A study found a correlation between increased consumption of artificial sweeteners and a higher risk of cardiovascular conditions like heart attack and stroke.
A study found a direct correlation between increased artificial sweetener consumption and a higher risk of cardiovascular conditions like heart attack and stroke. According to the findings, these food additives, which are consumed daily by millions of people and are found in thousands of foods and beverages, should not be regarded as a safe and healthy substitute for sugar. This is in line with the current position of many health agencies. Artificial sweeteners are frequently used in place of sugar as low-calorie or no-calorie alternatives. They make up a $7200 million (£5900 million; EUR7000 million) global market and are present in tens of thousands of goods, especially ultra-processed foods like artificially sweetened drinks, some snacks, and ready meals with fewer calories.
Consuming artificial sweeteners or artificially sweetened beverages (ASB) has been linked in numerous studies to weight gain, high blood pressure, and inflammation, but the evidence on how artificial sweeteners contribute to the development of various diseases, such as cardiovascular disease, is still conflicting (CVD). Additionally, a number of observational studies have used the consumption of ASB as a proxy to examine CVD risk, but none have measured the total dietary intake of artificial sweeteners.
Researchers from the French National Institute for Health and Medical Research (Inserm) and associates used data from 103,388 participants (average age 42 years; 80% female) in the web-based NutriNet-Sante study, launched in France in 2009 to examine relationships between nutrition and health, to further investigate this. A variety of potentially significant health, lifestyle, and sociodemographic factors were taken into consideration when assessing dietary intakes and consumption of artificial sweeteners using repeated 24-hour dietary records.
The analysis included artificial sweeteners of all types (aspartame, acesulfame potassium, and sucralose) from all dietary sources (beverages, tabletop sweeteners, dairy products, etc.). A total of 37% of participants used artificial sweeteners, with an average intake of 42.46 mg/day, or roughly one packet of tabletop sweetener per person or 100 mL of diet soda per day.
The average daily intakes for lower and higher consumer categories among participants who consumed artificial sweeteners were 7.46 and 77.62 mg, respectively. Higher consumers had a tendency to be younger, have a higher body mass index than non-consumers, were more likely to smoke, were less likely to be physically active, and were more likely to follow a weight loss diet. Additionally, they consumed less total energy and less alcohol, saturated and polyunsaturated fats, fibre, carbs, fruit, and vegetables while consuming more sodium, red and processed meat, dairy products, and non-sugary beverages. But the researchers considered these variations in their analyses.
An average of nine years of follow-up resulted in 1,502 cardiovascular events. They included transient ischemic attack, transient ischemic attack, angina, angioplasty (a procedure to widen blocked or narrowed arteries to the heart), and stroke. The researchers discovered that consuming artificial sweeteners in their entirety was linked to a higher risk of cardiovascular disease (absolute rate 346 per 100,000 person years in higher consumers and 314 per 100,000 person years in non-consumers).
Artificial sweeteners had a stronger link to the risk of cerebrovascular disease (absolute rates 195 and 150 per 100,000 person years in higher and non-consumers, respectively). Acesulfame potassium and sucralose were linked to an increased risk of coronary heart disease, whereas aspartame consumption was linked to an increased risk of cerebrovascular events (186 and 151 per 100,000 person years in higher and non-consumers, respectively) (acesulfame potassium: 167 and 164 per 100,000 person years; sucralose: 271 and 161 per 100,000 person years in higher and non-consumers, respectively).
Since this is an observational study, neither the cause nor the researchers' ability to rule out the possibility that additional unidentified (confounding) factors may have influenced their findings cannot be determined. Nevertheless, this was a sizable study that evaluated people's consumption of artificial sweeteners using accurate, high-quality dietary data, and the results are consistent with those of other studies that have linked exposure to artificial sweeteners with a number of risk factors for disease.
Accordingly, the researchers claim that their findings do not support the idea that CVD outcomes would be improved by replacing added sugar with artificial sweeteners. They add that additional prospective cohort studies are required to confirm these findings and that experimental studies are required to clarify biological pathways. In the interim, they contend that this research offers crucial insights into the context of the re-evaluation of artificial sweeteners being conducted by the European Food Safety Authority, the World Health Organization, and other medical organisations.