Artificial sweeteners are not only related to intestinal metabolism, but may also be related to heart disease

A large study of French adults published today in the British Medical Journal (The BMJ) shows a potentially direct link

The findings suggest that these food additives, which are consumed by millions of people every day and found in thousands of foods and beverages, should not be considered healthy and safe sugar substitutes, which is consistent

Artificial sweeteners are widely used as alternatives to no-calorie or low-calorie sugars

Some studies have linked the consumption of artificial sweeteners or artificially sweetened beverages (ASBs) to weight gain, high blood pressure, and inflammation, but the results remain unclear

To investigate further, a team of researchers and colleagues at the French National Institute of Health and Medical Research (Inserm) collected data on 103388 participants (average age 42; The study, based on the NutriNet-Santé website, was launched in France in 2009 to investigate the relationship between

Dietary intake and consumption of artificial sweeteners were assessed through repeated 24-hour dietary records, and a range of potential health, lifestyle and socio-demographic factors

The analysis included artificial sweeteners from all dietary sources (beverages, tabletop sweeteners, dairy products, etc.

In total, 37 percent of the participants consumed artificial sweeteners, averaging 42.

Among participants who consumed artificial sweeteners, the average intakes in the lower and higher consumption categories were 7.

High-spenders tend to be younger, have a higher body mass index, are more likely to smoke, are less physically active, and follow a weight loss diet compared to non-consumers

During a follow-up period of an average of 9 years, 1502 cardiovascular events

The researchers found that total intake of artificial sweeteners was associated with an increased risk of cardiovascular disease (an absolute ratio of 346 per 100,000 person-years for high-intake people and 314 per 100,000 person-years for non-intake people).

Artificial sweeteners were more associated with the risk of cerebrovascular disease (in high-sugar and non-sweetener populations, the absolute proportions per 100,000 person-years were 195 and 150,

Intake of aspartame was associated with an increased risk of cerebrovascular events (186 and 151 / 100,000 person-years in the hyperglycemic and non-hyperglycemia groups, respectively), while acesulfame potassium and sucralose were associated with an increased risk of coronary heart disease (acesulfame potassium: 167 and 164 per 100,000 people/ year; Sucralose: 271 and 161 sucralose intake per 100,000 people/year,

This is an observational study, so the cause cannot be determined, and the researchers cannot rule out the possibility that

Still, it was a large study that assessed an individual's artificial sweetener intake using accurate, high-quality dietary data, and the findings were consistent with other studies that linked

As a result, the researchers say, their results suggest that replacing added sugars with artificial sweeteners has no benefit for cardiovascular disease outcomes
.

They add that further prospective cohort studies are needed to confirm these results, as well as experimental studies to clarify biological pathways
.

At the same time, they argue, the study provides key insights
into the reassessment of artificial sweeteners currently being carried out by the European Food Safety Authority, the World Health Organization and other health agencies.

Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort