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(comment deleted)
Is this because of the artificial sweeteners in the drink or another ingredient?
I mean that was my main thought as well. Diet coke and sugar-free red bull are the most common diet sodas I see people drink. They also contain copious amounts of caffeine, which can cause heart issues at increased dosage.

Apart from this the article is not clear on what factors they controlled for, so it seems like garbage reporting.

And being a correlational study, it doesn't sound very convincing, since I would say high soda consumption is just one of many indicators of poor diet. And poor diet definitely affects your heart.

Fat people know they are fat.

Fat people, not wanting to be fat switch to diet soda.

Switching to diet soda alone isn't enough to lose large amounts of weight.

Alternative study title: fat people have more heart attacks.

The real burying of the lede here is within the first few sentences:

> Consuming two liters of diet soda [...] a day can increase the risk of a dangerous irregular heartbeat by 20% [...]

Much in the same way of the hysteria around soy causing gynecomastia, it happens when you consume absurd amounts of the stuff.

I found that odd in the article as well. I wonder if there are any drinks other than water of which you could drink two litres a day without any ill-effects to your health.
Green tea maybe?
How is that absurd amount?
2 litres of (diet) soda is definitely an absurd amount
(comment deleted)
2 liters of soda everyday is huge. If it was sometimes (in a party, etc) it would be fine, but I can't imagine drinking close to that amount everyday.

I am sure that people do even worse, but at that point you're in a bad situation if you drink normal (e.g.: the amount of sugar) or diet soda.

Daily recommend fluid intake for men is 3.7 liters (20% from food).

2l of something doesn't seem excessive.

2L of what is essentially a dessert liquid is very much absurd.

We're not talking about water.

2L of pretty much anything that isn't water is very likely too much.

Put it this way: go read up experiences on reddit of people doing the GOMAD diet.

The article is wrong. The study actually says two liters _per week_ increases risk of irregular heartbeat. 2L/week is much less absurd of an amount: it’s slightly less than 1 can per day.
Just because an explanation is satisfying to speculate about doesn't make it correct
I agree. Moralistic people want diet soda to have some sort of downside due to a feeling that they worked hard to lose/maintain their weight and therefore so should everybody else. The problem is every experimental study finds diet soda is really zero calorie and without any major downsides, it's only the observational studies that are flawed in the way I described that ever find these sort of "effects".
Such sweeteners are everywhere, for example in many sports drinks and sports supplements.
Which ones? There are dozens of artificial sweeteners and many of them are chemically unrelated.

What this study implies is that in addition to tasting sweet this diverse range of chemicals all have the same adverse effect on the heart which seems somewhat suspect to my mind.

Arguments over artificial sweeteners has been raging for decades without definite conclusions one way or other and they need to be resolved for the health of consumers.

It seems to me that lumping all these chemicals together into just 'sweeteners' isn't helpful and that each one should be studied in isolation to determine if one or more are actually injurious to health.

I accept that this might not be easy given that most artificial sweeteners are added as mixtures so as to optimize the sweetness to be as close to that of sucrose as is possible.

The data were sourced over 9.9 years from 201,856 individuals in the UK Biobank <https://www.ukbiobank.ac.uk>. These subjects were living in the UK and had received health care through the National Health Service.

From that sample, I guess we can surmise they included all artificial sweeteners commercially-available in the UK.

Better article: https://newsroom.heart.org/news/sweetened-drinks-linked-to-a...

Study (closed access): https://doi.org/10.1161/CIRCEP.123.012145 / https://pubmed.ncbi.nlm.nih.gov/38440895/

In a previous study about artificial sweeteners by the same lead author and also using Biobank participants, the 24-hour dietary recall questionnaire Oxford Web-Q <https://www.ceu.ox.ac.uk/research/oxford-webq> was used and "SSBs included fizzy drinks and squash, ASBs were defined as low calorie drinks, and PJs included pure orange juice, pure grapefruit juice and other pure fruit or vegetable juices".

[*Edit] You can see an example of the Biobank questionnaire likely used here on page 5: https://web.archive.org/web/20120410164808/https://www.ukbio...

Thanks for your reply and the references, I'm still working through them.

I'm not diabetic but where possible I avoid drinks high in sucrose and especially fructose for all the obvious reasons, so often the only choice available are those with artificial sweeteners.

However I'm concerned about my consumption of artificial sweeteners and try to avoid them where it's practical to do so. What's annoying are the many reports and studies about artificial sweeteners that imply that they have negative impacts on health but essentially none come to an outright conclusion that they are actually harmful and should be banned. When it comes to artificial sweeteners, we live in a do-nothing world.

For example, look at the hundreds of papers and reports about aspartame and still there are heated arguments over its safety the majority of which reckon it's safe. Despite the long history of reports about aspartame being safe it was nevertheless declared a possible carcinogen in 2023 by the International Agency for Research on Cancer (IARC); this being some 50 years after its introduction! With multiple studies, five decades of use and millions of consumers surely by now we ought to know one way or other whether aspartame is a carcinogen or not. How the hell is the average consumer to make sense of this new conflicting information?

Like most consumers I'm not a biochemist so I've not enough knowledge to do a proper risk assessment on aspartame or any other artificial sweetener, so how are we users to decide what's best and what to do?

For my part I use my somewhat limited knowledge of organic chemistry to decide which sweetener to consume. Despite the IARC's statement that aspartame may be a possible carcinogen I'd risk using it over say Sucralose. My rationale goes like this: aspartame is an ester dipeptide of aspartic acid and phenylalanine which are essential amino acids the body uses in protein synthesis and we understand that process. Moreover, we understand how aspartame is metabolized/breaks down and that the byproducts are mostly harmless but not all are—a nasty one being methanol. Whilst methanol is certainly dangerous the amount produced by the normal consumption of aspartame is less than the amount of methanol the body produces naturally (yes, the body does produce small amounts of methanol and knows how to handle it).

Compare that with Sucralose/E955 which is produced by the chlorination of sucrose where three of its hydroxyl (OH) groups are replaced by chlorine atoms. It seems that unlike sucrose most sucralose is not broken broken down by the body which means that part passes through the body without doing it harm. What remains unclear to me is what happens with the small amount of sucralose that the body does break down. What exactly happens to those three chlorine atoms during the molecule's reduction? There are reports about the dangers of sucralose but it remains unclear what they are and what exactly are its metabolites. (With aspartame, at least we know its produced from amino acids that the body is used to handling, but I'd agree that's not a solid argument.)

I'm not suggesting my rationale is right, nor do I suggest anyone follow it. What I am saying is that even those of us who have some knowledge of organic chemistry cannot get to the bottom of this sweetener problem. Why after 50 or more years has this matter not been resolved? If artificial sweeteners are a major concern then you'd reckon after such a length of time and with millions of users there'd be statistically significant numbers of medical incidents but that seems not to be the case.

Until matters are finally settled what are users of sweeteners supposed to do?