Is there a relationship between artificial sweetener consumption and cardiovascular disease?

By Dr. Jonathan Shurlock, edited by Dr. Ahmed El-Medany

A large group led by PhD candidate Charlotte Debras have published their findings from the NutriNet-Santé cohort in the BMJ. The authors aimed to study any association between dietary artificial sweetener intake and cardiovascular disease. The study cohort were based in France and included 103,388 participants (mean age 42.2±14.4, 79.8% female, 904,206 person years). Dietary intake was recorded through self-entered food diaries of randomly assigned 24 hour periods.

The authors found that total artificial sweetener intake was associated with an increased risk of cardiovascular disease (1,502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03). There was found to be a further associated between artificial sweetener consumption and cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100,000 person years in higher and non-consumers). On assessment of specific sweeteners, aspartame was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100,000 person years in higher and non-consumers).

The group suggest that their findings give evidence to a potential direct association between artificial sweetener consumption and cardiovascular risk. As they outline in their discussion, this topic has remained controversial despite various pieces of work on the topic.

Some criticism of the research methodology and analysis techniques used can be seen in the rapid response section of the article on the BMJ website. These findings are likely to both stimulate academic debate and change some individual’s dietary habits.

See full text here: https://www.bmj.com/content/378/bmj-2022-071204/rapid-responses