Are fake sugars causing real disease?

Doctor Buzz

So much of medicine is practiced within a shroud of mystery. When it comes to artificial sweeteners, an enigma that long has confounded me is: Why would anyone want to drink a Diet Coke? I’ve learned to allow my patients to have strange tastes in beverages. Should I be tolerant towards their drive to consume artificially sweetened foods and drinks, though? A new study joins a mixed bag of older research which suggests that I should not. I don’t think my Splenda-swilling patients have cause for alarm, however.

The work, published in the British Medical Journal, tracked over 100,000 French adults prospectively for more than a decade. Dietary consumption of several artificial sweeteners, primarily aspartame (Equal/Nutrasweet), acesulfame potassium (Sunett/Sweet One) and sucralose (Splenda), was determined via questionnaire, and then health outcomes in regard to heart events like anginal pain, stent, or heart attack, or brain events like TIA or stroke were followed both through participant report (with physician confirmation) and national health records. 

A rather nice study design, and ample size over a long enough study period to accumulate a significant number of events. True, as with any observational trial, there is risk of missed or mis-labeled events, mis-classified participants, statistical massage with multiple end points, and, of course, the potential for confounding: people who choose to reach for Splenda packets in lieu of the honey jar might just be inherently more or less healthy than their peers in ways that are hard to control for even when demographics and lifestyle differences are taken into account…

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