-cause mortality.

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The majority of participants (64.1%) reported they never or rarely (<1/wk) consumed ASBs. Only 5.1% of participants reported consuming ≥2 ASBs per day.

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After multivariate analysis, participants who consumed the highest amount of ASBs had significantly greater likelihood of experiencing all end points except hemorrhagic stroke compared with participants who never or rarely consumed ASBs. The hazard ratios (HRs) for the highest amount of ASB consumption vs never/rarely were 1.23 (95% CI, 1.02-1.47) for all stroke, 1.31 (95% CI,1.06-1.63) for ischemic stroke, 1.29 (95% CI, 1.11-1.51) for coronary heart disease, and 1.16 (95% CI, 1.07-1.26) for all-cause mortality.

In women who did not have a history of cardiovascular disease or diabetes mellitus, high ASB consumption was associated with a significant increase of small artery occlusion ischemic stroke (HR 2.44).

Women with a body mass index ≥30 with high ASB consumption had a significantly increased risk for ischemic stroke (HR 2.03).

“Because of the observational nature of the study, however, the possibility of residual confounding cannot be excluded,” the researchers wrote. “Future studies are needed to replicate the findings and to examine specific ASBs in relation to stroke and other outcomes to guide clinical recommendations.”


Mossavar-RahmaniY, Kamensky V, Manson JE, et al. Artificially sweetened beverages and stroke, coronary heart disease, and all-cause mortality in the Women’s Health Initiative. [published online February 14, 2019]. Stroke. doi:10.1161/STROKEAHA.118.023100