Approximately 37% of respondents said that they consume artificial sweeteners. The average daily intake was approximately one packet of a tabletop sweetener. Participants who consume higher amounts of artificial sweeteners—viewed as roughly two packets of a tabletop sweetener per day—were more likely to be young, have a higher body mass index (BMI), smoke and be less physically active. They were also more likely to be actively dieting to lose weight. In addition, the authors added, these participants were less likely to consume fruits and vegetables, but more likely to consume red or processed meats and dairy products.

Overall, after an average follow-up period of nine years, there were 1,502 cardiovascular events, which included myocardial infarctions, angina diagnoses, angioplasty procedures, transient ischemic attacks and strokes. Total artificial sweetener intake was linked to a heightened risk of CVD, and participants who reported consuming high amounts of these sweeteners were much more likely to suffer from cerebrovascular disease.

Diving deeper into the connections between artificial sweeteners and overall health, the authors reported that aspartame intake was linked to a greater risk of cerebrovascular events and acesulfame potassium and sucralose were linked to a greater risk of coronary heart disease.

“The 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, in line with the current position of several health agencies,” the authors wrote, noting that these sweeteners “might represent a modifiable risk factor for CVD prevention.”