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Drinking two liters or more per week of artificially sweetened beverages — the equivalent of a medium-sized fast-food diet soda a day — raised the risk of an irregular heartbeat called atrial fibrillation by 20% when compared to people who drank none, a new study found.

Known as A-fib, atrial fibrillation is an irregular heartbeat often described by many people who have it as a “quiver,” “flutter” or “flip-flop” of the heart in the chest.

Drinking a similar number of added-sugar beverages raised the risk of the condition by 10%, while drinking about four ounces of pure, unsweetened juices, such as orange or vegetable juice, was associated with an 8% lower risk of atrial fibrillation, the study found.

“This is the first study to report an association between no- and low-calorie sweeteners and also sugar-sweetened beverages and increased risk of atrial fibrillation,” said Penny Kris-Etherton, a professor emeritus of nutritional sciences at the Pennsylvania State University, in a statement. She was not involved in the new study.

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“We still need more research on these beverages to confirm these findings and to fully understand all the health consequences on heart disease and other health conditions,” said Kris-Etherton, who is also an American Heart Association nutrition committee member.

“In the meantime, water is the best choice, and, based on this study, no- and low-calorie sweetened beverages should be limited or avoided,” she added.

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“Age is one of the most important risk factors, so with the aging of the population it’s becoming more common,” Marcus said.

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“Previous research has shown high soft drink consumption to be association with increased risk of AF (atrial fibrillation),” said Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London, in a statement. He was not involved in the new study.

“Risk of AF is well known to be associated with type 2 diabetes, binge drinking of alcohol (commonly called holiday heart) as well as illicit drug use (cocaine),” Sanders said.

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Higher consumers of artificially sweetened beverages were more likely to be female, younger, weigh more and have a higher prevalence of type 2 diabetes, the study found. Those who drank more sugar-sweetened beverages were more likely to be male, younger, weigh more and have a higher prevalence of heart disease.

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People who drank both sugar-sweetened beverages and pure juice were “more likely to have a higher intake of total sugar than those who drank artificially sweetened drinks,” according to the statement.

“Our study’s findings cannot definitively conclude that one beverage poses more health risk than another due to the complexity of our diets and because some people may drink more than one type of beverage,” said lead study author Dr. Ningjian Wang, a professor at the Shanghai Ninth People’s Hospital and Shanghai Jiao Tong University School of Medicine in Shanghai, China.

“However, based on these findings, we recommend that people reduce or even avoid artificially sweetened and sugar-sweetened beverages whenever possible,” Wang said in the statement. “Do not take it for granted that drinking low-sugar and low-calorie artificially sweetened beverages is healthy, it may pose potential health risks.”

Correction: A previous version of the story attributed a quote by Professor Tom Sanders to another expert.

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