People who drink diet soda may be at a higher risk for heart disease, stroke and early death

Since the introduction of Diet Coke in 1982, artificially sweetened drinks have become increasingly ubiquitous in the American diet. In fact, according to a 2018 consumer survey, more than half of all Americans age 18 to 49 drank at least one Diet Coke at some point in the past four weeks. So it's hardly surprising that epidemiologists are studying the effects the zero-calorie sweeteners have on our health. The most recent study, published this week in the journal Stroke, drew conclusions that sound worrying: In postmenopausal women, drinking two or more of these beverages a day were linked to an earlier risk of stroke, heart disease, and early death.

The study collected diet and health information from more than 80,000 women between the ages of 50 and 79 as part of the Women’s Health Initiative, a longitudinal health study created in 1991 by the National Institutes of Health. The authors looked specifically for a connection between the consumption of diet sodas and other artificially sweetened beverages (like Snapple, Vitamin Water, or Crystal Light) and stroke, heart disease, and overall mortality.

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12 things your mother's health says about you
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12 things your mother's health says about you

Sketchy skeleton

Genetics play a big part in health conditions, so looking at your mom’s health can give you a clue what’s to come. This is especially true of complications that affect women more than men, like osteoporosis, a weakening of the bones. According to the CDC, osteoporosis affects 25 percent of women over 65, but only six percent of men—and recent research has found genetic variants predisposing some people to the disease. “There is strong evidence for an increased risk of osteoporosis if your mother had it,” says Todd Sontag, DO, a family medicine specialist with Orlando Health Physician Associates. “Many times this has to do with an inherited body structure of having lower body weight—less than 58kg [128 pounds] in adults or a BMI of less than 22.” Another risk factor is simply having a parental history (mom or dad) of hip fracture, he says. To mitigate these affects, make sure you’re getting enough calcium and vitamin D, and are living a healthy lifestyle. Here are the signs you’re not as healthy as you think.

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Crepey skin

Wonder if you’re going to get wrinkles or skin damage? Take a look at your mom’s face. Research has shown that male and female skin ages differently due to different hormones. “Your mother’s ability to break down collagen and the age when it started breaking down—the age when she got wrinkles—are passed down to you, as well as the pattern of collagen breakdown: Did she get wrinkles around her eyes first, or deeper lines around her mouth?” says dermatologist Purvisha Patel, MD, creator of Visha Skin Care. “Looking at pictures of her as she ages helps you understand how to combat your aging process.” Daily sunscreen and an anti-aging serum with retinol, vitamin C, ferulic acid, and vitamin E work to fight these genetic effects, she says. In addition, your skin type, passed down from your mother and your father, can affect your chances of sun damage and skin cancer. Those with fairer skin are most at risk. This is what dermatologists wish you knew about preventing wrinkles.

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Mental health

If you’re aware of what psychologists wish you knew about depression, you might already know that depression is diagnosed twice as often in women as in men, possibly as a result of hormonal fluctuations and women’s response to trauma and stress. “Another important aspect in gender studies shows that women have a more chronic course of depression than do men,” says psychologist Deborah Serani, PsyD, award-winning author of Living With Depression. “This means that females experience depression more often and for a longer duration of time than males.” Plus, it’s genetically linked, with Harvard Medical School experts noting that certain genetic mutations associated with depression occur only in women. So if your mother had depression, you should be on the lookout for symptoms, and get treatment if needed. “This is why knowing your family medical history is so important to become proactive about your own personal health,” Dr. Serani says. Here are the signs you’re healthy from every type of doctor.

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Eye issues

Women are more likely to have the eye condition glaucoma, and are also more likely to be visually impaired or blind from it, says the American Academy of Ophthalmology (AAO). Thanks to menopause, women are also more likely to have dry eye syndrome, which frequently occurs with glaucoma. Plus, glaucoma runs in families—so if your mom (or dad) has it, be sure to let your eye doctor know, and get screened for it regularly. “You are at higher risk for developing glaucoma and [another eye condition] macular degeneration if your mother had it,” says Dr. Sontag. “Just like everything else, there are other lifestyle factors that contribute as well.” The AAO says to also avoid smoking to reduce your risk. Here’s how to improve your eyesight—without eating carrots!

