A French population based prospective cohort study suggests a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease (CVD) risk. The study included 103 388 participants of the web-based cohort (mean age 42.2 years, 79.8% female, 904 206 person years) from 2009 to 2021. Dietary intakes and consumption of artificial sweeteners were assessed by repeated 24 h dietary records. Total artificial sweetener intake was associated with increased risk of CVD (hazard ratio [HR] 1.09); 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 (HR 1.18). Aspartame intake was associated with increased risk of cerebrovascular events (HR 1.17), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (acesulfame potassium: HR 1.40; sucralose: HR 1.31). The findings are in line with previous studies and suggest that artificial sweeteners should not be considered a healthy and safe alternative to sugar and might represent a modifiable risk factor for CVD prevention. Source: https://www.bmj.com