Millions of people have made the switch to diet soda, sometimes after following the doctor’s orders and/or because they think the beverages are better for their health.

But a new study says artificially sweetened drinks may not necessarily be a healthier alternative to ones filled with sugar.

Read more: 5 serious health risks of diet soda

Diet soda may increase stroke, dementia risk

According to findings published in the American Heart Association’s journal Stroke, people who drank diet soda daily were nearly three times as likely to develop stroke and dementia compared to people who didn’t drink diet soda. The same risk wasn’t found for those who consumed sugary beverages.

However, researchers associated higher consumption of both sugary beverages and diet sodas with smaller brain volumes.

Matthew Pase, a senior research fellow in the department of neurology at Boston University School of Medicine, was the lead author of the study, which involved data on more than 4,000 adults.

“Our findings indicate an association between higher sugary beverage intake and brain atrophy, including lower brain volume and poorer memory,” said Pase. “We also found that people drinking diet soda daily were almost three times as likely to develop stroke and dementia. This included a higher risk of ischemic stroke, where blood vessels in the brain become obstructed and Alzheimer’s disease dementia, the most common form of dementia.”

Researchers couldn’t determine an actual cause-and-effect relationship between artificial sweeteners and adverse impacts on the brain. They say further studies are needed.

What should you do?

In the meantime, many doctors will likely recommend that you avoid both sugary and artificially sweetened sodas.

Appearing on NBC News, Dr. Oz said the “worst thing you can do” is go back to drinking regular soda, which has been linked to obesity and other health problems.

Instead, here’s what Dr. Oz recommends:

• Swap out soda for water
• Drink coffee or tea
• Dilute soda with sparkling water

Beverage industry: Low-calorie sweeteners are safe

The American Beverage Association has responded to the study by saying that low-calorie sweeteners have been proven safe for consumption.

This is the full statement from the industry group:

Low-calorie sweeteners have been proven safe by worldwide government safety authorities as well as hundreds of scientific studies and there is nothing in this research that counters this well-established fact. The FDA, World Health Organization, European Food Safety Authority and others have extensively reviewed low-calorie sweeteners and have all reached the same conclusion ‘ they are safe for consumption.

While we respect the mission of these organizations to help prevent conditions like stroke and dementia, the authors of this study acknowledge that their conclusions do not ‘ and cannot ‘ prove cause and effect. And according to the National Institutes of Health (NIH), many risk factors can increase an individual’s likelihood of developing stroke and dementia including age, hypertension, diabetes and genetics. NIH does not mention zero calorie sweeteners as a risk factor.

Scientific evidence does show us that beverages containing these sweeteners can be a useful tool as part of an overall weight management plan. America’s beverage companies support and encourage balanced lifestyles by providing people with a range of beverage choices — with and without calories and sugar — so they can choose the beverage that is right for them.

You can read more about the new study in the American Heart Association’s journal Stroke.

Read more: Best way to control your weight? Hint: It’s not just diet or exercise!