Not all artificial sweeteners are created equal.
A new study out of Sweden reports that one of the most popular sugar substitutes — found in diet drinks, chewing gum and low-sugar yogurt — increases insulin levels in animals, potentially elevating their risk of heart attacks and stroke over time.
“One of my students was sipping on this sugar-free drink, and I said, ‘Why don’t you look into that?’” recalled senior study author Yihai Cao, who studies chronic diseases related to blood vessel disorders at the Karolinska Institute.
Some research has suggested that long-term use of artificial sweeteners may heighten the risk of stroke, heart disease and even premature death. Cao’s team wanted to explore exactly how the sugar substitute aspartame might cause harm.
Aspartame, which is about 200 times sweeter than sugar, is sold under the brand names Nutrasweet, Equal and Sugar Twin.
In 2023, the World Health Organization (WHO)’s International Agency for Research on Cancer (IARC) classified aspartame as “possibly carcinogenic to humans.”
For the new study, mice were fed food containing 0.15% aspartame every day for 12 weeks — that’s the equivalent of humans drinking about three daily cans of diet soda.
Aspartame-fed mice developed larger and more fatty plaques in their arteries and experienced higher levels of inflammation, a major contributor to heart disease.
Cao’s team blamed elevated insulin levels for the arterial plaque buildup, also known as atherosclerosis.
The researchers determined that the immune signal CX3CL1 is especially active under insulin stimulation.
“Because blood flow through the artery is strong and robust, most chemicals would be quickly washed away as the heart pumps,” Cao explained. “Surprisingly, not CX3CL1. It stays glued to the surface of the inner lining of blood vessels. There, it acts like a bait, catching immune cells as they pass by.”
Cao said many of these trapped immune cells are known to fuel blood vessel inflammation.
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When the researchers removed CX3CL1 receptors from one of the immune cells in aspartame-fed mice, the plaque accumulation didn’t occur.
The findings were published Wednesday in the journal Cell Metabolism.
Cao’s team plans to verify these results in humans and further target CX3CL1 since blood vessel inflammation can lead to stroke, arthritis and diabetes.
“Artificial sweeteners have penetrated almost all kinds of food, so we have to know the long-term health impact,” Cao said.
Stephanie Schiff, a registered dietitian nutritionist at Northwell Huntington Hospital, recommends cutting artificial sweeteners and sugar from your diet.
If you are diabetic and find you have trouble avoiding sugary beverages, consider the sweeteners allulose, monk fruit and stevia without erythritol, a commonly used artificial sweetener that has been linked to an increased risk of heart attack and stroke.
Otherwise, try sweetening your food with fruit — or get used to consuming foods and drinks that are less sweet.
“I’ve never seen a single study that concluded that increasing sugar or artificial sweetener intake was healthy,” Schiff told The Post. “It’s worth making changes in your diet to stay healthy.”