Migraines

There are multiple reasons you might have a migraine, and your mother is just one of them. According to the Mayo Clinic, women are three times more likely than men to have migraines, likely because of hormonal fluctuations. The National Headache Foundation notes that 70 to 80 percent of migraine sufferers have a relative who gets the debilitating attacks as well. “One of the main risk factors for migraines is family history of migraines,” Dr. Sontag says. “So yes, if your mother has migraines, you are more likely to develop them as well.” Emerging research is identifying how and why genetics play a role, with one large international study suggesting it may have to do with how the blood vessels function in the brain. But until we know more, if your mother suffers from migraines, you can try to reduce your risk by limiting other risk factors, like getting regular exercise and sleep, managing stress, and avoiding caffeine and any individual food triggers.

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Alzheimer's disease

Nearly two-thirds of those with Alzheimer’s are women, according to the Alzheimer’s Association. The exact reasons why are yet unknown, but seem to go beyond the simple fact that women live longer than men. Researchers have also found genetic links for Alzheimer’s. “There are genetic alleles that have been identified that increase risk of developing Alzheimer’s disease,” Dr. Sontag says. “A maternal history does increase the risk.” The National Institute on Aging reports that if your mother or father has a genetic mutation for early-onset Alzheimer’s (which appears from your thirties to mid-sixties), there’s a 50/50 chance you will inherit it—and if you do, there is a strong possibility of developing the disease. If your mother had Alzheimer’s or other dementia, you can reduce your risk by exercising, eating a heart-healthy diet, maintaining social ties, and staying mentally active. These are the early signs of Alzheimer’s disease every adult should know.

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Weight, body shape and fitness level

As with many other aspects of health, the condition of your body is partly genetic, partly environmental. So if your mother has a certain body type or weight, you may be more likely to have the same one—but that could be the result of learned behaviors, too. “While there is some solid research to support a maternal’s body shape and weight and its influence on her children, this is definitely not the only contributing factor,” Dr. Sontag says. “Many times, the lifestyle of the mother is what is learned and passed down to her kids, which includes the way she eats and exercises.” So if you grow up eating the same way as you mother, it’s not surprising if you develop a similar body. Likewise, the fitness level you can achieve is part hereditary, part lifestyle. “Genetics do play a strong role in our muscle make-up,” Dr. Sontag says. “No matter how much certain people train, they will never be as fast as Usain Bolt or Michael Phelps.” Still, if your mom is overweight, you can help avoid the same fate by eating healthy and exercising, with the goal of being the healthiest you can for your individual body.

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Heart disease and diabetes

Women may believe they don’t have to worry about heart disease, but just like men they need to understand their genetic heart disease factors. Given genetic similarities in weight and body shape, you and your mother might also have a similar risk of heart disease, the number one killer of women, as well as type-2 diabetes. A recent study presented at the American Society of Human Genetics found that maternally inherited gene variants of how women store fat can affect their risk of type-2 diabetes. “There is strong evidence that if your mother has heart disease, type-2 diabetes, or strokes, that you are at a higher risk to develop them,” Dr. Sontag says. “The younger the age that the mother developed it tends to correlate with a higher risk in the children.” But again, there are lifestyle factors to consider. “If your mother had a heart attack at 50, but weighed 300 pounds, never exercised, and smoked, the risk may be completely related to her lifestyle,” he says. “You can’t have soda every day and ice cream every night and then use your family history as an excuse when you develop diabetes.” Still, if your mother (or father) had early heart disease, Dr. Sontag recommends a checkup with a cardiologist. These are the physical and emotional ways heart disease is different for women.

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Pregnancy and fertility

If you’re looking to see what your pregnancy experience will be like, ask your mother about carrying you. “Gestational diabetes is more common in women who are risk for adult onset diabetes, which does run in families, so if you have a strong family history of diabetes, you are at increased risk for gestational diabetes,” says Pamela Berens, MD, an OBGYN with McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital. In addition, “preeclampsia is more common in women who have had high blood pressure, and high blood pressure may be inherited.” A Norwegian study showed severe morning sickness, or hyperemesis gravidarum, may be inherited as well. As for issues getting pregnant, most causes of infertility and miscarriage are not genetic—but some may be. “There appears to be an increased risk of endometriosis in first-degree relatives of women with endometriosis,” Dr. Berens says. “Rarely, some women with recurrent miscarriages can have an inherited chromosome issue that makes miscarriage more common, and genetic testing can be done.” For some other infertility conditions, such as PCOS, it’s not clear yet whether genetics are at play.

