title: 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.
  
  
  METHODS
  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.
authors.affiliation: Wellness Institute of Cleveland Clinic, Lyndhurst, OH 44124, USA. bernsta2@ccf.org
authors.forename: Adam M
authors.initials: AM
authors.lastname: Bernstein
authors.forename: Lawrence
authors.initials: L
authors.lastname: de Koning
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Flint
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rexrode
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000328:Adult; D000368:Aged; D002253:Carbonated Beverages; D019422:Dietary Sucrose / Q000008:administration & dosage / Q000009:adverse effects; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents