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We have often seen people use artificial sweeteners to reduce calorie intake. But are these artificial sweeteners really helpful? 

A recent study conducted by The BMJ shows that the people who were higher consumers of artificial sweeteners had an increased risk of cardiovascular disease, including stroke compared to the non-consumers. 

The researchers noted that three artificial sweeteners in particular were associated with higher risks.

As per them, Aspartame intake was associated with increased risk of cerebrovascular events, and acesulfame potassium and sucralose were associated with increased coronary heart disease risk. Aspartame, acesulfame potassium, and sucralose contributed to 58, 29, and 10 percent of total artificial sweetener intakes, respectively.

"Aspartame intake was associated with increased risk of cerebrovascular events (186 and 151 per 100,000 person years in higher and non-consumers, respectively), while acesulfame potassium and sucralose were associated with increased coronary heart disease risk (acesulfame potassium: 167 and 164 per 100,000 person years; sucralose: 271 and 161 per 100,000 person years in higher and non-consumers, respectively), the study showed. 

“Our results indicate that these food additives, consumed daily by millions of people and present in thousands of foods and beverages, should not be considered a healthy and safe alternative to sugar, in line with the current position of several health agencies," the authors wrote.

“Occasional artificial sweetener consumption is not likely to have a strong impact on CVD risk, and so even if some consumption might have been missed, it would probably have had a low impact on the study results," they said.

As per Market Data Forest, artificial sweeteners currently represent a $7200m (£5900m; €7000m) market globally, with a 5 percent annual growth projected to attain $9700m by 2028.

A team of researchers at the French National Institute for Health and Medical Research (Inserm) and colleagues, drew on data for over 100,000 participants. The average age of the participants was 42 years with 79.8 percent were female.

The study was based on the prospective NutriNet-Santé e-cohort, launched in France in May 2009 to investigate relations between nutrition and health. Dietary intakes and consumption of artificial sweeteners were assessed by repeated 24-hour dietary records and a range of potentially influential health, lifestyle, and sociodemographic factors were taken into account.

Artificial sweeteners from all dietary sources like beverages, table top sweeteners, dairy products, etc and by type (aspartame, acesulfame potassium, and sucralose) were included in the analysis. 

A total of 37 percent of participants consumed artificial sweeteners, with an average intake of 42.46 mg/day, which corresponds to approximately one individual packet of table top sweetener or 100 mL of diet soda. 

Compared with non-consumers, higher consumers tended to be younger, have a higher body mass index, were more likely to smoke, be less physically active, and to follow a weight loss diet. They also had lower total energy intake, and lower alcohol, saturated and polyunsaturated fats, fibre, carbohydrate, fruit and vegetable intakes, and higher intakes of sodium, red and processed meat, dairy products, and beverages with no added sugar. However, the researchers took account of these differences in their analyses.

During an average follow-up period of nine years, 1,502 cardiovascular events occurred which included heart attack, angina, angioplasty, transient ischemic attack and stroke.

It was found that total artificial sweetener intake was associated with an increased risk of cardiovascular disease (absolute rate 346 per 100,000 person years in higher consumers and 314 per 100,000 person years in non-consumers).

Artificial sweeteners were more particularly associated with cerebrovascular disease risk (absolute rates 195 and 150 per 100,000 person years in higher and non-consumers, respectively).

The research further stated that as it is an observational study, so can't establish cause, nor can the researchers rule out the possibility that other unknown (confounding) factors might have affected their results. 

Further prospective cohort studies need to confirm these results and experimental studies are needed to clarify biological pathways, they add. In the meantime, they suggest this study provides key insights into the context of artificial sweetener re-evaluation currently being carried out by the European Food Safety Authority, the World Health Organization, and other health agencies.

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Updated: 15 Sep 2022, 01:52 PM IST
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