Diet soda is not a safe alternative to sugary soda: artificially sweetened drinks are linked to higher mortality, especially circulatory deaths.
Original statement
ومن يتصوَّر أن الحل هو التحوُّل إلى "الدايت" يصدمه أهم رقم في الملف كله ... والقاعدة في نظام الطيبات بسيطة: لا الصودا السكرية، ولا الدايت.
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
Diet soda is not a safe alternative to sugary soda: artificially sweetened drinks are linked to higher mortality, especially circulatory deaths.
Origin
- Source status
- Archive editors
- Attribution
- Archive editors (study selection and narrative are the archive's, not necessarily Elawady's)
- Origin
- https://eltayebat.com/rule/soda/
- Attribution uncertainty
- The archive homepage states that the forbidden-food section is supported by research 'independently of Dr. Diaa's words'. No evidence was found that Elawady himself cited these studies.
- Claimed mechanism
Artificial sweeteners; (Elawady: carbonation).
- Claimed health effect
Mortality, stroke, diabetes.
- Population concerned
Adults
- Geographic restriction by Elawady
none found
Diverging source versions
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- الجن . آلام العمود الفقري . الحقيقه والسراب (Open source)
- Published
- 26 November 2025
- Timestamp
- not available (transcript has no timings)
- Attribution uncertainty
- Machine/CC transcript; wording may contain transcription errors.
Scientific assessment
Potentially true – Some evidence points in favour of the statement, but it is not sufficient for a clear judgement.
Certainty of evidence: low – Further research is likely to change the assessment considerably.
1. What was claimed?
Diet soda is not a healthy substitute; it is associated with death and disease.
2. What is demonstrably correct?
WHO 2023 (I-SOD-08): NSS do not confer long-term benefit for body fat and 'may' have undesirable effects (T2D, CVD, mortality). Mullee 2019 (A-SOD-17): HR 1.26 total and 1.52 circulatory mortality for >=2 glasses/day of ASB. Imamura 2015: ASB associated with T2D, likely biased.
3. What is wrong or exaggerated?
Associations are probably partly explained by reverse causation and confounding (WHO, Imamura, Malik 2019 note this). Within the archive's own bibliography, ASB were not associated with coronary heart disease (A-SOD-14, A-SOD-15), with gout (A-SOD-06) or with fatty liver (A-SOD-12). Malik 2019 (A-SOD-05) found ASB associations only in the highest category and only in women, which disappeared after adjustment for intermediate conditions (HR 1.00, 0.94-1.06) and in most sensitivity analyses; the authors attribute them largely to reverse causation, and replacing one daily serving of SSB with ASB was associated with 4% lower total mortality (HR 0.96, 0.94-0.98) and 5% lower CVD mortality (HR 0.95, 0.90-0.99). Imamura 2015 (A-SOD-08) concerns type 2 diabetes, not mortality; its ASB estimate is low certainty and non-significant after publication-bias calibration (RR 1.22, 0.98-1.52). Elawady himself said his objection to sodas is the carbonated water, not the sugar or sweetener (see C-SOD-14), which differs from the archive's reasoning.
4. What remains unclear?
True long-term effects of NSS.
5. Which studies support it?
A-SOD-17, I-SOD-08, A-SOD-23; A-SOD-08 (indirect: diabetes outcome, bias-sensitive).
6. Which studies contradict it?
A-SOD-14, A-SOD-15 (no CHD association), A-SOD-05 (ASB association limited to very high intake in women and explained by reverse causation; substitution of ASB for SSB associated with lower mortality).
7. What applies to Germany and Europe?
Sweeteners are authorised in the EU with ADIs; WHO's recommendation is conditional.
8. What is known about Egypt?
No Egypt-specific data.
9. What practical conclusion is appropriate?
Water is preferable to both sugary and diet sodas. For people who habitually drink sugary soda, one large cohort found switching to diet soda associated with slightly lower mortality (A-SOD-05), but this is observational and long-term benefit is not proven.
