Artificially sweetened drinks may be as bad for your health as those laden with sugar, a new study shows.
The work found a possible link between artificial sweeteners and heart disease, building on previous similar research.
The authors of the study, which was published in the British Medical Journal, said food and drinks that contain the substitutes should not be considered a health and safety alternative.
Several studies link the consumption of artificial sweeteners with weight gain, high blood pressure, and inflammation.
But findings were mixed about the role of artificial sweeteners in the cause of various diseases, including cardiovascular disease, researchers said.
To investigate the link further, a team of researchers at the French National Institute for Health and Medical Research, examined the health records of 103,388 people, who were on average 42 years old. Most, 80 per cent, were female.
They examined their consumption of artificial sweeteners from all dietary sources, including drinks, table top sweeteners, dairy products and by type, such as aspartame, acesulfame potassium, and sucralose.
More than a third, 37 per cent, consumed artificial sweeteners, with an average intake of 42.46 mg/day, which corresponds to about 100 millilitres, less than a third of a can of a diet drink.
They found that 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”.
Over a nine-year period, there were 1,502 "cardiovascular events" among participants, including heart attack, angina, angioplasty, which is a procedure to widen blocked or narrowed arteries to the heart, transient ischemic attack and stroke.
The researchers found total artificial sweetener intake was associated with higher cardiovascular disease.
"The findings from this large scale prospective cohort study suggest a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease risk," the authors said.
They pointed out that it was an observational study, so they cannot establish cause between consumption and health. Other factors may have affected the results too, they said.
Nevertheless, it was a large study that assessed individuals’ artificial sweetener intake using precise, high quality dietary data, they said.
Because of this, the study suggested there is no benefit to substituting sugar with artificial sweeteners when it comes to cardiovascular disease.
More studies are needed to confirm the results. But in the meantime, the 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 Organisation, and other health agencies.