(Dust 4x/picture)
"0 sugar 0 calories" and "0 sugar low calorie" sugar-free drinks usually use sugar as the main selling point of related foods to show the health characteristics of the product, such advertising models can now be seen everywhere, behind the public's widespread awareness of the risks of "high sugar" diets in recent years. In order to provide sweetness without sugar, "0 sugar" foods generally add artificial sweeteners, such as aspartame, acesulfame potassium, cyclamate, etc., and you can know what is added by looking at the ingredient list of qualified products. Considering that no calories are introduced without sugar, while artificial sweeteners have been seen as the perfect substitute for sugar for years, as scientific research progresses, there is growing evidence that artificial sweeteners may also present health risks.
Recently, researchers in France used a large local nutrition and health survey project to find that eating more artificial sweeteners is associated with an increased risk of cardiovascular disease, and there may be a potential direct association between the two, especially aspartame, acesulfame potassium, sucralose and other sweeteners.
The findings were based on a survey sample of more than 100,000 people, with an average age of about 42 years at the beginning of the study, and after a median follow-up survey of nearly 9 years, the researchers recorded more than 1,500 cases of cardiovascular disease, including more than 700 cases of coronary heart disease and more than 700 cases of cerebrovascular disease, and the average age of onset was nearly 63 years. When combined with the overall intake of artificial sweeteners, the data showed that people who consumed more sweeteners had a higher risk of cardiovascular disease, reaching 346 per 100,000 people. The study, published in the BMJ in September 2022, also found that artificial sweeteners were particularly strongly associated with the risk of cerebrovascular disease.
Analysis of participants' characteristics showed that while artificial sweeteners are popular worldwide, their intake varies greatly from person to person. Overall, the people in the study who ate more in the study were younger, had a higher body mass index, were more likely to smoke, were less physically active, and were more likely to eat diet meals and therefore may prefer sweeteners instead of sugar to reduce overall energy intake. Moreover, in comparison, the diet is not very healthy, the intake of fruits, vegetables, fiber, etc. is low, and the intake of salt, processed meat, sugar-free sweetener drinks is high. From the source of artificial sweeteners, sugar-free sweetener drinks are the main source of related substance intake, accounting for more than half of the sweeteners are ingested through drinking. In addition, the proportion of sweeteners on the table also reached 30%, followed by some yogurt, cheese and other dairy products. These are common sweetened commodities, especially sugar-free beverages that are becoming increasingly popular in the trend of replacing sugar, and new research has found that they may lead people to an increased risk of cardiovascular disease, which is not good news for the global cardiovascular disease burden.
Because cardiovascular disease is not only the leading factor in the global burden of disease, but has been on the rise in recent decades. According to the Global Burden of Disease Study, the number of cardiovascular diseases worldwide has increased dramatically from 270 million in 1990 to 520 million in 2019 over the past three decades, and the number of deaths has steadily increased from nearly 12 million to more than 18 million during that time. And even if you survive with the disease, cerebrovascular diseases such as stroke, once the onset will greatly affect people's autonomy and the quality of healthy life, so the related risks are worth noting.
In fact, the findings in the latest study are not isolated cases, just in April 2022, the World Health Organization conducted a systematic study on the scientific evidence of the health effects of non-sugar sweeteners, and found that if the sweetener intake is more, the risk of cardiovascular diseases such as stroke and hypertension will increase, and the overall mortality and incidence of cardiovascular diseases will also increase, of which the risk of death is increased by 19% and the risk of morbidity is increased by 32%. There was no significant improvement in obesity or cardiovascular and metabolic health indicators such as fasting blood sugar, insulin, blood lipids and blood pressure. Similar to what the latest study found, the associated risk relationship persisted after accounting for a large number of confounding factors, and the overall cardiovascular disease risk result that replacing sugar with artificial sweeteners did not show any health benefits and may be a new risk factor.
There are many risk factors for cardiovascular disease, just from the diet, fruits, vegetables, grains, nuts, legumes, fiber, omega-3 fatty acids in seafood, etc., these foods may be increased if consumed too little. At the same time, if red meat, processed meat, trans fatty acids, sugary drinks, etc. are consumed too much, the risk of cardiovascular disease is also increased. The latest research means that artificial sweeteners used to replace sugar may be similar to sugar-sweetened beverages, processed meats, etc., and are a potential risk factor for cardiovascular disease.
This finding is worth paying attention to, but also because the survey project on which the latest study relies has some obvious advantages, in addition to the large sample size, the most significant is the accuracy of dietary data statistics. Even so, there are limitations, such as the high number of women, the high level of education, and the possibility of limited representation in the overall local population. Moreover, observational studies have not yet been able to accurately draw causal relationships, considering that there is still the possibility of confounding factors interfering with the results, and the relevant conclusions still need to be verified by more large-scale studies and experimental data in the future.
It should be noted that in recent years, multiple laboratory studies have found that artificial sweeteners are not as safe and harmless as people reason. In 2014, Jotham Suez, a researcher in the Department of Immunology at the Weizmann Institute of Science in Israel, and others reported in Nature that they found that consuming artificial sweeteners increased the risk of glucose intolerance through analysis of mouse feces and human metabolic markers. In September 2022, the research team used 120 healthy adults to conduct randomized controlled experiments and found that artificial sweeteners not only impair blood sugar response, but also significantly alter the fecal and oral microbiome, as well as plasma metabolome, producing some blood sugar changes that vary from person to person. The relevant research has been officially published in the journal Cell (Cell), and the artificial sweeteners involved in the experiment include saccharin, sucralose, aspartame, stevia and so on. Although the clinical effect of these physiological reactions associated with sweeteners is unclear, combined with the findings of observational studies, more experimental data further questions the idea that artificial sweeteners can safely replace sugar.
In fact, due to the accumulation of relevant scientific evidence, some international health agencies such as the European Food Safety Authority and the World Health Organization have begun to re-evaluate the safety of artificial sweeteners in recent years. Scientists have not only found that artificial sweeteners are associated with an increased risk of cardiovascular disease, but also found a lot of evidence that leads to an increased risk of cancer. The latest French-based study was carried out by Charlotte Debras, a nutritional epidemiologist at the Sorbonne Nord in Paris, and others, who had previously reported the carcinogenic risk of sweeteners. "Consistent with the official recommendations of several public health agencies, these findings do not support the use of artificial sweeteners as a safe substitute for sugar in food or beverages." Charlotte DeBlas told Southern Weekend that people should recognize the "0 sugar 0 calories" scheme of replacing sugar with sweeteners, and its safety in terms of health is being increasingly questioned.
With regard to sugar, the World Health Organization has long recommended that people limit their daily intake of free sugars to less than 10% of their total energy intake, and preferably to less than 5% if possible. This equates to an optimal intake of no more than 25 grams of sugar per day for adults. Therefore, the latest research reveals the health risks of artificial sweeteners also does not mean that eating more sugar is better. Sweetness for many people, always has an irresistible attraction, especially sweet drinks, poor satiety, usually lead to a large intake of sugar or sweeteners. If you develop such eating habits, it is difficult not to drink sweetened drinks as water, sugar or sweetener intake. Based on the latest research, it should at least be recognized that although food additives such as sweeteners have been widely consumed, there is not sufficient scientific evidence that such "0 sugar and 0 calories" equals health.
Southern Weekend reporter Wang Jiangtao