Artificial sweeteners:
the sugar-free paradox
New developments in the sugar-free paradox have further cast doubt on whether artificial sweeteners represent a healthy way to cut calories or a potentially dangerous option.
Recent findings have explored connections between various sugar alternatives and risks to cardiovascular health, anxiety, and other issues.
A recent study found that consuming erythritol resulted in a significant increase in the risk of heart disease over three years.
The researchers also found that adding erythritol to whole blood or platelets promoted clot formation.
A large French study published in September 2022 found that total consumption of artificial sweeteners was associated with an increased overall risk of cardiovascular and cerebrovascular diseases. The NutriNet-Santé cohort study, involving 103,388 French adults, found that 37.1% reported consuming artificial sweeteners, primarily aspartame (58% of sweetener consumption), acesulfame potassium (29%), and sucralose (10%).
Over an average of nine years of follow-up, the intake of artificial sweeteners was associated with a 9% increased risk of cardiovascular or cerebrovascular events. The average intake was 42.46 mg/day among consumers, which corresponds to about one individual packet of tabletop sweetener or 100 mL of diet soda.
In a large recent prospective study, researchers examined the associations between the consumption of sugary and artificially sweetened beverages and various types of cancer. Of the 934,777 participants, over 28 years of follow-up, 135,093 died of cancer.
Researchers found that consuming two or more artificially sweetened beverages daily was associated with a 5% increased risk of death from pancreatic cancer.
Aspartame has also recently been associated with an increased risk of anxiety in a preclinical study conducted in a murine model. This occurred at doses less than or equal to 15% of the maximum daily intake recommended for humans by the U.S. Food and Drug Administration. Aspartame exposure also resulted in alterations in the expression of genes that influence the amygdala, a brain region that regulates anxiety and fear.
Another study done with sucralose showed that the feeling of hunger was greater after drinking sweetened water than in groups that drank water or water with sugar; this feeling was significantly greater in the group of women with obesity.
In weight-loss diets, it's advised to replace sugar and sweeteners with sweet fruits or dried fruits. For some experts, the best advice is moderation in general, avoiding excess sugar and artificial sweeteners. Adopting simple, proven advice, such as drinking more water and fewer processed beverages, may be the best strategy. However, the popularity of the topic may suggest that people are still very interested in hearing exactly what the evidence has to say about sugar alternatives.
- Sources:
https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9
https://www.nature.com/articles/s41591-023-02223-9
