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Diet Drinks Threaten the Brain

The message that we should all dramatically reduce our sugar consumption is really gaining traction and for good reason. This was a central theme of Grain Brain, and these ideas have certainly been validated since I published that book back in 2013.

Unfortunately, as people have learned about the threats of sugar consumption, soft drink manufacturers have decided to emphasize sugar-free beverages, sweetened with artificial sweeteners, as a “healthy” alternative. To be clear, nothing is further from the truth.

Please review my previous blogs and videos that show such a strong correlation between consuming artificially sweetened beverages and risk for weight gain, as well as type 2 diabetes. in a new study, published in the highly respected journal JAMA Neurology, researchers demonstrate that the risk for Alzheimer’s disease, dementia in general, and stroke, are all dramatically increased in people who drink these sugar-free beverages. One reason this may be happening has to do with the changes in the gut bacteria that occur when consumers are exposed to these chemicals. Watch the video, and hopefully you’ll think twice the next time somebody offers you a diet drink.

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  • Dr. Perlmutter, I avoid diet drinks, but I take a generous portion of Metamucil every day. My choices are the sugar or artificially sweetened versions. Should I ditch the fiber because of the risks imposed by the sweeteners? I’ve tried to find a fiber supplement without some form of sweetener and have been unsuccessful so far.

  • Annelise

    I would be interested in knowing, from Dr. Perlmutter, whether it’s ever “too late” for the body to show benefits from not using artificial sweeteners. My concern is that I’ve been drinking diet soda since it came out in the 80’s, not realizing, until the last couple of years, just how bad it really is. Could I have done irreparable damage?

    • David Perlmutter

      Never too late to take back control of your health.

      • Annelise

        Well said. Thank you for your work and sharing it so freely. Very appreciated.

  • bestofandy

    So what “damage” does Aspertame really do to the brain to bring on Alzheimer’s disease? You are only suggesting that Aspertame kills gut bacteria. Any group of special interest “medicine” research can conclude stuff like this to undercut diet drinks. What is the safe alternative other than sugared drinks?

    • Mary Ellen Ramos

      Water, it’s what our bodies need. Flavor with lemon juice. Tea, brewed not instant, in moderation. Herbal tea.

      • Peggy Stacy

        Tea, unsweetened. Coffee, black. If you need it sweet, stevia does the trick.

        • Roger Chappell

          Stevia tastes disgusting.

  • Darla Duke Lunsford

    I don’t drink diet soda but 2 splendid in my coffee in the morning.

    • Patricia Lowder Stevenson

      Switch to Stevia which is a natural sweetener. Splenda is just as bad as Equal and Sweet ‘n Low.

      • Roger Chappell

        Stevia tastes really bad though. Ruins coffee.

        • Patricia Lowder Stevenson

          Sorry. I use it in some things but I don’t drink coffee or tea so I don’t know about that.

        • David Perlmutter

          Roger: We’ve noted your comments about a message your comment has been deleted. Can’t say our team has done this and we’re trying to get to the bottom of the issue. That said, to make sure your voice is heard, we’re posting the full text of your second comment below. Do feel free to get in touch if you have questions or concerns.

          Roger Chappell:
          Posting again, because my previous one was deleted….
          If there was concrete proof, then the national guidelines for consumption would change.

          One study doesn’t prove anything, as the study notes itself in the following excerpt from it:
          Thus, diabetes mellitus was a partial but not full mediator of the association between artificially sweetened bevera ge intake and incident dementia. Prevalent hypertension was a potential mediator of the association between artificially sweetened beverage intake and incident all-stroke, but not ischemic stroke

          It was reported that daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke when examined as an independent outcome.

          In our study, diabetes mellitus —a known risk factor for dementia— was more prevalent in those who regularly consumed artificially sweetened soft drinks. Diabetes mellitus sta tus also partially mediated the association between artificially sweetened soft drink intake and incident dementia.

          Because our study was observational, we are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to consume diet beverages.
          In our study, prevalent hypertension, the single most important stroke risk factor, attenuated the association between artificially sweetened beverage intake and incident all-stroke, although not ischemic stroke. Prospective cohort studies, such as the Nurses Health Study, have demonstrated associations between higher intake of artificially sweetened beverages and an increased risk of inc ident hypertension. However, it remains unclear whether artificial sweeteners cause hypertension or whether diet beverages are favored by those most at risk.

          Limitations of the study include the absence of ethnic minorities, which limits the generalizability of our findings to populations of non-European decent.

          Second, the observational nature of our study precludes us from inferring causal links between artificially sweetened beverage consumption and the risks of stroke and dementia.

