Sweeteners and the risk of cardiovascular disease

A French study published in the British Medical Journal showed that sweeteners used to replace sugar in many drinks as well as foods, could be associated with an increased risk of cardiovascular disease.

Due to the harmfulness of added sugars, artificial sweeteners are used as an alternative to reduce the amount of sugar and calories associated while maintaining the sweet taste. But the safety of these food additives is up for debate.

An observational French study, published in March by researchers from various institutes, concluded that people who consumed the most sweeteners, especially aspartame and acesulfame-K, had a higher risk of developing cancer. To explore the risks associated with cardiovascular disease this time around, the researchers used the same methodology in health and sweetener consumption data for 103,388 French adults who participated in the NutriNet-Santé cohort study. Among other information, the volunteers detailed their food consumption. 37% of participants consumed sweeteners, at 42.46 mg/day, the equivalent of a single table-top sweetener or 100ml of diet soda.

After collecting information about the diagnosis of cardiovascular disease during the follow-up period (2009-2021), statistical analyzes examined the association between consumption of sweeteners and the risk of developing such diseases. According to the study, artificial sweeteners, including aspartame, acesulfame-K, and sucralose, are associated with an increased risk of cardiovascular disease and coronary heart disease.

Until then, studies had indicated an increased risk of these diseases associated with the consumption of sweetened beverages. No one considered exposure to sweeteners as a whole, according to the authors. “These findings, in line with the latest WHO report published this year, do not support the use of sweeteners as a safe alternative to sugar,” concluded Dr. Mathilde Toffer, director of research at Inserm and coordinator of the study. However, this has limits.

This “observational study cannot answer the question at hand” because of “the main differences in many characteristics of people who consume artificial sweeteners compared to those who do not,” according to Science Media, Naveed Sattar, professor of metabolic medicine at the University of Glasgow. In his view, it “strongly suggests a causal relationship between sweeteners and cardiovascular disease” with a methodology not strong enough. More research will be needed to replicate and confirm these findings.