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Associations of artificial sweetener intake with cardiometabolic disorders and mortality: a population-based study

Published online by Cambridge University Press:  18 October 2024

Jun-yan Kan ,
Dong-chen Wang ,
Yu Chang ,
Zi-hao Jiang ,
Xiao-min Jiang ,
Hao Xie ,
Xin-xin Jia ,
Ming-xing Chen  and
Yue Gu Open the ORCID record for Yue Gu [Opens in a new window]
Jun-yan Kan
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Dong-chen Wang
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Yu Chang
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Zi-hao Jiang
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Xiao-min Jiang
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Hao Xie
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Xin-xin Jia
Affiliation:
Admin Office, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, People’s Republic of China
Ming-xing Chen*
Affiliation:
Department of Cardiology, Northern Jiangsu People’s Hospital, Yangzhou 225000, People’s Republic of China
Yue Gu*
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
*
*Corresponding authors: Yue Gu, email: [email protected]; Dr Ming-xing Chen, email [email protected]
*Corresponding authors: Yue Gu, email: [email protected]; Dr Ming-xing Chen, email [email protected]
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Abstract

Artificial sweeteners are generally used and recommended to alternate added sugar for health promotion. However, the health effects of artificial sweeteners remain unclear. In this study, we included 6371 participants from the National Health and Nutrition Examination Survey with artificial sweetener intake records. Logistic regression and Cox regression were applied to explore the associations between artificial sweeteners and risks of cardiometabolic disorders and mortality. Mendelian randomisation was performed to verify the causal associations. We observed that participants with higher consumption of artificial sweeteners were more likely to be female and older and have above medium socio-economic status. After multivariable adjustment, frequent consumers presented the OR (95 % CI) for hypertension (1·52 (1·29, 1·80)), hypercholesterolaemia (1·28 (1·10, 1·50)), diabetes (3·74 (3·06, 4·57)), obesity (1·52 (1·29, 1·80)), congestive heart failure (1·89 (1·35, 2·62)) and heart attack (1·51 (1·10, 2·04)). Mendelian randomisation confirmed the increased risks of hypertension and type 2 diabetes. Moreover, an increased risk of diabetic mortality was identified in participants who had artificial sweeteners ≥ 1 daily (HR = 2·62 (1·46, 4·69), P = 0·001). Higher consumption of artificial sweeteners is associated with increased risks of cardiometabolic disorders and diabetic mortality. These results suggest that using artificial sweeteners as sugar substitutes may not be beneficial.

Keywords

National Health and Nutrition Examination SurveyArtificial sweetenerType 2 diabetes mellitusCVDDiabetic mortality
Type
Research Article
Information
British Journal of Nutrition , Volume 132 , Issue 8 , 28 October 2024 , pp. 1065 - 1072
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

†

These authors are co-first authors and equally contributed to this work.

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