The consumption of artificial sweeteners is associated with an increased risk of cardiovascular and cerebrovascular disease. The correlation, which has already emerged in the scientific literature, is confirmed by a French study. (1)
Artificial sweeteners and cardiovascular risks
The researchers selected 103,388 participants from the NutriNet-Santé cohort, the epidemiological project launched in France in 2009 to study the association between nutrition and health.
As per the protocol, participants (mean age 42.2 years, 79.8% female) reported their health conditions (with referral submission, in case of cardiovascular disease) and documented daily food consumption, through the 24-hour interactive online dietary record tool.
At the end of the observation (Oct. 5, 2021), the researchers divided the participants into three categories of artificial sweetener consumption (zero, within average, highest) and noted the respective incidence of cardiovascular disease.
80 mg per day of sweeteners
Net of participants who died (0.94 percent) or voluntarily dropped out of the study (9.4 percent), 37.1 percent of the sample consumed artificial sweeteners, about half of which came from soft drinks and the rest from food and table-top sweeteners.
The most consumed molecules were found to be.
- Aspartame, E 951 (58% of cases),
- acesulfame potassium, E 950 (29%)
- sucralose, E 955 (10%).
The remaining 3 percent were cyclamates (E 952), saccharin (E 954), thaumatin (E957), neohesperidine dihydrocalcone ( E959), steviol glycosides (E960) and aspartame-acesulfame potassium salt (E962).
The average per capita consumption was 42.46 mg/day, modulated in
- 7.46 mg/day among occasional users,
- 77.62 mg/day among heavy consumers.
Achieving a daily intake of close to 80 grams of synthetic sweetening molecules may seem exceptional. Yet, filling it is easy by frequently consuming packaged foods ‘without added sugar‘ but with synthetic sweeteners. These food additives are widely found in ultra-processed foods, such as soft drinks, snacks, ready meals, and dairy products (as we have seen with high-protein yogurts).
Sugar vs aspartame and Co.
Fears of consuming too much sugar are well founded. The consequence of developing tooth decay and metabolic diseases is certain. Therefore, EFSA urges people to consume as little as possible. (2) And the World Health Organization recommends limiting consumption to within 5 percent of daily energy intake. (3) That is, 100 kcal in a standard healthy adult diet of 2,000 kcal, equal to about 6 teaspoons of sugar. A threshold easily surpassed even by those who add it to their coffee.
Replacing sugar with synthetic sweeteners, however, is not the ideal solution.
‘Our results
suggest no benefit from replacing artificial sweeteners with sugar on CVD (cardiovascular disease, ed.) outcomes,’ say the study authors.
The result of the study
In a nine-year follow-up , intake of artificial sweeteners was associated with a 9% increased risk of cardiovascular and cerebrovascular disease.
Specifically,
- aspartame (E 951) was associated with an increased risk of cerebrovascular events,
- acesulfame potassium (E 950) and sucralose (E 955) were associated with an increased risk of coronary heart disease.
A total of 1,502 cardiovascular events occurred (at mean age 62.7 years) including.
- 730 coronary artery disease events (143 myocardial infarction, 75 acute coronary syndrome , 477 angioplasty events and 277 angina pectoris events),
- 777 cerebrovascular disease events (203 strokes and 598 transient ischemic events).
The incidence of these events was higher among heavy users of sweeteners: 346 cases per 100,000 person-years, compared with 314 among those who did not use them.
Identikit of the heavy consumer of synthetic sweeteners
The study also reveals the profile-type of the heavy (French) consumer of synthetic sweeteners:
– Tending to be young,
– With higher body mass index
– smoker,
– less physically active
– he slimming diet, with lower total energy intake and lower intake of alcohol, lipids (saturated and polyunsaturated), fiber, carbohydrates, fruits, and vegetables and higher intake of sodium, red and processed meat, dairy products, and beverages with no added sugar.
The argument that this profile is more prone to cardiovascular risk, regardless of sweeteners, was addressed in the study. And thus resolved: ‘We excluded CVD (cardiovascular disease, ed.) events that occurred during the first two years of follow-up and also tested models adjusted for body mass index at baseline, weight loss diet, and weight change during follow-up, which did not substantially change the results.’
Marta Strinati
Notes
(1) Debras C, Chazelas E, Sellem L, Porcher R, Druesne-Pecollo N, Esseddik Y et al. Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort BMJ 2022; 378 :e071204 doi:10.1136/bmj-2022-071204
(2) Marta Strinati. The harmful role of sugars in the diet, EFSA opinion. GIFT (Great Italian Food Trade). 1.3.22
(3) Guideline: sugars intake for adults and children. WHO (World Health Organization). 4.3.15 https://www.who.int/publications/i/item/9789241549028
Professional journalist since January 1995, he has worked for newspapers (Il Messaggero, Paese Sera, La Stampa) and periodicals (NumeroUno, Il Salvagente). She is the author of journalistic surveys on food, she has published the book "Reading labels to know what we eat".
