Strokes remain a leading cause of morbidity and mortality worldwide, representing a significant public health challenge. Various lifestyle factors have been implicated in the etiology of stroke, including dietary habits. In recent years, consumption patterns of sugary beverages—particularly soda, coffee, and fruit drinks—have drawn considerable attention due to their potential impact on health outcomes. This article examines the relationship between these beverages and stroke risk, synthesizing current research to highlight how excessive intake may contribute to cerebrovascular events.

How do strokes develop?

A stroke happens when there is a reduction or interruption in the blood supply to the brain, depriving the brain tissue of essential nutrients and oxygen. This may result in neurological damage and the death of brain cells.

There are two primary types of strokes: ischemic, caused by blockages in blood vessels, and hemorrhagic, resulting from bleeding in the brain. Identifying modifiable risk factors, such as diet, is crucial in preventing stroke and improving public health outcomes.

According to the National Health and Nutrition Examination Survey (NHANES), the National Coffee Association, and The Journal of Pediatrics, 48% of adults consume sugary beverages daily, 66% of adults drink coffee daily, and 60% of children and many adults consume fruit drinks daily.

What happens when we drink soda, coffee, and fruit drinks?

Coca-Cola or sodas are among the most consumed soft drinks in the world. In fact, almost 2 million bottles are reserved every day. 330 mL of Coke contains 35g of sugar, which is about 7 teaspoons. According to the American Heart Association (AHA), for men, no more than 9 teaspoons (about 36 grams) should be consumed per day, and WHO recommends that added sugar should make up less than 10% of total daily energy intake, and for further health benefits and advice, to cut free sugars to 5% of total energy intake to get further benefits.

Thus, by drinking one can of Coke, we have already ingested a sizable amount of sugar. The concentration of glucose in the blood begins to climb, and when the glucose level gets high, an internal regulation system kicks in, allowing you to maintain a steady blood sugar level throughout the day. The pancreatic hormone insulin, which has a hypoglycemic effect and lowers blood glucose levels, steps in.

How does it work?

It encourages the blood's glucose to enter the cells to use them for energy production and metabolism and store the excess glucose in the liver as glycogen to use them as backup when the body gets low glucose anytime.

And if the body’s glycogen stores are depleted, extra glucose is converted to fats and lipids, which will later result in weight gain and developing metabolic syndrome (diabetes mellitus) due to resistance to insulin that develops when the glucose level is constantly high, obesity when the excess glucose starts to be stored as fat (hypertension) that can result from drinking extra coffee, as it has caffeine, which stimulates heart activity.

What happens when there is excess sugar?

A diet high in sugar can cause a few metabolic and health problems, including:

  1. Enhanced fat retention: when the body uses more sugar than it needs for energy, the extra glucose is turned into fat (lipogenesis), which increases the amount of fat stored and may result in obesity.

  2. Resistance to insulin: insulin resistance, a condition in which cells lose their insulin sensitivity, can be brought on by long-term high sugar consumption. This reduces the absorption of glucose, raising blood sugar levels and possibly triggering type 2 diabetes.

  3. Dyslipidemia: overindulgence in sugar can increase the risk of atherosclerosis and cardiovascular disease by lowering HDL, which is good cholesterol, and raising triglyceride levels.

  4. Increased inflammation: high sugar levels in the blood can promote inflammation in the body that can lead to various health issues like cardiovascular and neurovascular diseases.

These factors are the main reasons for a person to damage the microvessels in the body and develop a stroke.

Coffee consumption

The association between coffee drinking and health outcomes is more intricate. Moderate coffee drinking has been linked to a decreased risk of stroke in certain studies; however, high intake may present dangers.

Protective benefits Larsson et al. (2011) conducted a cohort study that revealed that persons who consumed three to five cups of coffee daily had a reduced risk of ischemic stroke compared to non-coffee users.

The antioxidant and anti-inflammatory qualities of coffee consumption might result in heightened blood pressure and heart rate, thereby increasing stroke risk in susceptible individuals (Yuan et al., 2020). Furthermore, high intake of caffeinated energy beverages has been associated with arrhythmias, thereby elevating the risk of stroke (Grunewald et al., 2018).

Beverages derived from fruit

Fruit beverages, frequently promoted as nutritious substitutes, may possess elevated concentrations of added sugars, resulting in possible detrimental health consequences.

Nutritional value vs. sugar content

Numerous commercially sold fruit beverages have minimal genuine fruit juice and elevated levels of sugar. A study by Mendez et al. (2019) showed that elevated use of fruit drinks correlates with a heightened risk of obesity and metabolic syndrome, akin to the effects of soda drinking.

Influence on stroke probability

Studies published in the American Journal of Clinical Nutrition indicated that heightened intake of fruit beverages correlated with a 25% increase in stroke risk (Katan et al., 2017). This discovery highlights the necessity for customers to distinguish between 100% fruit juice and sugar-sweetened fruit beverages.

Data from epidemiological research

Multiple epidemiological studies have elucidated the connection between consumption of beverages and stroke risk.

Soda and stroke risk

According to a Framingham Heart Study, the individuals who consumed one or more servings of sweetened sugar beverages had a significantly increased risk of stroke in comparison to those who consumed less than one serving per week.

Coffee consumption and stroke risk

According to the data collected from the European Society of Cardiology Research, moderate coffee consumption (3-4 cups per day) is associated with a lower risk of stroke, particularly in women (Kim et al. 2018).

Fruit beverages and stroke risk

A meta-analysis of many cohort studies indicated that elevated intake of fruit drinks is associated with a heightened risk of stroke, underscoring the necessity for public health campaigns to inform consumers regarding the sugar content in these beverages (Geleijnse et al., 2018).

Consequences for public health

Given the link between sugary beverages and stroke risk, public health interventions should focus on lowering the consumption of sugar-sweetened beverages, excessive coffee, and sugary fruit drinks.

Instructional initiatives

Enhancing knowledge regarding the health hazards linked to these beverages is crucial. Public health initiatives ought to focus on young adults and adolescents, who represent the biggest consumers of sugary beverages.

Regulatory provisions

Enacting policies like sugar levies on sugary beverages may effectively diminish consumption. Urban areas such as Mexico City have experienced a decline in soda consumption after the implementation of these levies (Colchero et al., 2016).

Promoting the intake of water, unsweetened tea, and 100% fruit juice helps reduce the hazards linked to sugary drinks.

Conclusions

The consumption of coffee, soda, and fruit drinks has significant implications for stroke risk. While moderate coffee consumption may offer protective benefits, excessive intake of sugary beverages like soda and fruit drinks is consistently linked to increased stroke risk. As dietary practices evolve, it is essential to examine the health effects of these beverages through education, regulation, and the promotion of healthier alternatives. Continued study is essential to elucidate the intricate associations between beverage consumption and stroke risk, thereby informing public health guidelines aimed at mitigating the prevalence of stroke in the community.

Article written by Dr. Thiago Freire and Abdulmajid Ilyas Shari.

References

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