ArticleBMJ (Clinical research ed.)2022
Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort.
Article in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03335644 (The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors), which is not on this map. Cited by 120 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors
Who cites it
120 citing papers in PubMed, 8 syntheses or guidelines pooled it, 189 citations in OpenAlex.
- Health Effects of Sugar-Sweetened and Artificially Sweetened Beverages: Umbrella Review and Evidence-Based Consensus Statement of the Korean Diabetes Association and the Korean Nutrition Society.Diabetes & metabolism journal · 2026Pooled it
- Health behaviors to prevent cardiovascular risk: a systematic review.BMC cardiovascular disorders · 2025Pooled it
- Effects of Artificial Sweeteners on the Musculoskeletal System: A Systematic Review of Current Evidence.Nutrients · 2025Pooled it
- Artificially sweetened beverage consumption and all-cause and cause-specific mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies.Nutrition journal · 2024Pooled it
- 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association.Diabetes & metabolism journal · 2024Guideline
- Swallowed topical steroid therapy for eosinophilic oesophagitis in children: practical, evidence-based guidance by the BSPGHAN Eosinophilic Oesophagitis Working Group.BMJ paediatrics open · 2024Pooled it
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses.BMJ (Clinical research ed.) · 2024Pooled it
- Artificially Sweetened Beverages and Health Outcomes: An Umbrella Review.Advances in nutrition (Bethesda, Md.) · 2023Pooled it
- Effect of sweeteners and sweetness enhancers on weight management and gut microbiota composition in individuals with overweight or obesity: the SWEET study.Nature metabolism · 2025Trial
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- Ultra-processed food consumption during pregnancy and emotional and behavioral problems in offspring.European child & adolescent psychiatry · 2026Article
- Review
- Chronic Aspartame Exposure Leading to Hypertension in Mice may be Related to the Activation of the Wnt/β-Catenin Signaling Pathway in the Hypothalamus.Molecular nutrition & food research · 2026Article
- Steviol Glycosides (E960) FromFood science & nutrition · 2026Review
- Artificial and Other Non-Nutritive Sweeteners, the Microbiome, and Cardiometabolic Health.Current atherosclerosis reports · 2026Review
- The Purpose of Food Processing and Ultra-Processed Food: the Potential, Pitfalls and Path Forward for Public Health.Current nutrition reports · 2026Review
- Lipid Metabolic Effects Induced by Individual and Combined Exposure to Multiple Food Additives in Human Cells.Toxics · 2026Article
- Long-term artificial sweetener exposure increases the risk of atherosclerosis.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Artificial sweeteners and risk of cardiometabolic outcomes and mortality: a systematic review and meta-analysis.Nutrition research and practice · 2026Review
60 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo study the associations between artificial sweeteners from all dietary sources (beverages, but also table top sweeteners, dairy products, etc), overall and by molecule (aspartame, acesulfame potassium, and sucralose), and risk of cardiovascular diseases (overall, coronary heart disease, and cerebrovascular disease).
designPopulation based prospective cohort study (2009-21).
settingFrance, primary prevention research.
participants103 388 participants of the web based NutriNet-Santé cohort (mean age 42.2±14.4, 79.8% female, 904 206 person years). Dietary intakes and consumption of artificial sweeteners were assessed by repeated 24 h dietary records, including brand names of industrial products. MAIN OUTCOMES MEASURES: Associations between sweeteners (coded as a continuous variable, log10 transformed) and cardiovascular disease risk, assessed by multivariable adjusted Cox hazard models.
resultsTotal artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161).
conclusionsThe findings from this large scale prospective cohort study suggest a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease risk. Artificial sweeteners are present in thousands of food and beverage brands worldwide, however they remain a controversial topic and are currently being re-evaluated by the European Food Safety Authority, the World Health Organization, and other health agencies.
trial registrationClinicalTrials.gov NCT03335644.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.