BACKGROUND AND PURPOSE:

• Debras et al. (BMJ, 2022) investigated the associations between artificial sweeteners and risk of cardiovascular diseases (CVD)

METHODS:

• Population-based prospective cohort study
  • NutriNet-Santé cohort (France)
• Participants
  • General population
  • Followed from 2009 to 2021
• Exposures
  • Dietary intakes and consumption of artificial sweeteners
• Study design
  • Intake of artificial sweeteners was assessed by repeated 24 hour dietary records, including brand names of industrial products
  • Dietary intake of sweeteners was coded as a continuous variable
  • Risk of CVD was assessed using multivariable adjusted Cox Proportional Hazards models
• Primary outcome
  • CVD risk (overall, coronary heart disease, and cerebrovascular disease)

RESULTS:

• 103,388 participants
  • Mean age 42.2 years; 79.8% female
  • 904,206 person years
• Total artificial sweetener intake was associated with increased risk of CVD
  • Consumers: Incidence rate 346 per 100,000 person years
  • Non-consumers: Incidence rate 314 per 100,000 person years
  • Hazard ratio (HR) 1.09 (95% CI, 1.01 to 1.18); P=0.03; 1502 events
• Artificial sweeteners were particularly associated with cerebrovascular disease
  • Consumers: Incidence rate 195 per 100,000 person years
  • Non-consumers: incidence rate 150 per 100,000 person years
  • HR 1.18 (95% CI, 1.06 to 1.31); P=0.002; 777 events
• Aspartame intake was associated with increased risk for cerebrovascular events
  • Consumers: Incidence rate 186 per 100,000 person years
  • Non-consumers: Incidence rate 151 per 100,000 person years
  • HR 1.17 (95% CI, 1.03 to 1.33); P=0.02
• Acesulfame potassium and sucralose were associated with increased coronary heart disease risk
  • Acesulfame potassium
    • Consumers: incidence rate 167 per 100,000 person years
    • Non-consumers: Incidence rate 164 per 100,000 person years
    • HR 1.40 (95% CI, 1.06 to 1.84); P=0.02
  • Sucralose
    • Consumers: Incidence rate 271 per 100,000 person years
    • Non-consumers: incidence rate 161 per 100,000 person years
    • HR 1.31 (95% CI, 1.00 to 1.71); P=0.05

CONCLUSION:

• Consumption of artificial sweeteners is associated with an increased risk of CVD, particularly with use of aspartame, acesulfame potassium, and sucralose
• The authors state

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

Learn More – Primary Sources:

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

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