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Written by: Cameron Rosario
Medically reviewed by: Rob Philibert MD PhD


For several years, evidence of the detrimental health consequences of consuming sugar sweetened beverages (SSBs) has been building. From carbonated and noncarbonated soft drinks to sports drinks, the caloric sweeteners (high-corn syrup, sucrose or fruit juice concentrates) that contribute to a higher risk for obesity, type 2 diabetes, and cardiovascular risk are now the leading source of added sugars to one’s diet in many countries.

To combat this problem, in 2018, soft drink companies have invested $296 million into encouraging individuals to switch to the diet alternative of their favourite sugar sweetened beverages. Within these diet beverages are artificial sweeteners including aspartame and sucralose, both of which claim to allow a consumer to indulge in their favourite beverage without the added guilt that comes with their sugar-sweetened counterparts. However, research has alluded to the possibility that these diet beverages may not be the beneficent health phenomenon consumers have been expecting.

The Research

In the Journal of the American College of Cardiology, a study published using data from the French NutriNet-Santé cohort analyzed the long-term link between nutrition and cardio-metabolic health. The study tracked over 104,760 individuals for 10 years through a web-based 24-hour dietary record. The investigators concluded that consumers of both artificially sweetened diet beverages and SSBs had a greater risk for first incident cardiovascular disease compared to individuals that drank neither type of beverage. This study supported the previously made hypothesis that artificially sweetened beverages may not solve the increased risk for health disease that was associated with SSBs.

A study using data from the Women’s Health Initiative Observational Study published in the American Heart Association journal Stroke investigated the long-term impact of artificially sweetened diet beverages on the heart health of post-menopausal women (ages 50-79). Within the span of 12 years, 81,714 women were surveyed about their diet and their medical exams were tracked to investigate possible outcomes of stroke, heart disease, and death. The study found that women who consumed artificially sweetened diet beverages on a regular basis had a 23% increased risk for an embolic (i.e. clot) stroke, 29% increased risk for heart disease and a 16% greater risk for premature death in comparison to less frequent/rare consumers.

It is important to note that although neither of these publications directly established that the diet beverages were harmful, they concluded that diet beverages should be consumed with caution. In fact, the proposed negative effects of consuming high levels of diet beverages are suggested to go beyond increasing one’s risk for heart disease and associated risk factors (obesity and type 2 diabetes). The American Heart Association (AHA) and American Diabetes Association (ADA) warn individuals of the misconceptions that come with the “zero calories”, “zero sugar” and “diet” label. When consumed under the right circumstances, artificial sweeteners can aid in decreasing the number of added sugars and calories in one’s diet. However, the AHA and ADA have expressed concerns surrounding the use of this labeling because some consumers use it as an excuse to indulge in other sources of sugars and calories, ultimately counteracting the main purpose of artificial sweeteners.

Additionally, scientists have also suggested the potential for a high consumption of artificial sweeteners to skew an individual’s taste for naturally sweet food. An obesity and weight-loss specialist at the Harvard-affiliated Boston Children’s Hospital, Dr. David Ludwig, explained this to be a result of the high potency of artificial sweeteners and the subsequent overstimulation of sugar receptors from high consumption. He proposes that as an individual becomes accustomed to the hyperintense sweetness, they may find other less intense sweet foods to be unpleasant or even unpalatable. Consequently, this causes them to shun our healthy and nutritious foods, including fruits and vegetables and resort to artificially sweetened foods that offer little to no nutritional value.


Though artificially sweetened diet beverages do have the potential to help one minimize their caloric intake and sugar consumption, studies have suggested that they may not be an entirely safe substitute for sugar sweetened beverages. Like many other things, it may be that these beverages should be used in careful moderation. In that spirit, instead of reaching for a diet soda, try to avoid sugary drinks all together and opt for a glass of water or some naturally sweetened fruits!


  1. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/behind-the-headlines/diet-drinks-linked-to-heart-and-stroke-risk
  2. https://www.cardiosmart.org/news/2019/2/study-links-diet-drinks-to-increased-risk-of-stroke-and-heart-disease
  3. https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030
  4. https://www.ewg.org/news-insights/news/study-ditching-diet-drinks-may-reduce-risk-heart-disease
  5. https://www.sciencedirect.com/science/article/abs/pii/S0735109720365967?via%3Dihub
  6. https://www.healthline.com/health-news/diet-soda-no-better-than-regular-soda-for-heart-health#Artificial-sweetener-use-associated-with-heart-disease