Artificial sweeteners linked to increased risk of heart disease, study finds

Artificial sweeteners are linked to an increased risk of heart disease and "should not be considered a healthy, safe alternative to sugar," researchers say.

The harmful effects of added sugars have long been established for multiple chronic diseases, leading food companies to use artificial sweeteners instead in a wide range of foods and beverages consumed daily by millions of people worldwide.

However, their use has come under intense scrutiny in recent years, although study results are divided as to to their role in various diseases.

Their role in cardiovascular disease has been previously suggested in experimental studies, but data from human studies were limited and studies previous observational studies focused u only on artificially sweetened beverages used as a proxy.

Now, results from a large-scale prospective cohort study suggest a direct potential as an association between higher consumption of artificial sweetener and an increased risk of cardiovascular disease.

"Our results indicate that these food additives, consumed daily by millions of people and present in thousands of foods and drinks, should not be considered a healthy and safe alternative to sugar, in line with the current position of several health agencies,” the researchers wrote in the BMJ.

In the study, of 103,000 French adults, artificial sweeteners were associated with an increased risk of cardiovascular, cerebrovascular and coronary heart disease. "The results suggest that artificial sweeteners may represent a modifiable risk factor for the prevention of cardiovascular disease," they wrote.

The research, led by experts from University Sorbonne Paris Nord, examined consumption of sweeteners from all food sources, including beverages, table-top sweeteners and dairy products, and compared it to their risk of heart or circulatory diseases.

The participants were on average 42 years old, and four out of five were women. Sweetener consumption was tracked using diet logs.

Participants recorded everything they ate, including the brand, for 24 hours , with their diet diary being repeated three times at six-month intervals – twice on weekdays and once on weekends. About 37% of them consumed artificial sweeteners.

During an average follow-up period of about a decade, 1502 cardiovascular events were recorded, including heart attacks, strokes, mini-strokes and angina pectoris.

Consumption of artificial sweeteners was linked to a 9% higher risk of cardiovascular disease, reported the BMJ. When researchers looked at specific types of disease, they found that consuming artificial sweeteners was linked to an 18% higher risk of cerebrovascular disease - conditions that affect blood flow to the brain.

< p class="dcr-xry7m2"> A specific type of sweetener - aspartame - was associated with a 17% increased risk of cerebrovascular events, while acesulfame potassium and sucralose were associated with an increased risk of coronary artery disease.

The study was observational, so cannot establish cause, nor rule out the possibility that other unknown factors may have affected the results. Nevertheless, according to the researchers, this was a large study that assessed the consumption of artificial sweeteners using accurate, high-quality dietary data, and the results were consistent with other studies linking artificial sweeteners to markers of poor health. Further studies were needed, they said.