Used to replace sugar in many drinks but also foods, sweeteners could be associated with increased risks of cardiovascular disease, according to a French study published Thursday in the British Medical Journal.
Given the harmfulness of added sugars, artificial sweeteners are used as alternatives in thousands of foods and beverages to reduce the amount of sugar and associated calories while maintaining a sweet taste.
But the safety of these food additives is debated.
People who consume the most sweeteners, in particular aspartame and acesulfame-K, have a higher risk of cancer, concluded a French observational study, published in March by researchers from different institutes (Inserm, Inrae, Sorbonne University Paris Nord, Cnam).
To explore this time the associated cardiovascular risks, the researchers used the same methodology on the health and sweetener consumption data of 103,388 French adults participating in the NutriNet-Santé cohort study.
Among other information, the volunteers detailed their food consumption.
37% of participants consumed sweeteners, on average 42.46 mg/day, equivalent to an individual sachet of table-top sweetener or 100 ml of diet soda.
After collecting information on the diagnosis of cardiovascular diseases over the follow-up (2009-2021), statistical analyzes investigated the associations between consumption of sweeteners and the risk of such diseases.
According to the study, artificial sweeteners, including aspartame, acesulfame-K and sucralose, are associated with increased risks of cardiovascular, cerebrovascular and coronary heart disease.
Over nine years of follow-up, 1,502 cardiovascular events occurred (heart attacks, angina pectoris, angioplasties, strokes, etc.).
Until then, studies had suggested an increased risk of cardiovascular disease associated with the consumption of sweetened beverages. None looked at exposure to sweeteners as a whole, according to the authors.
“These results, in line with the latest WHO (World Health Organization) report published this year, do not support the use of sweeteners as safe alternatives to sugar,” concludes Dr. Mathilde Touvier, research director at Inserm and coordinator of the study.
However, this has limits.
This “observational study cannot answer the question posed” because of “major differences in many characteristics of people who consume artificial sweeteners compared to those who do not”, judged in particular, with the Science Media Center, Naveed Sattar, professor of metabolic disease medicine at the University of Glasgow.
In his eyes, it “suggests far too strongly a causal link between sweeteners and cardiovascular disease” with a methodology that is not solid enough, and it would take “longer-term and larger-scale randomized trials”.
Further research will be needed to replicate and possibly confirm these results.