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Artificial Sweeteners May Not Be a Heart-Smart

Artificial sweeteners are linked to higher cardiovascular disease risks.

Drinks with artificial sweeteners

Drinks with artificial sweeteners, defined as drinks containing nonnutritive sweeteners, have been marketed as a healthier alternative to their sugar-sweetened counterparts, but they also may be bad news for heart health.

A study in the Journal of the American College of Cardiology linked both high intakes beverages with sugar (median intake, 185 millilitres per day) and beverages with artificial sweeteners (median intake, 176.7 mL per day) to higher cardiovascular disease risks, when comparing consumers to nonconsumers. People who consumed these beverages less frequently (median intake 40–46.7 mL per day) still had higher CV risks, compared with nonconsumers, even after taking into account a wide range of confounding factors.

Researchers looked at records for 104,760 adults in France who filled out three validated web-based 24-hour dietary records every 6 months, examining cases of cardiovascular disease (including stroke, heart attack and angioplasty) during follow-up from 2009-2019.

The question remains why? Is there something inherently problematic such as upsetting the microbiome or promoting hyperinsulinemia with drinking these sugar-free sweeteners? Does consuming artificially sweetened drinks lead to poor diet choices overall? Do different sweeteners have different impacts on heart health? Clearly, more large-scale studies and mechanistic investigations are warranted.

See also: Delicious Danger? A Research Update on Artificial Sweeteners


Matthew Kadey, MS, RD

Matthew Kadey, MS, RD, is a James Beard Award–winning food journalist, dietitian and author of the cookbook Rocket Fuel: Power-Packed Food for Sport + Adventure (VeloPress 2016). He has written for dozens of magazines, including Runner’s World, Men’s Health, Shape, Men’s Fitness and Muscle and Fitness.

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