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Postpartum depression

You should also ask your mom if she suffered from postpartum depression after pregnancy. Like other aspects of mental health, it may be passed from mother to daughter. “Studiesshow that postpartum depression is genetically linked,” Dr. Serani says. “Your risk for PPD increases if your mother, or another family member—sister, aunt—has experienced it.” One small study from Johns Hopkins found specific chemical alterations in two genes that, when they occur during pregnancy, can predict whether a woman will develop postpartum depression with 85 percent accuracy. The researchers hope this will eventually lead to a blood test that can give pregnant women a better indication of their risk—but for now, knowing your family history is important. “Ask your mother about her postpartum experiences,” Dr. Serani says. “This can informally clue you in to whether or not depression is a risk factor for you.” Here are seven dangerous postpartum depression myths.

Breast and ovarian cancers

Awareness on the genetic link of breast and ovarian cancers may be due in part to Angelina Jolie, whose mother died from breast cancer. After discovering she carried the BRCA1 gene, the actress underwent a preventive mastectomy, reducing her breast cancer risk from 87 percent to under 5. “The gene mutations that are most commonly associated with hereditary breast and ovarian cancer are the BRCA1 and 2 gene mutations,” Dr. Berens says. “If you have a suspicious family history—for example, if you have multiple family members with breast or ovarian cancer, if the breast cancer happened at an early age, or if the same family member had both cancers—it is more suspicious that you could have a genetic tendency.” Talk to your doctor about your individual risk if you mom or other female relatives had one of these cancers, and consider seeing a genetic counselor for genetic testing.

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Menopause

Studies have shown that the age at which your mother went through menopause will be partly responsible for when you do. In addition, if your mother went through menopause early, you should let your doctor know. “Premature ovarian insufficiency, before 40, can be caused by a number of conditions, and some of these conditions can be inherited—for instance women who are fragile X carriers,” Dr. Berens says. Fragile X is a gene mutation linked to the X chromosome, and it can trigger anxiety, hyperactivity, and intellectual disability. As for menopause symptoms such as hot flashes and night sweats, Dr. Berens says scientists are trying to clarify if there’s a genetic link. The first study of its kind in humans, from UCLA, might have found a related gene variant, but more research is needed. Next, check out what your sweat says about your health.

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First things first: the authors did take confounding factors into account. That means the conclusions are after considering the characteristics we already know influence a person’s chances of having a stroke or heart disease, like smoking, poor nutrition, hypertension, diabetes status, and age. Once those elements were controlled for, the authors found that women who consumed two or more artificially sweetened beverages each day were 31 percent more likely to have a stroke, 29 percent more likely to have heart disease, and 16 percent more likely for premature death than the women who either drank one artificially sweetened beverages per week or less.

However, the authors caution that neither this study, nor ones like it, prove that drinking diet soda causes these diseases. “The most important thing with all prospective studies like this is that you can’t establish causality. Perhaps people who drink diet soda have some other characteristic that is related to stroke that we don’t yet know about,” says Sylvia Wassertheil-Smoller, the study's senior author and an epidemiologist at the Albert Einstein College of Medicine in New York.

She notes that its impossible to prove with certainty artificial sweeteners cause detrimental health effects without doing a clinical trial, which would involve giving an excessive amount of artificial sweeteners to a group of people. Beyond that, scientists use the best research tools they have, including longitudinal health studies with data drawn from large pools of people from diverse areas of the country—which is what this study does.

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Soda sizes compared to US
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Soda sizes compared to US
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This isn’t the first study to look into the connections between artificial sweeteners and long-term health consequences. In a study published in 2017, also in the journal Stroke, people who consumed diet sodas every day were three times more likely to have a stroke or develop dementia when compared to people who consumed the drinks once a week or less. Again, though, the results are correlative, meaning there isn't enough evidence (or science on the mechanisms) to say artificial sweeteners caused those people to develop dementia or have a stroke.