Assessment details
- Rationale for certainty of evidence
WHO (2023) conditionally recommends against using non-sugar sweeteners for weight control because long-term benefit was not shown and observational data suggest possible harms, but notes likely confounding. Cohort associations for ASB are inconsistent (positive in EPIC, NHS; null for CHD in HPFS and NHS-CHD analyses).
- Source quality
Archive highlights positive associations and omits null findings within its own bibliography (A-SOD-14, A-SOD-15) and the authors' caveats.
- Regional transferability
High; EPIC includes Germany.
- Individual exceptions
People with diabetes: WHO's NSS recommendation explicitly excludes individuals with pre-existing diabetes.
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 25 October 2026 provisional
In plain language
Some large studies found more deaths among heavy diet-soda drinkers, but others found no link with heart disease. People who are already overweight or ill often choose diet drinks, which can create a misleading link. In one large US study, people who replaced a sugary drink with a diet drink had a slightly lower death risk. The WHO advises not to rely on sweeteners for weight control because no long-term benefit has been shown. Plain water is the best alternative.
Studies on this claim
Studies supporting the claim (2)
-
Soft drinks and death in 10 European countries
Mullee A et al.. JAMA Intern Med 2019 · PMID 31479109 · DOI 10.1001/jamainternmed.2019.2478Cohort studycited by the Tayebat archivefull text checked★ key studyTwo or more soft drinks a day were linked with higher death rates; for diet drinks the link was even stronger, which may partly reflect who chooses diet drinks.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Are total, SSB and ASB soft drinks associated with total and cause-specific mortality?
- How was the study done?
Population-based prospective cohort (EPIC), 10 European countries.
- How many people, animals or samples were studied?
451,743; 41,693 deaths; Adults without cancer, heart disease, stroke or diabetes
- What was actually found?
>=2 glasses/day vs <1/month: total soft drinks HR 1.17 (1.11-1.22); SSB 1.08 (1.01-1.16); ASB 1.26 (1.16-1.35); ASB and circulatory deaths 1.52 (1.30-1.78); SSB >=1/day and digestive deaths 1.59 (1.24-2.05).
- How large was the observed effect?
HR 1.17 total; 1.08 SSB; 1.26 ASB
- What do the results mean in everyday life?
Soft drinks are linked with earlier death in Europe.
- What are the study's limitations?
Observational; drink intake asked only once at baseline; residual confounding; diet-drink results may reflect people at risk switching to diet drinks; sugar-sweetened drinks were not linked to heart or circulatory deaths in this cohort.
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High (includes Germany).
- What can explicitly not be concluded from this study?
It cannot prove that soft drinks cause death, nor that sugary soft drinks raise cardiovascular death in Europeans (that association was not significant here).
-
WHO on non-sugar sweeteners
World Health Organization. WHO news release 2023Guideline / position statementindependent cross-checkfull text checked★ key studyWHO advises not to use sweeteners for weight control, because no long-term benefit was shown; possible harms may be confounded.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Should NSS be used for weight control/NCD risk reduction?
- How was the study done?
International guideline (news release read in full).
- How many people, animals or samples were studied?
Not applicable; All people except those with pre-existing diabetes
- What was actually found?
Recommends against NSS to control weight or reduce NCD risk; NSS confer no long-term benefit for body fat; potential undesirable effects (T2D, CVD, mortality) from long-term use; recommendation conditional because observed links might be confounded by baseline characteristics and complicated patterns of NSS use.
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
Water or unsweetened drinks are preferable.
- What are the study's limitations?
Conditional; observational evidence for harms
- What does it say about Elawady's specific claim?
Supports C-SOD-10 (no proven benefit); limits C-SOD-06 (confounding).
- Do the results apply to Germany and Europe?
Applies globally.
- What can explicitly not be concluded from this study?
That sweeteners cause disease.
No study in this group is marked as key.
Studies contradicting or limiting the claim (3)
-
Sweetened drinks and heart disease in men
de Koning L et al.. Circulation 2012 · PMID 22412070 · DOI 10.1161/CIRCULATIONAHA.111.067017Cohort studycited by the Tayebat archiveabstract only checkedMen with highest sugary-drink intake had 20% more heart disease; diet drinks showed no link.
