Could zero-calorie sweeteners increase your risk for cardiovascular disease?

Zero-calorie artificial sweeteners may not be as dangerous as they seem. Carmen Martínez Torrón/Getty Images A large-scale study involving French citizens spanning more than a decade assessed their consumption of artificial sweeteners. Observational studies periodically check participants’ food and drink intake and ask participants to report on their health periodically. By the end of the study, the researchers learned that participants who consumed higher levels of artificial sweeteners experienced cardiovascular disease events at higher rates than participants who did not consume artificial sweeteners.

Although artificial sweeteners may seem like a good alternative to sugar to reduce calorie intake, a study published in The BMJTrusted Source suggests there may be a link between such sweeteners and an increased risk of cardiovascular disease (CVD), including stroke. The research, conducted by the French National Institute for Health and Medical Research, is not the first to suggest a link between artificial sweeteners and an increased risk of heart disease, however, it is the largest to date. The study included data from more than 100,000 participants.

Is it okay to take artificial sweeteners? When people try to cut sugar out of their diet, for reasons like trying to lose weight or trying to control their blood sugar, they may turn to artificial sweeteners. Artificial sweeteners have been around for more than 100 years. Saccharin, for example, found in Sweet’N Low sugar substitute, was first discovered in 1879. Since then, researchers have discovered many other artificial sweeteners, including sucralose, aspartame, stevia and xylitol.

There is almost always controversy surrounding artificial sweeteners. As the Harvard School of Public Health notes, concerns include the development of type 2 diabetes and weight gain but the evidence is mixed and inconclusive. Despite the concerns, the Food and Drug Administration considers approved sweeteners generally safe to use, as long as people do not exceed the acceptable daily intake for each type.

For example, with sucralose (found in Splenda), a 132-pound person can consume 23 packets before exceeding the recommended limit. Sweeteners are studied
The study began in 2009 with the launch of the NutriNet-Santé e-cohort. People interested in taking part in the “world’s largest nutrition study” can register online. More than 170,000 signed up for the study, and the researchers narrowed their field to 103,388. Selected participants included those aged 18 and over, as well as people who filled out questionnaires related to “diet, health, anthropometric data, lifestyle and sociodemographic data, and physical activity.”

The average age of the included participants was 42 years, and the majority of participants were female (79.8%). Over the following years, the researchers periodically collected information from the participants such as all food and drink consumed in a 24-hour period. To ensure participants were accurate with their food logs, the researchers required them to submit photos.

In addition, participants also reported their use of artificial sweeteners. The researchers wanted to know the amount and brand of sweetener. Approximately 37% of participants reported using artificial sweeteners, with participants divided into non-users, lower users (artificial sweetener intake below the median) and higher users (artificial sweetener intake above the median). The participants consumed an average of 42.46 mg/day. They use the following types of artificial sweeteners.

aspartame, acesulfame potassium, sucralose, safe, saccharin, thaumatin, neohesperidine dihydrochalcone, steviol glycosides, aspartame-acesulfame potassium salt
The researchers also collected other health information from the participants throughout the study period, including information from “any new health events, medical treatments and examinations.” In addition, participants provided documentation of any CVD reports. The higher the use the higher the risk.

Could zero-calorie sweeteners increase your risk for cardiovascular disease?

At the end of the study, the researchers compared the number of cardiovascular events experienced by people who used artificial sweeteners with the number of events experienced by people who did not consume these sweeteners. The researchers found that people who were higher users of artificial sweeteners had an increased risk of cardiovascular disease compared to non-users.

Participants reported 1,502 cardiovascular events during follow-up, including 730 coronary heart disease events and 777 cerebrovascular disease events. Higher users of artificial sweeteners experienced 346 events per 100,000 person-years and non-users experienced 314 events per 100,000 person-years.

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