Artificially sweetened drinks may not be any healthier for the heart than sugary drinks

Sweetened drinks and artificially sweetened drinks are associated with a higher risk of cardiovascular disease, which suggests that artificially sweetened drinks may not be the healthful alternative it is often claimed to be, according to a research letter in the Journal of the American College of Cardiology.

Research has shown that diets including sugar-sweetened drinks can have a negative impact on cardio-metabolic health. Artificially sweetened beverages have been suggested as a healthier alternative, but their impact on cardiovascular health is not fully known. In this paper, researchers looked at data from the French NutriNet-Santé cohort to study the relationship between cardiovascular disease risk and consumption of sweetened and artificially sweetened beverages.

Records for 104,760 participants were included. They were asked to fill in three 24-hour diet registers validated every six months. Artificially sweetened beverages have been defined as those containing non-nutritive sweeteners. The sugary drinks consisted of all drinks containing 5% or more sugar. For each beverage category, the participants were divided into non-consumers, low consumers and high consumers.

The researchers looked at the first incident cases of cardiovascular disease during follow-up from 2009-2019, which were defined as stroke, transient ischemic attack, myocardial infarction, acute coronary syndrome, and angioplasty. After excluding the first three years of follow-up to account for potential reverse causation bias, 1,379 participants had first incident cases of cardiovascular disease. Compared to non-consumers, both the higher consumers of sweetened and artificially sweetened beverages had higher risks of first-accident cardiovascular disease, after accounting for a wide range of confounding factors.

In addition to an increased risk of heart health problems, Eloi Chazelas, Ph.D. The student, lead author of the study and member of the nutritional epidemiology research team (Sorbonne University Paris Nord, Inserm, Inrae, Cnam) has said the study could have further regulatory implications.

“Our study suggests that artificially sweetened beverages may not be a healthy substitute for sweetened beverages, and these data provide further arguments to fuel the current debate on taxes, labeling and regulation of sugary and artificially sweetened beverages,” he said Chazelas.

The researchers said that in order to establish a causal link between artificially sweetened and sweetened beverages and cardiovascular disease, replication in large-scale prospective cohorts and mechanistic investigations will be required.