Many people who want to lose weight or reduce calories may turn to artificial sweeteners as one way to help achieve these goals. But a new study suggests that replacing real sugar with artificial sweeteners may increase the risk of cardiovascular disease.
This study, which followed more than 100,000 adults for about a decade, is among the largest to date to identify cardiovascular problems with sugar substitutes. Overall, artificial sweeteners were associated with a 9 percent increased risk of any type of cardiovascular disease and an 18 percent greater chance of stroke, according to the The results are published in BMJ.
“Our results suggest that this food additive, which is consumed by millions of people daily and present in thousands of foods and beverages, should not be considered a healthy and safe alternative to sugar,” the study authors wrote. BMJ.
At the start of the study, none of the participants had a history of cardiovascular disease or diabetes – and none were diagnosed with these conditions during the first two years of follow-up. The average age of the participants was 42 years and most of them were female.
Participants completed a series of about five nutritional questionnaires over the first two years of the study, which showed that 37 percent of them consumed artificial sweeteners. According to the study, those who consumed an average of about 43 milligrams (mg) per day, roughly the amount found in one table-top sweetener or 100 milliliters (3.4 ounces) of diet soda. The people with the highest consumption of artificial sugar consumed an average of 78 mg per day, while the individuals with the lowest intake of sugar consumed an average of 7.5 mg per day.
During the study period, the participants had a total of 1,502 cardiovascular conditions, including heart attacks, strokes, and damaged and blocked blood vessels, and medical procedures to restore blood flow in blocked arteries or veins.
The annual absolute risk of developing cardiovascular disease was 314 cases per 100,000 people among participants who did not consume artificial sweeteners, compared with 346 cases for those with the highest consumption of sugar substitutes.
The study also found that certain risks were higher with certain sweeteners. For example, aspartame, sold under the brand names NutraSweet and Equal, was associated with a 17 percent higher risk of stroke. Acesulfame potassium, sold under the brand names Sweet One and Sunett, was associated with a 40% increased risk of coronary heart disease.
The study was not a controlled trial designed to prove whether and how artificial sweeteners may directly cause cardiovascular disease. It is also possible that the results were distorted by participants’ poor recall of what they ate and drank, as this was determined using questionnaires.
Many artificial sweeteners are approved as safe as food additives by US Food and Drug Administration (FDA). Recommended daily limits vary by type of sweetener, but the equivalent of 23 tabletop packets per day is considered safe, according to Harvard TH Chan School of Public Health.