Soft Drinks and other foods consumed by millions of Americans contain artificial sweeteners as well as other additives. Snack foods, dairy products, ready-to-eat meals, and those little packets you find at restaurants are also popular.
Some people avoid the health risks associated with added sugars by using these, but artificial sweeteners may also harm your health, especially in higher amounts.
Recent large observational study suggests that heart-related risks include.
They found that people who consumed higher amounts of artificial sweeteners were at increased risk of cardiovascular disease, including stroke and other cerebrovascular diseases.
Researchers found that age and gender are key factors in determining diet quality. Participants ranged in age from 18 to 80 and were predominantly female.
Individuals completed questionnaires about diet, health, physical activity, and personal information at the start of the study.
They also completed multiple dietary assessments at the beginning of the study and every 6 months afterward. During these dietary recalls, they were asked to report every food and beverage they consumed over a 24-hour period. They were also asked to recall every food and beverage they had consumed over a 24-hour period.
This provided researchers with a detailed estimate of people’s consumption of artificial sweeteners from all sources, as well as their intake of fruits, vegetables, dairy products, red meat, and other types of nutrients.
People also reported on new health events, medical treatments, and examinations — including those related to cardiovascular diseases, including heart disease, heart attack, and stroke.
Around 37% of participants consumed some form of artificial sweetener throughout the study period. On average, these people consumed 42 milligrams of artificial sweetener daily, which is equivalent to one individual packet of tabletop sweetener or 3.4 ounces (100 milliliters) of diet soda.
The daily artificial sweetener consumption of “high consumers” was around 78 milligrams; for “low consumers” it was around 8 milligrams. There was also a group of people who didn’t consume any artificial sweeteners.
People who consumed higher amounts of artificial sweeteners wereleaner, had a higher body mass index (BMI), and were more likely to be less active and dieted, rather than eat less calories.
Eating less, drinking less, and burning up fewer calories also helped them lose weight. They consumed lesser amounts of saturated and polyunsaturated fats, fiber, carbohydrates, and fruits and vegetables; and they consumed greater amounts of salt, red meat, and dairy products.
Researchers took into account these differences as well as other factors such as age, sex, physical activity, education, smoking status, and family history of cardiovascular disease.
“There appears to be an increased risk of cardiovascular events after the adjustment [for artificial sweetener use]. However, that signal remains,” said cardiologist Elizabeth H. Dineen of the Susan Samueli Integrative Institute at UCI Health in Orange County, California, who was not involved with the research.
Researchers found that artificial sweeteners were associated with an increased risk of cardiovascular disease in people who had followed others for 9 years on average.
People who consumed more artificial sweeteners had a 9% increased risk of cardiovascular disease compared to people who did not consume artificial sweeteners.
People who consumed the most fake sugar were at an 18% increased risk of stroke or other cerebrovascular disease compared to those who didn’t consume any.
It was also found that consumers of aspartame and acesulfame potassium were at risk for cerebrovascular disease, whereas consumers of sucralose were at risk for coronary heart disease.
In addition to tracking the amount of artificial sweeteners consumed, the dietary assessments also recorded participants’ intakes of other types of artificial sweeteners — including plant-based stevia — but these were not included in the analysis because participants consumed too little of them.
Researchers also looked at whether substituting artificial sweeteners for added sugar would reduce the risk of cardiovascular disease, cerebrovascular disease, or coronary heart disease. They found no benefit, according to them, so they wrote.
The researchers said that artificial sweeteners “should not be considered a healthy and safe alternative to sugar” based on the study results. These substances are “used extensively in products around the world” and so should not be considered safe alternatives to sugar.
Overall, Dineen said the study was well-done, but there are certain limitations. One is that it is an observational study, so we can’t prove a causal link between artificial sweeteners and cardiovascular disease.
However, other research has found that people who consume higher amounts of artificially sweetened beverages have a higher chance of cardiovascular disease and stroke.
Previous research on the risk of cardiovascular disease has focused mostly on the consumption of artificial sweeteners in beverages. This, however, included all food sources.
Dr. Lori Chong, an Ohio State University Wexner Medical Center dietitian, says artificial sweeteners are appearing in foods you wouldn’t expect, such as crackers and bread.
Soft drinks accounted for 53% of artificial sweetener consumption in the new research, but people also consumed artificial sweeteners in tabletop sweeteners (30%) and yogurts and cottage cheese (8%).
One of the dangers associated with consuming artificial sweeteners is heart problems.
In a new study published in March 2022 in PLoS ONE, the authors found an increased risk of cancer associated with higher consumption of artificial sweeteners, especially aspartame and acesulfame-K.
“Based on other studies and this one, it appears wise to limit artificial sweeteners,” said Dineen, also an assistant professor of medicine, cardiovascular diseases, at UCI School of Medicine in Irvine, California.
There is no doubt that following preventive strategies — such as dietary interventions — is important for everyone, regardless of whether cardiovascular disease has been diagnosed, she said.
In addition to this study, Chong has previously recommended that people reduce their consumption of artificial sweeteners—but “avoid at all costs” is not one of her recommended phrases.
Of course, for different people, limiting the intake of artificial sweeteners will mean different things.
If you regularly consume certain foods and beverages, you might want to consider alternatives or ways to reduce the artificial sweeteners, said Chong.
Limiting added sugars does not mean returning to the original sugars, said Chong.
She said to follow the World Health Organization’s recommendation of eating no more than 10% of your daily calories from added sugars—or no more than 5% for additional health benefits.
She recommends looking at the ingredient lists on food packages.
“Buy enough whole foods—fresh fruit and vegetables—that do not require an ingredient label. Keep things short and simple, and make sure you eat enough.”
People should take heed of studies like this one and others, which can help them eat healthier, but healthy eating is often intuitive, said Dineen.
“She said that most people know what is generally healthy versus not, but that it can be difficult to break our habit.”
A dietitian said some people with eating habits difficulties might profit from receiving dietary counselling, either individually or in a group.
According to Dr. Taylor, the Mediterranean diet has been a “staple in the world of prevention, when it comes to heart disease.”
The diet is high in fruits, vegetables, whole grains, and health fats, and fish and seafood are traditionally included. In order to create a Mediterranean-specific diet, Dineen said individuals should consider their health factors and preferences.
