A new study found that artificially sweetened drinks can be just as damaging to your heart as sugary ones.
"Our study suggests that artificially sweetened beverages may not be a healthy substitute for sugar beverages. These data provide additional arguments to fuel the current debate on the tax, labeling and regulation of sugary beverages and artificially sweetened beverages," said lead author Eloi Chazelas, a PhD student and member of the nutritional epidemiology research team at Sorbonne Paris rd University in a statement.
"We already know that sugary drinks are bad news when it comes to cardiovascular and other health outcomes," said cardiologist Dr. Andrew Freeman, co-chair of the Diet and Lifestyle Working Group of the American College of Cardiology, who was not involved in the study.
“A lot of people said, 'Well, maybe diet sodas and artificially sweetened beverages are better than sugar-sweetened beverages.' However, in recent years there has been recent evidence that artificially sweetened beverages, especially in women, may be are harmful, if you will, "Freeman said.
Danielle Smotkin, a spokeswoman for the American Beverage Association, emailed CNN that "low-calorie and calorie-free sweeteners have been classified as safe by regulatory agencies around the world and there is extensive research, including a study by the World Health Organization that shows that these sweeteners are a useful tool in helping people reduce sugar consumption and control weight.
"We support the WHO's call to reduce the amount of sugar in their diets and we are doing our part by creating innovative beverages with less or no sugar, clear calorie labeling, responsible marketing practices and smaller package sizes," said Smotkin.
Association, not causality
The new study, published Monday in the Journal of the American College of Cardiology, analyzed data from over 100,000 adult French volunteers who participated in NutriNet-Santé, France. This is an on-going nutritional study that started in 2009 and asks participants to complete three validated web-based 24-hour nutrition reports every six months. The study is expected to be completed in 2029.
The volunteers were divided into three groups: non-users, low-consumption and high-consumption of diet or sugary drinks. The sugary drinks included soft drinks, fruit drinks and syrups with at least 5% sugar and 100% fruit juice. Diet drinks only contained non-nutritious sweeteners like aspartame or sucralose and natural sweeteners like stevia.
During the follow-up from 2011 to 2019, drinking and eating habits were compared separately with the first cases of "stroke, transient ischemic attack, myocardial infarction, acute coronary syndrome and angioplasty".
The authors said they eliminated early cases of heart disease in the first three years, adjusted to a "range of confounders" that could skew the data, and found a small but statistically significant result.
Compared to people who did not drink artificially sweetened beverages, high consumers were 20% more likely to suffer from cardiovascular disease at any given time. The researchers found that higher consumers of sugary drinks compared to non-consumers had a similar result.
However, the authors said the study could only show a link between the two, not a direct cause.
"To establish a causal link, replications in other large prospective cohorts and mechanistic studies are required," said the authors.
The Calorie Control Council, an international association representing the low and reduced calorie food and beverage industries, made the following statement:
"Epidemiological studies, including those based on large samples, are subject to potential pitfalls, including reverse causality (subjects choose low and no calorie sweeteners (LNCS) as a weight control tool for overweight / obesity) and residual confusion (inability to control factors that affect health outcomes), the researchers found. "
A growing body of research
According to researchers, not having more detailed studies is a major caveat because it's impossible to determine if the association is due to a specific artificial sweetener, type of drink, or some other hidden health problem.
"We know that people who consume diet sodas are sometimes already overweight or obese, so one has to wonder what other confounders and lifestyles may already exist," Freeman said.
"We also know that when you eat something sweet, your body triggers insulin and a host of other things that can sometimes lead to weight gain."
Still, this isn't the first time diet drinks have been linked to heart problems.
A 2019 study found that drinking two or more artificially sweetened beverages a day was linked to an increased risk of clotting-related strokes, heart attacks, and early death in women over 50.
The study found that the risks were highest in women with no history of heart disease or diabetes, and women with obesity or African American people.
According to another 2019 study, drinking four or more artificially sweetened beverages increased the risk of premature death from cardiovascular disease in women. The same effect was not seen in men. Previous research has also shown a link between diet drinks and stroke, dementia, type 2 diabetes, obesity, and metabolic syndrome, which can lead to heart disease and diabetes.
"What about those diet drinks?" asked Yasmin Mossavar-Rahmani, Associate Professor of Clinical Epidemiology and Population Health at Albert Einstein College of Medicine in the Bronx, New York, who was the lead author for the 2019 study.
"Is it about the sweeteners? Are they doing something for our intestinal health and our metabolism? These questions need to be answered," Mossavar-Rahmani said in a previous CNN interview.
Until these answers are found, Freeman encourages his patients to choose their drinks carefully.
"I tell them the perfect drink for human consumption remains water, probably always," Freeman said. "And maybe just under a second of unsweetened teas and unsweetened coffees.
"And the rest probably shouldn't be consumed regularly – if at all."
What to do if you are addicted
It can be difficult to give up this love affair, even knowing that the item you love – sugary drinks and diet drinks – may not be good for your health. Here are some tips from experts on how to reduce.
Don't go cold turkey. A tough approach to love is difficult and can cause you to fail, so CNN representative Lisa Drayer suggests gradual weaning.
"Cut down on one serving a day until you only have one drink a day," Drayer told CNN in a previous interview. "Then aim for one every other day until you can completely drain soft drinks.
Drink water, even if it is carbonated. According to experts, water is the perfect hydration for the human body. If it's not your favorite drink, try adding some sparkle.
"Try pouring fruit into water – you can buy a pitcher, fill it with water, and then add slices of orange, lemon, strawberry, watermelon, or whatever fruit you want to give the water the fruity flavor and add sweetness to your hair on the palate ", she said.
If you find that you're addicted to the crackling and popping of soda too, give in to carbonated water.
Alternating "with seltzer / sparkling water can help you cut down," added Drayer. "Finally, you can replace soft drinks with seltzer or mineral water if you crave carbon dioxide."
Try a quick sugar-free challenge. According to Dr. Sharon Horesh Bergquist, assistant professor of medicine at Emory University School of Medicine in Atlanta, we can teach ourselves every two weeks to crave less sweet things in less short time.
She suggests trying a two-week sugar-free challenge. Once you get through those first intense food cravings, your taste buds will adjust to find "natural foods with sugar more satisfying," she said.