The findings of a large study of French adults suggest a potential direct association between higher artificial sweetener consumption and increased cardiovascular disease risk, including heart attack and stroke. The findings, published by The BMJ, indicate that these food additives, consumed daily by millions of people and present in thousands of foods and drinks, should not be considered a healthy and safe alternative to sugar, in line with the current position of several health agencies. “Our results indicate that these food additives, consumed daily by millions of people and present in thousands of foods and beverages, should not be considered a healthy and safe alternative to sugar, in line with the current position of several health agencies,” the researchers wrote in the BMJ. In the study, of 103,000 French adults, artificial sweeteners were associated with increased risk of cardiovascular, cerebrovascular, and coronary heart diseases. “The results suggest that artificial sweeteners might represent a modifiable risk factor for cardiovascular disease prevention,” they wrote. Researchers used more than 100,000 adults from France for the study. Participants had an average age of 42, and four in five were women. Sweetener intake was tracked using diet records. Participants noted everything they ate, including which brand was used. Some 37% of participants consumed artificial sweeteners. During an average follow-up period of nine years, 1,502 cardiovascular events occurred. They included heart attack, angina, angioplasty (a procedure to widen blocked or narrowed arteries to the heart), transient ischemic attack and stroke. Artificial sweetener consumption was linked to a 9% higher risk of cardiovascular disease, the BMJ reported. Artificial sweeteners from all dietary sources (beverages, tabletop sweeteners, dairy products, etc) and by type (aspartame, acesulfame potassium, and sucralose) were included in the analysis. The researchers found that total artificial sweetener intake was associated with an increased risk of cardiovascular disease (absolute rate 346 per 100,000 person-years in higher consumers and 314 per 100,000 person-years in non-consumers). A specific type of sweetener – aspartame – was associated with a 17% increased risk of cerebrovascular events, while acesulfame potassium and sucralose were linked to increased risk of coronary heart disease. The study was observational, so cannot establish cause, nor rule out the possibility that other unknown factors may have affected the results.