President Trump reportedly drinks 12 Diet Cokes each day, a habit that might help him and other diet soda aficionados sidestep the calories and sugar in regular soda—but one that isn't necessarily without health risks, Marwa Eltagouri writes for the Washington Post's "To Your Health."

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Almost 50% of adults and 25% of children ingest artificial sweeteners every day, according to the Journal of the Academy of Nutrition on Dietetics. But there has been relatively little experimental research on the health effects of artificial sweeteners—and the studies conducted so far provide inconclusive findings, Eltagouri writes. For instance, a research review published earlier this year in the Canadian Medical Association Journal found only seven randomly controlled studies on artificial sweeteners, all of which involved about 1,000 people for a six-month time period.

And experts remain divided. According to some experts, artificial sweeteners—including sucralose and stevia—could be good alternatives for people hoping to avoid the high-sugar content of regular soda. But others caution that artificial sweeteners have the potential to confuse the mind and body, leading consumers to eat or drink more sweets without paying attention to calories.

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Research is more conclusive when it comes to the amount of artificial sweeteners ones should consume: 12 cans of artificially sweetened beverages per day is probably not a healthy choice.

The potential risks of drinking diet sodas

Among other risks, one study in Stroke found that people who drank an artificially sweetened beverage daily were three times more likely than those who consumed such beverages no more than once per week to be diagnosed with Alzheimer's disease or to have an ischemic stroke due to blockage of blood vessels over a 10-year time period.

That said, Matthew Pase, a neurologist at the Boston University School of Medicine, cautioned that this study showed correlation, not causation, and that the overall risk of stroke and dementia remained small. "Three percent of the people had a new stroke and five percent developed dementia, so we're still talking about a small number of people developing either stroke or dementia," he said.

Separately, the American Beverage Association in response to the study said "hundreds of scientific studies" have demonstrated the safety of low-calorie sweeteners and that nothing in the Stroke study "counters this well-established fact."

Another risk, according to Eltagouri, is the consumption of too much caffeine. The Mayo Clinic recommends around 400 milligrams of caffeine a day at most, roughly equivalent to 10 cans of soda. According to Eltagouri, consuming 12 Diet Cokes' worth of caffeine could lead to insomnia, migraines, muscle tremors, and restlessness.

Further, diet soda intake has been linked to weight gain, Eltagouri writes. For instance, the Canadian Medical Association Journal research review, which assessed 30 studies tracking people's diets, found that people who consumed artificial sweeteners had higher obesity rates—as well as higher rates of hypertension, metabolic syndrome, and Type 2 diabetes. And a 2015 study that assessed 10 years' worth of data for 749 people ages 65 years and older and found that those who drank diet soda daily or occasionally gained nearly three times more belly fat than those who did not drink it at all.

But some research shows that the effects of artificial sweeteners could depend on how they are assessed and what they are paired with, Eltagouri writes. For example, one study found that children who drank an artificially sweetened beverage every day for 18 months gained less weight than those who drank a sugary beverage daily over the same time span. And another researcher—Dana Small, a neuroscientist at Yale University—said her work suggests that artificial sweeteners may cause weight gain if they're consumed alongside carbohydrates, as the mix with food could disrupt the metabolic response of the body (Eltagouri, "To Your Health," Washington Post, 12/12).

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