[cpbotha]

Large prospective cohort study (103 388 participants) showing that artificial sweeteners and specifically aspartame are associated with increased risk of cardiovascular disease: https://www.bmj.com/content/378/bmj-2022-071204

"...findings 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..."

Also, artificial sweeteners might not help with obesity: "Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study" https://www.nature.com/articles/s41366-023-01336-y

[Nursie]

It's all good information in the bmj paper, and there's a lot to take in there.

But reading this bit -

"Compared with non-consumers, higher consumers (unadjusted comparisons) 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; they had lower total energy intake, and lower alcohol, lipid (saturated and polyunsaturated), fibre, carbohydrate, fruit and vegetable intakes, and higher intakes of sodium, red and processed meat, dairy products, and beverages with no added sugar"

I'm not sure how much we can say this is a smoking gun, and how much we can say people who are less healthy and have worse outcomes are also using more sweeteners. In fact the authors note this in weaknesses -

"Additionally, reverse causality could lead to higher artificially sweetened food and beverage consumption among participants who were overweight or obese, and already had poorer cardiovascular health at baseline before CVD diagnosis. However, this factor probably does not entirely explain the observed associations because we excluded CVD events occurring during the first two years of follow-up and we also tested models adjusted for baseline body mass index, weight loss diet, and weight change during follow-up, which did not substantially change the results."

So it seems that even though they have tried to control for that, they can't eliminate it, so I wouldn't personally draw any strong conclusions.

For the record, I don't consume particularly much of any artificial sweetener, though I am fond of the occasional diet coke.