          Third, the use of a self-report FFQ to obtain dietary intake data may be subject to recall bias, thus, introducing error into our estimated models.
          Fourth, although we addressed confounding in numerous ways, we cannot exclude the possibility of residual confounding.

          Finally, we did not adjust for multiple comparisons meaning that some findings may be attributable to chance.

  • Mary Nelson

    What about things like that powdered to put in coffee to replace dairy? I read the ingredients on one and it was frightening.

    • Coconut milk is great in your coffee.. Just read the label as some brands put in sugar and carageenan. I like the Califa brand best.

      • Angelica Klimon

        I use nut milks mixed with coconut milk for my coffee in place of milk and both work great together or on their own. I prefer cashew milk over almond milk as i find the cashew milk is creamier. If you can make it homemade even better. Make sure to buy sugar free if you buy the nut milks from the store.

  • John Perry

    Does the sugar industry sponsor or influence these studies as they have in the past ?

  • Roger Chappell

    David, Your headline suggests that the study is conclusive and proves a direct link. It does not. The fact that you put this up suggests that you either didnt read the study or failed to comprehend it.

    Here is where your assumption falls apart, and why the study doesn’t prove anything: (from the study itself):

    Thus, diabetes mellitus was a partial but not full mediator of the association between artificially sweetened beverage intake and incident dementia. Prevalent hypertension was a potential mediator of the association between artificially sweetened beverage intake and incident all-stroke, but not ischemic stroke

    It was reported that daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke when examined as an independent outcome.

    In our study, diabetes mellitus—a known risk factor for dementia—was more prevalent in those who regularly consumed artificially sweetened soft drinks. Diabetes mellitus status also partially mediated the association between artificially sweetened soft drink intake and incident dementia. Because our study was observational, we are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to consume diet beverages.

    In our study, prevalent hypertension, the single most important stroke risk factor, attenuated the association between artificially sweetened beverage intake and incident all-stroke, although not ischemic stroke. Prospective cohort studies, such as the Nurses Health Study, have demonstrated associations between higher intake of artificially sweetened beverages and an increased risk of incident hypertension.22 However, it remains unclear whether artificial sweeteners cause hypertension or whether diet beverages are favored by those most at risk.

    Limitations of the study include the absence of ethnic minorities, which limits the generalizability of our findings to populations of non-European decent.

    Second, the observational nature of our study precludes us from inferring causal links between artificially sweetened beverage consumption and the risks of stroke and dementia.

    Third, the use of a self-report FFQ to obtain dietary intake data may be subject to recall bias, thus, introducing error into our
    estimated models.

    Fourth, although we addressed confounding in numerous ways, we cannot exclude the possibility of residual confounding. Finally, we did not adjust for multiple comparisons meaning that some findings may be attributable to chance.

  • Roger Chappell

    Oh look, My comment that countered this article has been deleted.

  • Roger Chappell

    Posting again, because my previous one was deleted….

    If there was concrete proof, then the national guidelines for consumption would change.
    One study doesn’t prove anything, as the study notes itself in the following excerpt from it:

    Thus, diabetes mellitus was a partial but not full mediator of the association between artificially sweetened beverage intake and incident dementia. Prevalent hypertension was a potential mediator of the association between artificially sweetened beverage intake and incident all-stroke, but not ischemic stroke

    It was reported that daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke when examined as an independent outcome.

    In our study, diabetes mellitus —a known risk factor for dementia— was more prevalent in those who regularly consumed artificially sweetened soft drinks. Diabetes mellitus status also partially mediated the association between artificially sweetened soft drink intake and incident dementia.
    Because our study was observational, we are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to consume diet beverages.

    In our study, prevalent hypertension, the single most important stroke risk factor, attenuated the association between artificially sweetened beverage intake and incident all-stroke, although not ischemic stroke. Prospective cohort studies, such as the Nurses Health Study, have demonstrated associations between higher intake of artificially sweetened beverages and an increased risk of incident hypertension. However, it remains unclear whether artificial sweeteners cause hypertension or whether diet beverages are favored by those most at risk.

    Limitations of the study include the absence of ethnic minorities, which limits the generalizability of our findings to populations of non-European decent.

    Second, the observational nature of our study precludes us from inferring causal links between artificially sweetened beverage consumption and the risks of stroke and dementia.

    Third, the use of a self-report FFQ to obtain dietary intake data may be subject to recall bias, thus, introducing error into our estimated models.
    Fourth, although we addressed confounding in numerous ways, we cannot exclude the possibility of residual confounding.

    Finally, we did not adjust for multiple comparisons meaning that some findings may be attributable to chance.

  • Nancy Kishino

    Is Stevia considered an artifical sweetner?

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