Can calorie-free sweeteners increase your risk of cardiovascular disease?

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Calorie-free artificial sweeteners may not be as harmless as they seem. Carmen Martinez Torrón/Getty Images
  • A massive study involving French citizens that spanned more than a decade assessed their use of artificial sweeteners.
  • The observational study periodically checked participants’ food and beverage consumption and asked participants to regularly report on their health status.
  • At the end of the study, researchers learned that participants who consumed higher levels of artificial sweeteners had cardiovascular disease events at a higher rate than participants who did not consume artificial sweeteners.

While artificial sweeteners may appear to be a good alternative to sugar to reduce caloric intake, a study published in The BMJ suggests that there may be a link between these sweeteners and an increased risk of cardiovascular disease (CVD), including stroke.

The research, led by France’s National Institute of Health and Medical Research, is not the first study to suggest a link between artificial sweeteners and an increased risk of heart disease, however, it is the most significant. nowadays. The study included data from more than 100,000 participants.

When people try to cut sugar from their diet, for reasons such as weight loss or blood sugar control, they may turn to artificial sweeteners.

Artificial sweeteners have been around for over 100 years. Saccharin, for example, found in Sweet’N Low sugar substitute, was discovered for the first time in 1879. Since then, researchers have discovered many other artificial sweeteners, including sucralose, aspartame, stevia, and xylitol.

There has almost always been 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 varied and inconclusive.

Despite concerns, the Food and drug administration considers approved sweeteners to be 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 could consume 23 packets before exceeding the recommended limit.

The study began in 2009 with the launch of the NutriNet-Santé e-cohort. Those interested in participating in “the world’s largest nutrition study” could register online.

More than 170,000 people enrolled in the study, and the researchers narrowed their scope to 103,388. Participants chosen included people aged 18 and over, as well as people who completed questionnaires about “diet , health, anthropometric data, lifestyle and socio-demographic data, and physical activity”.

The average age of the participants included was 42 years and the majority of the participants were women (79.8%).

Over the next few years, the researchers periodically collected information from the participants, such as all foods and beverages consumed during a 24-hour period. To ensure participants were accurate in their food diaries, the researchers asked them to submit photos.

Additionally, participants also reported their consumption 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-consumers, lower consumers (artificial sweetener consumption below the median), and high consumers (artificial sweetener consumption above the median). Participants consumed an average of 42.46 mg/day. They consumed the following types of artificial sweeteners:

  • aspartame
  • acesulfame potassium
  • sucralose
  • cyclamates
  • saccharin
  • thaumatin
  • neohesperidin dihydrochalcone
  • steviol glycosides
  • aspartame-acesulfame potassium salt

Researchers also collected other health information from participants throughout the study, including information about “any new health events, medical treatments, and examinations.” In addition, participants provided documentation of all CVD reports.

At the end of the study, the researchers compared the number of cardiovascular events experienced by people who consumed artificial sweeteners to the number of events experienced by people who did not consume these sweeteners.

Researchers found that people who consumed more artificial sweeteners had an increased risk of cardiovascular disease compared to non-consumers.

Participants reported 1,502 cardiovascular events during follow-up, including 730 coronary heart disease events and 777 cerebrovascular disease events.

Heavy users of artificial sweeteners experienced 346 events per 100,000 person-years and non-consumers experienced 314 events per 100,000 person-years.

3 particularly problematic sweeteners

“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, consistent with the current position of several agencies. health,” write the authors. authors.

The authors noted that they don’t believe occasional use of artificial sweeteners is as problematic as daily use. “Occasional consumption of artificial sweeteners is not likely to have a large impact on CVD risk, and so even if some consumption could have been missed, it would likely have had a small impact on the results of the study.”

Additionally, the authors noted that three artificial sweeteners in particular were associated with higher risks.

According to the authors, “Aspartame consumption was associated with an increased risk of cerebrovascular events, and acesulfame potassium and sucralose were associated with an increased risk of coronary heart disease.”

Talk to Medical News Today Commenting on the study, Dr. Jeff Gladd, a physician in integrative medicine and chief medical officer of online healthcare company Fullscript, noted that while artificial sweeteners sparingly were unlikely to pose health concerns, their regular use can eventually cause some problems.

“No-calorie artificial sweeteners such as aspartame, saccharin and sucralose are commonly added to many ‘diet’ and ‘sugar-free’ processed foods such as pastries, puddings, candies, soft drinks, etc.” , said Dr. Gladd.

“Since artificial sweeteners are commonly found in highly processed foods, I recommend limiting their intake altogether. Some safer alternatives include natural options such as allulose, monk fruit, and stevia which don’t seem to not have the same concerns,” he added.

“[R]Research suggests that heavy use of artificial sweeteners may actually lead to weight gain and obesity, and according to some animal trials, consumption of artificial sweeteners may alter the gut microbiota and potentially increase the risk of some cancers, although more research is needed to support these claims. .”
— Dr. Jeff Gladd

“Although prospective studies such as this are not confirmed evidence of causation, this potential link in combination with associations of consumption with obesity and gut microbiome issues should add motivation to limit their consumption,” did he declare.

Dr. Vicken Zeitjian, a cardiologist at the University of Texas Health Sciences Center in San Antonio, Texas, also spoke with DTM about the study.

“The link between artificial sweeteners and coronary heart disease/stroke is not surprising given that artificial sweeteners are associated with diabetes, hypertension, hyperlipidemia, hypertriglyceridemia, and obesity. “, said Dr. Zeitjian.

Dr Zeitjian noted that the study may not be applicable to all populations, however, said “it gives us insight into whether artificial sweeteners may be involved in coronary heart disease and cerebrovascular disease.”

“We live in an age where we focus on prevention, and therefore this study shows that controlling risk factors from a dietary perspective may have reduced the incidence of heart attacks and strokes.”
—Dr. Vicken Zeitjian

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