(RxWiki News) The debate rages on… are diet drinks okay when trying to cut calories when you're losing weight? Or do they put you at higher risk for heart disease, as some recent studies have claimed?
Researchers can't be sure that diet drinks have no risks at all, but they are beginning to understand that the bigger issue isn't the drinks as much as it is the diets of the people who consume diet beverages.
"Eat a healthy diet with more fruit, fish and whole grains."
Kiyah Duffey, PhD, a nutrition professor at the University of North Carolina Gillings School of Global Public Health, led a study that investigated both people's drink choice habits and those same people's diets.
Duffey wanted to figure out whether the perceived risks of diet drinks were a result of the drinks themselves or, instead, risks associated with other characteristics of people who drink diet beverages.
Duffey and colleagues used 20 years worth of data from over 4,161 young adults enrolled in the Coronary Artery Risk Development in Young Adults study.
They divided people into two groups according to their typical diets. One group included the 1,778 participants who ate a fairly healthy diet, termed a "prudent" diet, with more fruit, fish, whole grains, nuts and milk.
The other group, of 2,383 participants, ate what the researchers termed a "western" diet, which included more fast foot, pizza, meat and poultry and snack foods.
Then the researchers compared the drink choice patterns of these two groups. Supporting the findings of previous studies, Duffey found that people who drink diet beverages are generally less healthy than those who don't.
But that's not the whole story.
Not surprisingly, the healthiest people were those who ate a prudent diet and did not drink diet beverages. They were 22 percent less likely to be large-waisted, 28 percent less likely to have high triglyceride levels and 36 percent less likely to have symptoms of metabolic syndrome, a disorder that primarily afflicts obese individuals.
They also showed moderately lower risk of developing high blood sugar and high blood pressure.
But the second healthiest group included those who ate a prudent diet and did drink diet beverages. They were 7 percent less likely to have large waists, 20 percent less likely to have high triglycerides levels and 16 percent less likely to develop metabolic syndrome.
The individuals who ate a western diet had the highest risk of heart disease, whether they drank diet drinks or not.
So what matters most in terms of reducing heart disease risks is not whether a person does or does not drink diet beverages but what their overall diet is.
"Our study confirms the recommendations of the American Diabetes Association and many weight-loss programs, which suggest people drink these beverages as a way to cut calories and lose or control weight, but only in the context of the whole diet," Duffey said.
The study appears in the April issues of the American Journal of Clinical Nutrition. The authors declared no conflicts of interest.
The research was funded by the National Institutes for Health and the Kaiser Foundation Research Institute as well as the University of North Carolina-Chapel Hill, the University of Alabama at Birmingham, the University of Minnesota and Northwestern University.