Artificial sweeteners tied to increased heart risk, new study finds

Artificial sweeteners added to thousands of foods and beverages (sodas, yogurts, pancake syrups, jams, baked goods, frozen desserts, gum, candy) to help us satisfy our sweet tooth with fewer (or zero) calories and no sugar added.

But the effect of artificial sweeteners on body weight and health has long been debated.

Short-term randomized controlled trials have mainly shown that, when substituted for sugar-sweetened beverages, artificially sweetened beverages help prevent weight gain.

However, the results of numerous observational studies suggest that, in the long term, regular intake of these substances may have deleterious effects on cardiometabolic health, such as increased waist circumference, elevated blood sugar levels, insulin resistance and inflammation.

Now, new research published in The British Medical Journal adds to the growing evidence that a high intake of artificial sweeteners can harm cardiovascular health.

latest finds

For the study, researchers examined the link between artificial sweetener intake and cardiovascular disease risk in 103,388 participants enrolled in the NutriNet-Santé study, an ongoing health and nutrition study conducted among adults living in France.

The participants, who were followed for nearly a decade, provided three-day, 24-hour dietary records, which included product brands, at the start of the study and every six months thereafter. The researchers calculated the participants’ total artificial sweetener intake (from food, beverages, and tabletop sweeteners), as well as the intake of different types of artificial sweeteners.

Diet soft drinks accounted for half (53 percent) of the artificial sweeteners consumed. Other major contributors were tabletop sweeteners (30 percent) and flavored dairy products, such as yogurt and cottage cheese (8 percent). Aspartame, acesulfame potassium, and sucralose accounted for the majority of total artificial sweetener intake.

Participants who had a higher intake of total artificial sweeteners had a higher risk of developing cardiovascular disease compared to non-users. The average daily intake of artificial sweeteners among people classified as “heavy consumers” was 77 mg, equivalent to about two packets of tabletop sweetener or 200 mL of diet soda.

Aspartame intake was linked to an increased risk of stroke; sucralose and acesulfame potassium were associated with an increased risk of coronary heart disease.

The researchers took into account several factors related to cardiovascular risk, such as age, family history, smoking, physical activity and dietary components.

Strengths, caveats

The study’s strengths include its large sample size and high-quality dietary data. The researchers collected repeated 24-hour dietary records, which are known to be more accurate than the food frequency questionnaires typically used in nutrition studies.

A limitation of this study is that the findings show only correlations; They do not establish a cause and effect relationship.

Additionally, some participants assessed as heavy consumers at the start of the study may have increased their intake of artificial sweeteners in response to having cardiovascular disease risk factors and may have already had poorer cardiovascular health.

How artificial sweeteners can harm

These new findings are consistent with those of several other large observational studies that investigated the association between artificially sweetened soft drinks and cardiovascular disease risk.

There are plausible ways that artificial sweeteners may increase heart risk. Previous studies have linked artificially sweetened beverages to metabolic syndrome, a cluster of cardiovascular disease risk factors that can include abdominal obesity, high blood pressure, high blood triglycerides, increased blood sugar and HDL (good) cholesterol. bass.

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Artificial sweeteners can also activate sweet taste receptors in the gut, which can disrupt the body’s blood glucose regulation.

And experimental studies have shown that some artificial sweeteners alter the composition of the gut microbiome in a direction that can lead to inflammation and glucose intolerance.

To do?

Due to lack of consensus on whether regular use of sugar-free sweeteners is effective in the long term weightlossor linked to other long-term health effects, in July the World Health Organization proposed a draft guideline recommending that “sugar-free sweeteners should not be used as a means of achieving weight control or reducing the risk of non-communicable diseases”.

If you are a daily consumer of artificial sweeteners, I advise you to reduce them. That doesn’t mean you need to avoid them entirely; there is no evidence that occasional use is harmful.

Replace drinks without alcohol with sparkling water, flavored carbonated water without sugar, or plain water with a slice of citrus.

If you add a packet of sweetener to coffee, tea or hot cereal, reduce gradually and progressively. The same goes for real sugar.

Replace artificially sweetened yogurt with plain yogurt; sweeten it with fruit.

The good news: your taste buds will prefer a less sweet flavor.

Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD