If you’ve been a diet soda lover for years, it’s no small feat to try to cut down on the number of cans you’re crushing per week. What’s better than an ice cold, lemon-squeezed afternoon Diet Coke alongside some deliciously salty snack? You can’t deny: The duo’s iconic.

However, you’ve likely also heard chatter over the years about artificial sweeteners maybe not being the most ideal choice for your gut and overall long-term health. So if it’s diet soda or nothing when it comes to your mealtime drink of choice, this begs the question: Is drinking diet soda with a meal better or worse than simply drinking nothing? Let’s find out.

Health implications that have been linked to diet soda consumption

This question really boils down to two curiosities: the health impacts of diet soda and the importance of hydration—and which is more important. Let’s start with what impact diet soda has on our health.

So much research has been conducted around diet soda and its health implications, from nearly every angle you can imagine. Here are some of the biggest takeaways:

Stroke and heart disease

Diet soda can impact heart health. An article published in Stoke examined data from the Women’s Health Initiative and found that drinking two or more artificially-sweetened beverages (ASBs), including diet soda, per day was associated with increased risk for stroke, heart disease, and all-cause mortality. Another review echoed these findings, with ASBs being linked with overall increased cardiovascular disease risk. Diet soda has also been linked to increased risk of type 2 diabetes and metabolic syndrome.

Brain health

Emerging research is also finding links between brain health and diet soda. The most common artificial sweetener found in diet soda is aspartame, made primarily of amino acids aspartic acid and phenylalanine. Aspartame intake can lead to increased levels of these amino acids in the brain and according to a review in Nutritional Neuroscience, these specific building blocks of protein can inhibit the formation and release of neurotransmitters including dopamine, serotonin, and norepinephrine in the brain. These neurotransmitters regulate neurophysiological activity. Aspartame may also elevate cortisol (a stress hormone) levels in our brain as well as create free radicals. All of this translates to diet sodas containing aspartame having the potential to impact our brain health. Another review found aspartame-containing foods, like diet soda, to be correlated to migraines as well.

Bone health

When it comes to diet colas in particular, bone health can also be a concern. One study found that the phosphoric acid combined with the caffeine found in colas, including diet varieties, was associated with lower bone mineral density. These findings were only tied to colas, not other carbonated soft drinks, as they are the only sodas containing phosphoric acid, generally. While another found that soda consumption of all kinds was associated with increased risk for hip fracture in postmenopausal women, a tell-tale sign of low bone density.

Dental health

Our teeth are also not safe from the effects of diet soda, due to its acidic nature. One research group found both regular and diet soda to be associated with negative impacts on tooth enamel, while another linked them to actual tooth erosion.

Still, correlation ≠ causation

TL; DR? A significant body of research has been done on the implications of diet soda, and it’s clear that there aren’t many mentions of health perks. However, it’s important to keep in mind that more research (on artificial sweetener in particular) is needed, and that many of these studies suggest correlation rather than causation. Finally, know that the American Cancer Society and supporting studies have deemed aspartame not to be linked with cancer, and that aspartame and foods containing the sugar substitute have been deemed safe by both the U.S. Food and Drug Administration (FDA) and World Health Organization (WHO).

Importance of hydration

Speaking of health perks. While that information about diet soda’s health impacts may be deterring, what about hydration? Isn’t hydration important enough to prioritize drinking diet soda at a meal over nothing?

Hydration is indeed important for nearly every aspect of human life, especially given that our bodies are made up of mostly water. Staying well-hydrated helps to maintain optimal organ function, especially within our kidneys and brains. It also helps our bodies digest food easily, helps keeps our immune system and energy levels intact, and boosts skin health.

Diet soda provides some water, but it also often contains caffeine, which can have a diuretic effect, though minor. This means that it actually causes the body to release water through urine, having the potential to possibly dehydrate us slightly. The water from diet soda will still provide more hydration than its caffeine content will dehydrate, but this dynamic is something to keep in mind.

This means that [diet soda] actually causes the body to release water through urine, having the potential to possibly dehydrate us slightly. The water from diet soda will still provide more hydration than its caffeine content will dehydrate, but this dynamic is something to keep in mind.

You might have also heard some so-called health buffs recommend actually not drinking fluids with meals as they could interfere with saliva, digestive enzyme, or stomach acid production, while speeding digestion—all of which could result in undesirable symptoms like gas, bloating, diarrhea, or even constipation. However, there’s no scientific evidence to back these claims. Rather, drinking at meals can actually aid in digestion and help food move through the digestive tract more smoothly. This lends to less bloating, gas, and constipation. Drinking with meals can also help you feel more satisfied after eating.

So, is diet soda bad for you?

So, what’s the bottom line? With the evidence available, ideally we’d steer clear of diet sodas due to their health implications. However, overall hydration and drinking at meals is super important. The easy medium here is to find healthy alternatives.

If the soda flavor is what you’re after, there are so many healthier alternatives out there, including Poppi, Olipop, and even Rowdy Mermaid is coming out with a line of Good Mood Sodas. While these options have a small amount of added sugar, none containing more than 5 grams, which is significantly less than that of the regular stuff. They’ll all still deliver on the caffeine, flavor, and even offer additional health benefits through the inclusion of fiber and prebiotics.

Otherwise, flavored waters, seltzers, tea, coffee (bonus point for decaf!), and fresh, no sugar added juices are also great alternatives. While some of these will provide caffeine, there will be no added sugar anywhere in sight and all will offer the hydration we’re looking for.

And while it might be time to choose a diet soda alternative due to its concerning potential health impacts, there are so many other options that will deliver hydration, caffeine, and downright deliciousness.