Choose your beverage wisely

Women and men who were enrolled in the Nurses' Health Study and the Health Professionals Follow Up Study answered questions about their soda consumption. They also provided information about consumption of other beverages, including orange juice, milk, tea, and coffee. The studies lasted for 28 and 22 years, respectively, and the number and type of strokes that occurred were recorded.

Here's what the studies found:

• Compared with people who never drank soda, those who drank one or more bottles of sugar-sweetened or low-calorie soda per day had an increased risk of stroke.
• Stroke risk was more pronounced in women than in men. Women who drank one or more bottles of sugar-sweetened soda per day had a 19% higher stroke risk than those who never drank it. Hemorrhagic stroke risk increased by 31% in women who drank more than one low-calorie soda per day.
• Caffeinated and decaf coffee were associated with a significantly lower risk of stroke compared with one serving of sugar-sweetened or low-calorie soda per day.
• Skim milk was associated with an 11% lower risk of stroke when substituted for low-calorie soda, and tea and orange juice tended to lower stroke risk when substituted for sugar-sweetened or low-calorie soda.

"In sugar-sweetened sodas, the sugar load may lead to rapid increases in blood glucose and insulin, which over time lead to glucose intolerance, insulin resistance, and inflammation," said lead study author, Adam Bernstein of the Cleveland Clinic and the Harvard School of Public Health. "These physiologic changes in turn influence atherosclerosis, plaque stability, and thrombosis--a risk factor for ischemic stroke."

Bernstein says that the caramel coloring in many sugar-sweetened and low-calorie sodas can cause inflammation and damage blood vessels, which in turn can lead to artery disease and increase the risk of stroke.

Several substances in coffee, including chlorogenic acid, lignans, and magnesium act as antioxidants and blood sugar regulators that may help reduce stroke risk.

Stroke facts

Stroke is a leading cause of death and disability in many industrialized countries. The risk of stroke increases with age. Men are more likely than women to have a stroke, and African American people are at greater risk than white people. While you can't do much about your gender or heritage, many stroke risk factors are in your control:

• Smoking greatly increases stroke risk by raising blood pressure, damaging blood vessels, and contributing to coronary artery disease.
• Being overweight places an extra burden on the circulatory system.
• Having high blood pressure leads to blood vessel damage. Untreated hypertension can cause blood vessels to burst or clog more easily.
• Having high cholesterol can increase your risk of stroke by contributing to coronary artery disease.
• Having certain heart rhythm abnormalities (like atrial fibrillation) can lead to blood clots that may result in stroke.
• Having diabetes increases stroke risk by contributing to blood vessel dysfunction and inflammation in the body.

Act FAST

Time is of the essence when diagnosing and treating someone who has suffered a stroke. If you suspect that someone may have had a stroke, remember to act FAST:

• F=Face. Ask the person to smile. Does their mouth droop on one side?
• A=Arms. Ask the person to raise their arms. Does one arm drift down?
• S=Speech. Ask the person to repeat a simple sentence. Does their speech sound strange or slurred?
• T=Time. Act fast. If any of these symptoms is present, call 911 immediately.

(Am J Clin Nutr 2012;95:1190-9)