Artificial sweeteners may increase risk of heart disease: What do experts say?

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A new study has found artificial sweeteners may be linked to heart disease and the risk of stroke.

The study, which was published in the British Medical Journal, involved more than 100,000 adults in France, 80 per cent of whom were women. In the web-based study, the average age of participants was 42.

Researchers found that participants who consumed a lot of aspartame, which is found in sweeteners such as NutraSweet and Equal, as well as in food like diet sodas, chewing gum, desserts and yogurt, were at an increased risk of stroke compared to people who didn’t consume any.

Participants who consumed sucralose, which is found in Splenda, baked goods, beverages and dairy desserts, as well as acesulfame potassium, which is used in sugar-free pop, had a higher risk of coronary artery disease.

Launched in 2009, the study had participants complete five online questionnaires about their diet, health, lifestyle and physical activity. They were also asked about sociodemographic data like education and occupation.

Over time, participants completed dietary assessments every six months. During these assessments, they had to report every food and drink they had over a 24-hour period. They were also asked to report any new medical conditions and treatments that came up.

Overall, 37 per cent of participants consumed artificial sweeteners. The study found participants consumed about 42 milligrams per day, which is about one individual packet of tabletop sweetener or 100 millilitres of diet soda.

What are artificial sweeteners?

Artificial sweeteners are an alternative to sugar to sweeten foods and drinks. They are made from chemicals and natural substances, and have fewer calories compared to sugar.

Many people use artificial sweeteners to lose weight, control blood sugar and limit sugar intake.

According to the British Medical Journal's study, more than 23,000 products worldwide contain artificial sweeteners.

However, Health Canada regulates the use of sugar substitutes and has deemed them safe for most people.

What Canadian experts say about the study

Dr. Marc Ruel, president of the Canadian Cardiovascular Society, tells Yahoo Canada that while the study broaches a very important public health question, the conclusions are not supported by the data.

"I think the conclusions are overstated. This is an observational study, meaning researchers are looking at the links. They're correlations, they're not causation," he explains. "If someone's going to drink Pepsi versus Diet Pepsi or vice-versa, I don't think this study changes much. This does not provide sufficiently scientifically supported conclusions to change."

Ruel also points to a limitation of the study: The fact that pre-existing diabetics were excluded.

According to the cardiovascular expert, many participants at the age of 42 may have "silent diabetes," meaning they have not been diagnosed with the disease yet and will be later in life.

"You see a population at risk that has not been accounted for," he adds. "We know diabetic or pre-diabetic people are at a hugely increased risk of cardiovascular disease. They may have changed their behaviour, including taking artificial sweeteners, based on their knowledge of that risk."

Improving cardiovascular health

Participants of the British Medical Journal study who consumed high amounts of artificial sweetener were younger, had a higher body mass index, were more likely to smoke and were less physically active. They also consumed high amounts of sodium, red and processed meat as well as dairy products, and consumed fewer fruits and vegetables.

When it comes to cardiovascular health, Ruel says there are lifestyle changes he would recommend to lower a person's risk of heart disease.

The recommendations include eating a Mediterranean-type diet, which includes fruits and vegetables, beans, nuts, whole grains, lean poultry and fish. He also advises minimizing alcohol consumption, avoiding smoking and being physically active.

"All sweets should be curtailed as much as possible, whether they are artificial sweeteners or non-artificial sweeteners," Ruel shares. "That being said, if you're in an area where there's a huge level of consumption of sweetened drinks, well, then I don't think this discloses the small impact that artificial sweeteners might have in decreasing obesity and cardiovascular complications in the long run."

The Canadian Heart and Stroke Foundation's heart-healthy tips also suggest maintaining a healthy weight and managing stress to prevent premature heart disease.

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