ASB not associated with CHD or biomarkers.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Are SSB and ASB associated with CHD and biomarkers?
- How was the study done?
Prospective cohort (HPFS) 22 years.
- How many people, animals or samples were studied?
42,883; 3,683 CHD cases; Male health professionals
- What was actually found?
Top vs bottom SSB quartile RR 1.20 (1.09-1.33); ASB RR 1.02 (0.93-1.12); SSB associated with higher TG, CRP, IL-6, TNF receptors and lower HDL, Lp(a), leptin.
- How large was the observed effect?
RR 1.20 (SSB); 1.02 (ASB)
- What do the results mean in everyday life?
Sugary, not diet, drinks linked to heart disease.
- What are the study's limitations?
Observational design; residual confounding possible; Self-reported dietary intake
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Causation.
-
Sugary drinks and heart disease in women
Fung TT et al.. Am J Clin Nutr 2009 · PMID 19211821 · DOI 10.3945/ajcn.2008.27140Cohort studycited by the Tayebat archiveabstract only checkedTwo or more sugary drinks a day: 35% higher heart disease risk; diet drinks not linked.
Artificially sweetened beverages not associated with CHD.
Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Is SSB consumption associated with CHD in women?
- How was the study done?
Prospective cohort (NHS) 1980-2004.
- How many people, animals or samples were studied?
88,520; 3,105 CHD cases; Women aged 34-59 without CHD, stroke, diabetes
- What was actually found?
RRs 1.0, 0.96, 1.04, 1.23 (1.06-1.43) for 1/d and 1.35 (1.07-1.69) for >=2/d (P trend <0.001); attenuated but significant after BMI, energy and diabetes adjustment; ASB not associated.
- How large was the observed effect?
RR 1.35 (1.07-1.69)
- What do the results mean in everyday life?
Sugary drinks linked to heart disease.
- What are the study's limitations?
Observational design; residual confounding possible; Self-reported dietary intake
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Causation.
-
Sugary and diet drinks and death in 118,000 US adults
Malik VS et al.. Circulation 2019 · PMID 30882235 · DOI 10.1161/CIRCULATIONAHA.118.037401Cohort studycited by the Tayebat archivefull text checked★ key studyTwo or more sugary drinks a day: 21% higher death risk; diet drinks linked only at the highest intake and only in women.
ASB association limited to highest category and to women (NHS); authors call for confirmation.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Are SSB and ASB associated with total and cause-specific mortality?
- How was the study done?
Two prospective cohorts (HPFS 1986-2014; NHS 1980-2014); repeated FFQs; Cox models.
- How many people, animals or samples were studied?
118,363 (37,716 men; 80,647 women); 36,436 deaths; Health professionals and nurses free of chronic disease at baseline
- What was actually found?
SSB >=2/d vs <1/mo: total mortality HR 1.21 (1.13-1.28); CVD mortality 1.31 (1.15-1.50); cancer mortality 1.16 (1.04-1.29). ASB: only highest category, total 1.04 (1.02-1.12), CVD 1.13 (1.02-1.25); association in NHS but not HPFS (P interaction 0.01); not with cancer mortality.
- How large was the observed effect?
HR 1.21 total, 1.31 CVD (SSB)
- What do the results mean in everyday life?
Regular sugary drinks are linked with earlier death.
- What are the study's limitations?
Health professionals (limited generalisability); Observational design; residual confounding possible; Self-reported dietary intake
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
That diet drinks are as harmful as sugary ones; causality
No study in this group is marked as key.
Studies with mixed or unclear results (2)
-
Sugary drinks, diet drinks, juice and diabetes
Imamura F et al.. BMJ 2015 · PMID 26199070 · DOI 10.1136/bmj.h3576Meta-analysiscited by the Tayebat archivefull text checkedEach daily sugary drink was linked with 13-18% more diabetes; diet drinks and juice also showed (possibly biased) links.
ASB association likely biased (publication bias, residual confounding).
Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Are SSB, ASB and fruit juice associated with T2D independently of adiposity?
