Q&A: Diet Sodas and Stroke Risk Factors

Dr. Sinatra, I've seen news reports that drinking diet soda can increase my risk of stroke and heart attack. What's the real story?

Drinking diet soda can increase your risk of heart attack and stroke, according to a paper presented at the American Heart Association's International Stroke Conference being held in Los Angeles. Researchers said that consuming as little as one diet soda a day could increase your risk of stroke or heart attack by 48 percent.

The connection appears to be related to metabolic syndrome. When your body tastes the sweetness of a diet soda, it releases insulin to handle the expected sugar. When no sugar show up in the diet food, you have an insulin overload in your bloodstream. A constant overload makes your cells less responsive to insulin. A high level of insulin also triggers hunger signals and a craving for other sweet foods. I can't tell you how many times I've seen someone holding a diet soda in one hand and a doughnut in the other.

There may also be a connection to the type of sweetener used in diet sodas. During the period of this study, the most common diet sweetener was aspartame (NutraSweet). In the past couple of years, some makers have switched to acesulfame-K or even to a stevia extract. I don't think the switch is going to make much difference, though. While I do like stevia, the whole concept of diet sodas is the problem here.

The Conventional Response

As you can imagine, the beverage industry isn't very happy with the results of this study. The American Beverage Association's senior vice president for science policy (they have one of these?) said there's no evidence "that diet soda uniquely causes increased risk of vascular events or stroke."

What surprises me is the response of some highly visible physicians. Dr. Richard Besser, a health and medical editor for ABC News, says that, "I wouldn't change behavior based on [this study]." The same response came from Walt Willett, with the Harvard School of Public Health: "We shouldn't really change our behavior."

What are these guys thinking? The evidence has been clear for a while now that diet sodas contribute to obesity and increase your risk of cardiovascular disease, including stroke. This most recent study is another nail in the coffin for diet sodas.

Reduce your Stroke Risk Factors

People drink diet sodas for one reason: to manage their weight. There are healthier ways to do so, however. And those healthier ways do not include drugs for weight loss.

The answer to weight loss is the same as it's always been: improve your diet, and become more active. Yes, it is that simple and effective. It isn't always easy, though, so I've provided some help for you.

The first step in weight loss it to get your diet in order. That doesn't mean starving yourself, which can depress your metabolism and hamper your weight loss efforts even more; often it just means making smarter food choices. One thing you do have to do is cut out the sugar. As I've said before, sugar is a bigger heart risk than cholesterol. You can also rely on my PAMM diet for healthy food choices. I have plenty of heart-healthy recipes for you. The good news is that food that's good for your heart is also good for your weight.

When it comes to activity, I know it can be hard to get yourself going if you're not used to exercising. That's why I recommend yoga for heart health as a good starting place. Forget the image of bending yourself into a pretzel. Basic yoga is simple, and you can do it yourself with a minimum of equipment.

Combine these two—diet and exercise—and you'll find that the pounds and inches will disappear.