And, crucially, a recent meta analysis published last month in the British Medical Journal, which looked at data from 35 observational studies (like the two mentioned in Stroke) and 21 controlled studies, researchers found no statistically significant connection between artificial sweeteners and cardiovascular disease, kidney disease, cancer, or cognition.

Wassertheil-Smoller says sporadic diet soda drinkers should not be particularly concerned. “We didn’t begin to see this relationship until people got up to drinking diet soda daily or more than two times a day.” Further, she said, the study questionnaire only asked the participants if they drank two or more drinks per day—not a specific number—so it could be that those at highest risk are drinking far more than two drinks per day. “[Diet soda] warrants continued study and investigation," says Wassertheil-Smoller.

Research has been done to try to determine how artificial sweeteners affect the body, including many recent studies, mostly in mice, on how the sweeteners affectthe composition of bacteria in the gut, which play a role in our health. Other factors might be at play, too. Wassertheil-Smoller says identifying potential genetic factors, for example, could reveal new mechanisms.

The science on the connection between diet sodas and weight loss is also unclear. Studies done on that connection are inconclusive, though some suggest that consuming artificial sugar tricks your brain into craving more sugar.

Her biggest piece of advice for people concerned about potential detrimental effects of drinking diet soda: “Almost nothing you do, with the exception of extreme things like bungee jumping, will be a serious detriment to your health if you do it occasionally.”

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Things in your home that can cause cancer
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Things in your home that can cause cancer

Your big, comfy couch

Your favorite sofa could be killing you, and not just because it lures you away from activity: Many sofas, mattresses, and other cushioned furniture are treated with TDCIPP, a flame retardant known to cause cancer (i.e., a carcinogen). TDCIPP was used so frequently prior to 2013 that a study out of Duke University found it in the blood of everyone they tested. It's also one of ten chemicals most frequently found in household dust, according to this study.

What can you do?

Consider replacing cushioned furniture you purchased prior to 2013, according to the Natural Resources Defense Council—and check furniture labels on any purchases.

And while you're at it, make sure you aren't around any of these other causes of cancer.

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Your curtains and carpets

Cadmium is a carcinogenic byproduct of cigarette smoke. If you smoke in your house, cadmium and other cigarette smoke by-products may be lurking, especially on soft surfaces such as curtains and carpet—even long after the smell of smoke is gone. There's even such a thing as third-hand smoke and it's resistant to even the strongest cleaning products. Here's where you can learn more about third-hand smoke and its dangers.

What can you do?

Quit smoking—here are 23 tips to kick start kicking the habit—and never allow smoking in your home.

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Your leather recliner

Chromium (VI) is a known carcinogen found in tanned leather, wood furniture, certain dyes and pigments used in textiles, and cement. To give you an idea of the prevalence of chromium VI, one study out of Denmark found that almost half of imported leather shoes and sandals contained some level of the carcinogen.

What can you do?

As with TCIPP, pay attention to labeling. And don't be shy about asking questions of your furniture salesperson.

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Your garden

Dioxin is a carcinogen that forms as a chemical byproduct and ends up in our soil and water. It's in the dust on shelves, the dirt on floors, and the residue on vegetables. Your risk of cancer from dioxin exposure may be greater than one in one-thousand, says clean-living guru, Sophia Ryann Gushée.

What can you do?

Wear gloves when working in the garden, and always wash up before heading inside. Additionally, avoid backyard burning of household trash.

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Your old fridge

According to cancer.org, carcinogenic PCBs can turn up in old appliances, fluorescent lighting fixtures, and electrical transformers. While no longer commercially produced in the United States, PCBs are still manufactured and used in developing countries, and of all PCBs ever produced, up to 70 percent are still in the environment. Diet is another major source of exposure, according to Gushée.

What can you do?

Get rid of those old appliances and fluorescent light fixtures. Pay attention to advisories regarding PCB-contaminated fish and fish-eating wildlife.

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Your cleaning products

Formaldehyde is a known carcinogen found at home in food, cosmetics, a variety of cleaning products (such as dishwashing liquids, fabric softeners, and carpet cleaners), paint, foam insulation, and on permanent press fabrics. In addition, you can be exposed by breathing smoke from gas cookers and open fireplaces.

