Can artificial sweeteners increase the risk of heart attack? How much sugar can one have then?

For all those who like to add sweeteners to their morning tea, thinking they are safe and will keep their sugar levels in check, know this: They could affect your heart.
In a new study, researchers have identified a possible link between artificial sweeteners and heart disease and concluded that food additives “should not be considered a healthy and safe alternative to sugar.” The new study, published in The BMJ, examined and tracked more than 100,000 adults from France. The authors, led experts from the Sorbonne Paris Nord University, examined participants’ intake of sweeteners from all dietary sources including drinks, table top sweeteners, and dairy products and compared it to their risk of heart or circulatory diseases. Participants had an average age of 42 and four out of five were female.

WHAT WERE THE FINDINGS?
The researchers had an average follow-up period of nine years and recorded 1,502 cardiovascular events, including heart attacks, strokes, transient ischemic attacks and angina. Artificial sweetener consumption was linked to a nine per cent higher risk of heart disease. Isolating the risk factors for every kind of illness, they found that artificial sweetener consumption was linked to an 18 per cent higher risk of cerebrovascular disease. In fact, a sweetener with aspartame was associated with a 17 per cent increased risk of cerebrovascular events, while acesulfame potassium and sucralose were associated with increased coronary heart disease risk. “In this large-scale, prospective cohort of French adults, artificial sweeteners (especially aspartame, acesulfame potassium and sucralose) 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. The findings indicate that these food additives, consumed daily 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.”
WHAT DOES IT MEAN FOR INDIA?
Commenting on the study, Dr K Srinath Reddy, cardiolog and president, Public Health Foundation of India (PHFI), said, “Artificial food additives have mostly proved hazardous to health. Trans fats, introduced to lengthen shelf life of food products, have now been shown to shorten human life. Artificial sweeteners also carry risks, as shown in this study. It is likely that the lining of blood vessels may be irritated, resulting in endothelial dysfunction. The recommendation for reducing consumption of refined sugar is justified, to prevent obesity, cardiovascular disease and diabetes. However, that should not lead to extensive use of artificial sweeteners. The best scient of all time is Nature. It experiments with a vast diversity of its products, using the laboratory of evolutionary biology, to determine what is best for the human body.”
Insing that observational studies like these can only show an association, Dr Reddy said that, “More research will help to corroborate these findings and elucidate the mechanisms while the precautionary principle can apply to public policy and personal practice.”

Dr K K Talwar, cardiolog at PSRI, said that anything laced with chemicals will always be harmful to the body as a whole and he has never recommended sweeteners for this reason. “The study corroborates what we had known for a long time. This will certainly stimulate more studies in this area to get evidence-based information,” he added.
Dr Nityanand Tripathi, Director & HOD, Cardiology & Electrophysiology, Fortis Hospital Shalimar Bagh, says, “Artificial sweeteners are synthetic sugar substitutes and they are intense because they are sweeter than sugar. There are many studies on the effects of artificial sweeteners. This is a matter of concern because artificial sweeteners are frequently used in many dairy products, chocolates and drinks. Many diabetic patients are also using artificial sweeteners as it does not affect the insulin level, nor does it increase the sugar. It also does not increase triglycerides (a type of fat found in the body). Therefore it was thought that it would be safe. But contrary to that, another large data has come in a recent study involving almost one lakh patients, where it has been shown conclusively that artificial sweeteners do increase the cardiovascular risk and also the risk of getting heart attack and CVS 9 per cent and aspartame, particularly 17 per cent. Therefore, it is prudent that one should not consume large amounts of artificial sweeteners.”