Many of us opt for diet drinks, believing zero-calorie sodas are healthier than their sugary alternatives.
It may not be quite so simple, however.
Research into artificial sweeteners like aspartame, often a key ingredient in diet pop, has thrown up mixed results. Soda fanatics may benefit from switching to a calorie-free alternative, however, animal studies have suggested aspartame could cause cancer.
Now, after analysing 14 studies with 1.2 million adults between them, scientists from Zhengzhou University in China found those who consumed either sugary or artificially-sweetened drinks were up to 23% more likely to die prematurely.
Lead author Dr Hongyi Li told the Journal of Public Health: “High consumption of both artificially-sweetened beverages and sugar-sweetened beverages showed significant associations with a higher risk of cardiovascular disease mortality and all-cause mortality.
“This information may provide ideas for decreasing the global burden of diseases by reducing sweetened beverage intake.”
Read more: 10 surprising foods full of sugar
In the 14 studies, some of which followed their participants for more than 20 years, 137,310 deaths occurred.
The risk of dying was found to increase with every 250ml sugary drink consumed a day, with a typical can of pop being 330ml.
Overall, consuming sugary drinks was linked to a 5% higher risk of dying from any cause, rising to 13% when it came to heart disease specifically. Other causes of death, like cancer, were not included in the analysis.
The participants who drank the most sugary sodas were 12% and 20% more likely to die from any cause and heart disease, respectively, than those who consumed the least.
Artificially-sweetened drinks were linked to an overall 4% higher risk of dying prematurely from any cause, rising to 7% for heart disease.
The participants who consumed the most diet drinks were 12% and 23% more likely to die from any cause and heart disease, respectively, than those who consumed the least artificially-sweetened sodas.
It is unclear exactly why this heightened risk occurs. It has been suggested ingredients in sugary or artificially-sweetened drinks may damage the heart. People who regularly consume soda may also be less healthy overall, with a poor diet and sedentary lifestyle.
In 2017, scientists from London and Brazil reported people who drink sugar-free soda may mistakenly think they are making a healthy choice, causing them to eat more overall. The sweet flavour of diet drinks could also trigger sugar cravings.
Watch: Diet soda doesn’t aid weight loss
The UK government introduced a sugar tax on soft drinks in April 2018. Manufacturers of drinks that contain more than 5g (a teaspoonful) of sugar per 100ml must therefore pay a levy of 18p per litre to the Treasury.
The levy rises to 24p per litre for drinks with more than 8g of sugar per 100ml.
Households are said to have consumed 10% less sugar from soft drinks by April 2019, however, soda sales have remained steady.
Consumers are thought to have switched to lower-sugar alternatives, while manufacturers may have reformulated recipes to avoid the levy.
A spokesperson from the British Soft Drinks Association told MailOnline: “Soft drinks are safe to consume as part of a balanced diet.
“The sector recognises it has a role to play in helping to tackle obesity, which is why soft drinks manufacturers have led the way in reformulation work.”
The campaign group Action on Sugar maintains: “People should ideally avoid sugar-sweetened and artificially-sweetened drinks, and choose a healthier option such as water.”
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Diet drinks no healthier than sugary sodas, study suggests