What can you do?

Here is a list of household products that contain formaldehyde, according to the U.S. Department of Health and Human Services. Choose your cleaning products carefully—here are some chemical-free ways to clean your home. Also, be sure to ventilate your cooking areas.

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Your closets

The dry-cleaning chemical perchloroethylene (tetrachloroethylene or "perc") is a carcinogen that can build up wherever you store your dry-cleaned clothes. It's also found in spot removers, shoe polish, and wood cleaners.

What can you do?

Wear gloves when polishing your shoes and cleaning wood. If you dry-clean your clothing, try to find a dry-cleaner who doesn't use perc. And check out the times you can feel free to ignore the dry-clean only label.

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Your vinyl flooring and miniblinds

Phthalates are suspected of causing cancer and may adversely affect human reproduction or development. They're found in vinyl flooring, shower curtains, synthetic leather, miniblinds, wallpaper, and anything made with PVC vinyl. They're also found in food packaged in plastic.

What can you do?

Stay away from products made with PVC vinyl. Look for products that are labeled as phthalate-free. Toss plastic toys made before 2008, according to mindbodygreen.com, and switch to glass and stainless containers and bottles. And reconsider your use of plastic wraps and food containers.

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Your favorite rice and chicken dinner

Everyone knows arsenic is poisonous, but in smaller doses, it's also carcinogenic. Yet you can find it in foods you probably eat regularly—including chicken, rice, and certain fruit juices, as well as in degreasing products, dyes, furniture wax, glues, lubricants, nylon, and paints.

What can you do?

Serve only organic chicken, and follow these rice-related guidelines issued by Consumer Reports. Check the labels on your household products; people following a gluten-free diet may be at particular risk of arsenic exposure.

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Your insulation

Asbestos has been out of favor for decades, thankfully, but you can still find it in the insulation of older homes. As the insulation eventually deteriorates, asbestos fibers become airborne. Since asbestos fibers stick to clothing and shoes, workers exposed to asbestos on the job can also bring asbestos into their homes.

What can you do?

Follow these guidelines to reduce asbestos exposure in your home.

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Your styrofoam cups

Styrene is a known carcinogen widely used in the manufacturing of polystyrene plastics, which can be made into foam and rigid plastic products such as cups, plates, trays, utensils, packaging, and packing peanuts. Styrene may leach into your hot coffee or soup if you're using styrofoam containers. It's also present in cigarette smoke and in all of these home maintenance, automotive, and crafting productsWhat can you do? Avoid using styrofoam to hold hot foods and liquids, and read your product labels carefully. Find out the 12 foods you should never microwave.  

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Your library books

According to the Library of Congress and other government sources, medical supplies, library books, and museum artifacts may all be sterilized or fumigated with ethylene oxide, which is a known carcinogen. What can you do? Mostly a problem for people who work with the chemical, you can minimize exposure by not bringing items into your house that have been exposed to ethylene oxide.

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Your weedkiller

No one likes weeds, but if you decide to decimate them using herbicides such as Roundup, which contains the carcinogen glyphosate, you may be raising your risk for cancer.

What can you do?

Make a practice of carefully reading the labels on your weedkillers. And consider using some of these natural weed killers that don't contain dangerous chemicals.

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Your bug spray

Pantry pests and other creepy crawlies can carry disease. But if you eliminate them using chemical pesticides, you're increasing your risk of cancer. Chemical pesticides include those that you use on your pets, such as flea collars and tick-repellant.

What can you do?

Seek out less-toxic pesticide alternatives—or make your own, like this natural tick repellent that works.

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Your granite counter

Radon is formed naturally from the radioactive decay of uranium in rocks and soil. It raises the risk of lung cancer—especially if you also smoke, says Ashley Sumrall, MD, FACP, a Charlotte-based oncologist. If you live in an area where the amount of uranium and radium in rocks is high, you can be exposed to radon through cracks in your foundation. You can also be exposed to radon if you have a granite countertops.

What can you do?

If you live in an area with high levels of uranium and radium, or if you have granite countertops, consider having your home's radon levels measured. Here's what you need to know about radon testing.

Next, find out the causes of cancer that might surprise you.

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