- How was the study done?
Systematic review and random-effects meta-analysis of prospective cohorts; PAF estimation (US, UK).
- How many people, animals or samples were studied?
17 cohorts; 38,253 cases; 10,126,754 person-years; Adults without diabetes
- What was actually found?
Per serving/day: SSB +18% (9-28%; I2 89%) and +13% (6-21%) after adiposity adjustment; ASB +25% and +8% (publication bias and residual confounding indicated); fruit juice +5% (-1 to 11%) and +7% (1-14%). PAF: 8.7% USA, 3.6% UK.
- How large was the observed effect?
+18% per serving (+13% adiposity-adjusted)
- What do the results mean in everyday life?
Neither diet drinks nor juice are proven healthier alternatives to sugary drinks.
- What are the study's limitations?
High heterogeneity; observational studies; protocol not registered; ASB and juice results likely biased
- What does it say about Elawady's specific claim?
Supports C-SOD-01; mixed for C-SOD-10; limits C-SUG-06 (juice association).
- Do the results apply to Germany and Europe?
High (UK PAF estimated).
- What can explicitly not be concluded from this study?
Causation; that diet drinks or juice cause diabetes; diet-drink effects on mortality
-
Sweetened drinks dose-response
Qin P et al.. Eur J Epidemiol 2020 · PMID 32529512 · DOI 10.1007/s10654-020-00655-yMeta-analysiscited by the Tayebat archiveabstract only checkedEach extra 250 mL/day of sugary drinks was linked with 12-19% higher risks of obesity and diabetes; diet drinks showed similar links.
Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Dose-response of SSB/ASB with obesity, T2D, hypertension, mortality.
- How was the study done?
Dose-response meta-analysis of prospective cohorts.
- How many people, animals or samples were studied?
39 articles; Adults
- What was actually found?
Per 250 mL/day SSB vs ASB: obesity RR 1.12 vs 1.21; T2D 1.19 vs 1.15; hypertension 1.10 vs 1.08; all-cause mortality 1.04 vs 1.06 (with I2 up to 92.6%).
- How large was the observed effect?
T2D RR 1.19 per 250 mL/d (SSB)
- What do the results mean in everyday life?
More sweetened drinks, more risk in observational data.
- What are the study's limitations?
High heterogeneity; Cohorts only; Reverse causation for ASB
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Causation, especially for diet drinks.
No study in this group is marked as key.
Regional context
Germany / EU
Sweeteners are authorised in the EU with ADIs; WHO's recommendation is conditional.
Egypt
No Egypt-specific data.
What applies in my country?
General scientific assessment
Potentially true Diet soda is not a proven health benefit; evidence of real harm is uncertain.
The following areas of food safety are relevant to this statement:
- Additives and processing
- Controls, imports, recalls, labelling
Honey, sugar, sweets
Choose a country to see the checked information for it.
Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.
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References
- Association Between Soft Drink Consumption and Mortality in 10 European Countries.. Mullee A et al.. JAMA Intern Med 2019 · PMID 31479109 · DOI 10.1001/jamainternmed.2019.2478
- WHO advises not to use non-sugar sweeteners for weight control in newly released guideline (Use of non-sugar sweeteners: WHO guideline, 2023) — news release. World Health Organization. WHO news release 2023
- Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men.. de Koning L et al.. Circulation 2012 · PMID 22412070 · DOI 10.1161/CIRCULATIONAHA.111.067017
- Sweetened beverage consumption and risk of coronary heart disease in women.. Fung TT et al.. Am J Clin Nutr 2009 · PMID 19211821 · DOI 10.3945/ajcn.2008.27140
- Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults.. Malik VS et al.. Circulation 2019 · PMID 30882235 · DOI 10.1161/CIRCULATIONAHA.118.037401
- Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction.. Imamura F et al.. BMJ 2015 · PMID 26199070 · DOI 10.1136/bmj.h3576
- Sugar and artificially sweetened beverages and risk of obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies.. Qin P et al.. Eur J Epidemiol 2020 · PMID 32529512 · DOI 10.1007/s10654-020-00655-y