Investigating the potential link between artificial sweeteners and heart disease 

Investigating the potential link between artificial sweeteners and heart disease 
© iStock/AntonioGuillem

A large study of French adults has found a potential direct association between higher artificial sweetener consumption and increased cardiovascular disease risk. 

Researchers have found a possible connection between artificial sweetener consumption and cardiovascular disease risk, including heart attacks and stroke. The findings illuminate that these food additives, commonly found in low-calorie drinks, sweets, and fruit juices, should not be considered a healthy and safe sugar alternative. 

Artificial sweeteners are widely used as no or low-calorie alternatives to sugar. They represent a $7200m global market. These sweeteners have been scrutinised for decades, with many researchers reporting the negative effects of their consumption, such as cancer, weight gain, high blood pressure and inflammation; however, solid scientific findings remain mixed. 

The new study is published in The BMJ. 

Examining artificial sweetener consumption and heart health

A team of researchers at the French National Institute for Health and Medical Research (Inserm) used data from 103,338 participants (average age 42 years; 80% female) partaking in the NutriNet-Santé study, which was launched in 2009 to explore nutrition and health. 

Dietary intakes and consumption of artificial sweeteners were assessed by repeated 24-hour dietary records and the team accounted for influential factors. The team included artificial sweeteners from all dietary sources and included aspartame, acesulfame potassium and sucralose in the analysis. 

The researchers noted that 37% of participants consumed artificial sweeteners with an average intake of 42.46 mg/day, which is equivalent to one individual packet of tabletop sweetener or 100Ml of diet coke. 

High consumers more likely to smoke

The researchers found that compared to non-consumers of artificial sweeteners, higher consumers tended to be younger, have a higher body mass index, were more likely to smoke, be less physically active, and follow a weight loss diet. Furthermore, they also had a lower total energy intake, lower alcohol, saturated and polyunsaturated fats, fibre, carbohydrate, fruit and vegetable intakes, and higher intakes of sodium, red and processed meat, dairy products, and beverages with no added sugar. However, the researchers accounted for these differences in their analyses. 

During an average follow-up period of nine years, 1,502 cardiovascular events occurred; this included heart attacks, angina, angioplasty, transient ischemic attack and stroke.  

The researchers found that total artificial sweetener intake was associated with an increased 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). 

Consumption of artificial sweeteners was specifically associated with cerebrovascular disease risk (absolute rates 195 and 150 per 100,000 person-years in higher and non-consumers, respectively). 

Aspartame, a popular sweetener, was also associated with an increased risk of cerebrovascular events (186 and 151 per 100,000 person-years in higher and non-consumers, respectively), whilst acesulfame potassium and sucralose were associated with increased coronary heart disease risk (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). 

It is important to note that the researchers outline that the study is observational therefore, it cannot establish a cause, and other factors may have affected the results. 

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