00:00diet soda is going to give you atrial
00:01fibrillation what's up guys we're back
00:04with another educational video this week
00:05we're talking about diet sodas do they
00:07give you atrial fibrillation but first
00:10like the video subscribe to the channel
00:11and leave a comment for the algorithm so
00:14a new paper got published and got a ton
00:17of press as per usual with anything
00:19involving artificial sweeteners and diet
00:21soda so they were looking at people who
00:22consumed high amounts of artificially
00:24sweetened beverages versus people who
00:27took in fruit juice versus people who
00:30just drank sugar sweetened Beverages and
00:31what they found was that over 2 L per
00:35week of diet soda intake or artificially
00:39sweetened beverage intake was associated
00:40with a significantly greater risk of
00:42atrial fibrillation now a lot of people
00:44were freaking out about this but the
00:46reality is there's a lot of confounding
00:47variables in this study because it is an
00:49epidemiology study and if we look at
00:53what the authors said in terms of their
00:56explanation I don't think it really
00:58makes sense but let's let's back up a
01:00bit so first of all one of the big
01:02confounding variables here is we know
01:04that people who are more overweight or
01:06obese are more likely to drink diet soda
01:10and in fact we see that that is the case
01:13people who drank artificially sweetened
01:16beverages actually had higher body mass
01:20index than people who were drinking
01:23sugar sweeten beverages in terms of from
01:25the from the non-consumers to the
01:27highest level of consumers they had a
01:30greater incidence of diabetes type two I
01:34believe and they were more likely to
01:37have lower rates of physical activity
01:41and more likely to drink more alcohol so
01:45actually amongst people who drank sugar
01:46sweetened beverages so regular soda they
01:49had decreasing levels of alcohol intake
01:51slightly as they increased their level
01:53of sugar sweetened beverages people who
01:56were drinking artificially sweetened
01:57beverages had increasing levels of
01:59alcohol intake there's a lot of
02:01confounding variables in here now they
02:02said they co-varied out these variables
02:05and co-variation is a way that you can
02:07account for some of these uh confounding
02:10variables when you're doing statistics
02:11but I'm sorry you cannot co-variate out
02:14like a dozen things like you can stats
02:17people will argue with me but I I
02:20strongly disagree that you could just
02:21co-variate out everything the other
02:23issue is caffeine intake caffeine has
02:26been shown to be a risk factor for
02:27atrial fibrillation but again you know
02:31they didn't assess whether these were
02:32caffeinated or uncaffeinated Beverages
02:35and it would have been hard to tell you
02:36know even the sugar sweetened beverages
02:39could have caffeine them as well so it's
02:42possible that there was a difference in
02:43caffeine intake but it's hard to know
02:45and we can't really lay that at their
02:47feet now I think the interesting portion
02:50of this is again people who drink diet
02:54soda are actually more likely to be
02:55overweight or obese not because it
02:57causes them to be overweight or obese
02:58but because they're more likely to
02:59attempt to diet and they will use diet
03:02sodas as a tool during that so they are
03:04already at a higher risk of atrial
03:06fibrillation because obesity raises the
03:09risk of atrial fibrillation now one of
03:11the things that was interesting was that
03:13they said that the two plausible
03:15mechanisms they saw were an increase in
03:16insulin resistance and vagus nerve
03:20stimulation now here's the problem with
03:22that we know that in studies where
03:25people drink diet soda in place of
03:27regular soda they actually get
03:29improvements and insulin sensitivity
03:30because they lose body weight they
03:32actually saw a higher risk of atrial
03:34fibrillation in people drinking the
03:36artificially sweetened beverages versus
03:37those drinking the su Sugar sweetened
03:39beverages how do you explain that
03:41because if insulin resistance and vagal
03:44nerve stimulation is possibly driving
03:45this increased risk of atrial
03:47fibrillation then the sugar sweetened
03:49beverages should have a higher risk
03:51because they are going to contribute
03:52much more to insulin resistance and they
03:54will also have the vagal nerve
03:55stimulation whereas artificial sweet
03:58nerves are just going to have the nerve
04:00stimulation so that doesn't really make
04:03sense for an explanation because you're
04:04seeing the results Go reverse of what
04:06they should be based on that particular
04:08mechanism that they're proposing and I I
04:10also looked at they were assessing
04:13relative risk okay so it's important to
04:16understand relative risk so it was about
04:18a 20% increased relative risk now that
04:22sounds scary but if we look at the
04:24absolute risk so the absolute risk in
04:26this population of atrial fibrillation
04:345.1% amongst people who consume more
04:37than two liters of artificially
04:39sweetened beverages per week doesn't
04:41sound nearly as scary now again it is a
04:4320% relative risk increase because if
04:46you increase 4.6 by 20% you get 5.1 but
04:50again a lot of people freak out about
04:51this stuff because they're thinking it
04:53goes from a risk of 4.6 to 24.6 and that
04:56is not how relative risk works so again
05:00based on the fact that this is
05:01epidemiology based on the fact that
05:03there's a lot of confounding variables
05:04here based on the fact that their own
05:08mechanism that they listed as plausible
05:10doesn't make sense based on the
05:12differences that they had between sugar
05:14sweetened Beverages and the artificially
05:16sweetened beverages uh and the fact that
05:19we can't equate for caffeine intake I
05:21don't really know what to make of this I
05:22think it's worth having some better
05:25designed long-term cohort studies and
05:29examining the is but I don't really know
05:31what to make of this I think that these
05:33are quite frankly data artifacts and if
05:37you have hundreds of thousands of pieces
05:39of data and you dig through enough of
05:42them you can find risk increases for
05:45weird stuff now I I'm not trying to
05:48totally dismiss it I'm not saying it was
05:50a poor analysis or anything like that
05:53I'm just saying that based on the
05:55limitations and the confounding
05:56variables you cannot say that artificial
06:00sweeteners are going to cause atrial
06:02fibrillation uh what you can say is that
06:05people who are more likely to drink
06:07artificially sweetened beverages maybe
06:08at higher risk for atrial fibrillation
06:11but that's probably because of insulin
06:12resistance and higher body weight I very
06:15much doubt it is due to the artificial
06:18sweeteners if you guys are sick and
06:20tired of the headlines in the media and
06:24social media confusing you when you just
06:26feel like you got it figured out make
06:27sure you subscribe to my research review
06:30every month we break down five studies
06:32that are popular in nutrition and
06:34training and fitness and we break them
06:36down in a way that's pable and easy to
06:38understand we talk about what they
06:41tested how they tested why they tested
06:43it who they tested on what they found
06:46and then we tell you what their
06:48interpretation of the results were and
06:49then we give you our opinion of their
06:52results we also give you practical
06:55takeaways that you can apply so if
06:57you're looking to cut through the BS and
06:59uplevel your knowledge click the link in
07:01the description and sign up for reps
![Welp, Here's what the Fed *Just* Said [Fed FOMC Minutes]](/_next/image?url=https%3A%2F%2Fi.ytimg.com%2Fvi%2Fl8u23oq1E9E%2Fhqdefault.jpg&w=3840&q=75)
