>Background: Consumption of sugar-sweetened soda has been associated with an increased risk of cardiometabolic disease. The relation with cerebrovascular disease has not yet been closely examined.>Objective: Our objective was to examine patterns of soda consumption and substitution of alternative beverages for soda in relation to stroke risk.>Design: The Nurses’ Health Study, a prospective cohort study of 84,085 women followed for 28 y (1980–2008), and the Health Professionals Follow-Up Study, a prospective cohort study of 43,371 men followed for 22 y (1986–2008), provided data on soda consumption and incident stroke.>Results: We documented 1416 strokes in men during 841,770 person-years of follow-up and 2938 strokes in women during 2,188,230 person-years of follow-up. The pooled RR of total stroke for ≥1 serving of sugar-sweetened soda/d, compared with none, was 1.16 (95% CI: 1.00, 1.34). The pooled RR of total stroke for ≥1 serving of low-calorie soda/d, compared with none, was 1.16 (95% CI: 1.05, 1.28). Compared with 1 serving of sugar-sweetened soda/d, 1 serving of decaffeinated coffee/d was associated with a 10% (95% CI: 1%, 19%) lower risk of stroke and 1 serving of caffeinated coffee/d with a 9% (95% CI: 0%, 17%) lower risk. Similar estimated reductions in risk were seen for substitution of caffeinated or decaffeinated coffee for low-calorie soda.>Conclusions: Greater consumption of sugar-sweetened and low-calorie sodas was associated with a significantly higher risk of stroke. This risk may be reduced by substituting alternative beverages for soda.
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