Soda consumption and the risk of stroke in men and women

Abstract

Background: Consumption of sugar-sweetened soda has been associated with an increased risk of cardiometabolic disease. The relation with cerebrovascular disease has not yet been closely examined.

Objective: Our objective was to examine patterns of soda consumption and substitution of alternative beverages for soda in relation to stroke risk.

Design: The Nurses' Health Study, a prospective cohort study of 84,085 women followed for 28 y (1980-2008), and the Health Professionals Follow-Up Study, a prospective cohort study of 43,371 men followed for 22 y (1986-2008), provided data on soda consumption and incident stroke.

Results: We documented 1416 strokes in men during 841,770 person-years of follow-up and 2938 strokes in women during 2,188,230 person-years of follow-up. The pooled RR of total stroke for ≥ 1 serving of sugar-sweetened soda/d, compared with none, was 1.16 (95% CI: 1.00, 1.34). The pooled RR of total stroke for ≥ 1 serving of low-calorie soda/d, compared with none, was 1.16 (95% CI: 1.05, 1.28). Compared with 1 serving of sugar-sweetened soda/d, 1 serving of decaffeinated coffee/d was associated with a 10% (95% CI: 1%, 19%) lower risk of stroke and 1 serving of caffeinated coffee/d with a 9% (95% CI: 0%, 17%) lower risk. Similar estimated reductions in risk were seen for substitution of caffeinated or decaffeinated coffee for low-calorie soda.

Conclusions: Greater consumption of sugar-sweetened and low-calorie sodas was associated with a significantly higher risk of stroke. This risk may be reduced by substituting alternative beverages for soda.

FIGURE 1.

Pooled RRs and 95% CIs associated with substitution of alternative beverages for sugar-sweetened soda (A) and low-calorie soda (B) among 43,371 men and 84,085 women (1 serving/d). RRs and variances for each substitution from each cohort were derived from a Cox proportional hazards multivariate model and then pooled in a fixed-effects model to arrive at a summary estimate of the effect of substituting one beverage for another in relation to total stroke risk; the Q statistic P value for between-study heterogeneity (null hypothesis is that there is no heterogeneity between Health Professionals Follow-Up Study and Nurses’ Health Study) for estimate of effect of substitutions is >0.05.