Cohort studycited by the Tayebat archiveabstract only checked A-UPF-19 standard review
Artificial sweeteners and heart disease in France
Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort.
Overview
Debras C et al.. BMJ 2022 · PMID 36638072 · DOI 10.1136/bmj-2022-071204
Higher sweetener intake: 9% higher cardiovascular risk.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Are artificial sweeteners associated with CVD?
- How was the study done?
Prospective cohort with repeated 24-h records.
- How many people, animals or samples were studied?
103,388; 1,502 CVD events; Adults, 79.8% women
- What was actually found?
Total sweeteners CVD HR 1.09 (1.01-1.18); cerebrovascular 1.18 (1.06-1.31); aspartame cerebrovascular 1.17 (1.03-1.33); acesulfame-K CHD 1.40 (1.06-1.84); sucralose CHD 1.31 (1.00-1.71).
- How large was the observed effect?
HR 1.09 (1.01-1.18)
- What do the results mean in everyday life?
Small possible signal.
- What are the study's limitations?
Reverse causation; Residual confounding
- What does it say about Elawady's specific claim?
Mixed for C-UPF-07.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Causation.
Scientific in-depth review
1. Full reference
- Authors
- Debras C, Chazelas E, Sellem L, Porcher R, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaësse C, De Sa A, Lutchia R, Fezeu LK, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Huybrechts I, Srour B, Touvier M
- Journal
- BMJ
- Year
- 2022
- Identifier
- PMID 36638072 DOI 10.1136/bmj-2022-071204 · PMC9449855
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Public funding declared; WHO grant
2. Research question
Are artificial sweeteners associated with CVD?
3. Study design and population
- Study design
- Cohort study – Prospective cohort with repeated 24-h records.
- Population
Adults, 79.8% women
- Country
France
- Period
2009-2021
- Sample size
103,388; 1,502 CVD events
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Sweetener intake (log10 continuous)
- Comparator
Non-consumers
- Endpoints
CVD, CHD, cerebrovascular
- Statistical methods
Cox
5. Actual results
- Results
Total sweeteners CVD HR 1.09 (1.01-1.18); cerebrovascular 1.18 (1.06-1.31); aspartame cerebrovascular 1.17 (1.03-1.33); acesulfame-K CHD 1.40 (1.06-1.84); sucralose CHD 1.31 (1.00-1.71).
- Absolute risks
CVD 346 vs 314 per 100,000 PY (higher vs non-consumers)
- Authors' conclusion
Suggests potential association between higher sweetener intake and CVD.
6. Strengths
- Large; detailed exposure
7. Weaknesses
- Reverse causation
- Residual confounding
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Confounding.
9. Assessment of the statistical interpretation
Small absolute differences.
10. Relevance to the specific claim
Mixed for C-UPF-07.
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Signal.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | unknown |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Causality.
15. Linked fact checks
- Artificial sweeteners (aspartame, acesulfame-K, sucralose) are linked to higher cancer and cardiovascular risk. – Studies with mixed or unclear results
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Listed in the archive bibliography only (no archive interpretation card).
- A. What was actually studied?
Sweeteners and CVD.
- B. What did the authors find?
As above.
- C. What conclusions do the authors themselves draw?
Potential association.
- D. What does the archive derive from it?
Supports sweetener harm.
- E. Is this derivation scientifically justified?
Association only.
- Adequacy of the interpretation (by the archive)
- not applicable