Artificially sweetened beverages, a new study has found, may be just as bad for your heart as the sugar-laden kind.

“Our study suggests artificially sweetened beverages may not be a healthy substitute for sugar drinks, and these data provide additional arguments to fuel the current debate on taxes, labeling and regulation of sugary drinks and artificially sweetened beverages,” said lead author Eloi Chazelas, a doctoral student and member of the nutritional epidemiology research team at the Sorbonne Paris Nord University, in a statement.

“We already know that sugar-sweetened beverages are bad news when it comes to cardiovascular and other health outcomes,” said cardiologist Dr. Andrew Freeman, co-chair of the American College of Cardiology nutrition and lifestyle work group, who was not involved in the study.

 “A lot of people said, ‘Well, maybe diet sodas and artificially sweetened beverages are better than sugar-sweetened beverages.’ But there’s been recent evidence in the last couple years that would suggest that there are possible harms, if you will, from artificially sweetened beverages, particularly in women,” Freeman said.

Danielle Smotkin, a spokesperson for the American Beverage Association, told CNN via email that “low- and no-calorie sweeteners have been deemed safe by regulatory bodies around the world and there is a substantial body of research, including a study by the World Health Organization, that shows these sweeteners are a useful tool for helping people reduce sugar consumption and manage weight.

“We support the WHO’s call for people to reduce sugar in their diets and we are doing our part by creating innovative beverages with less sugar or zero sugar, clear calorie labeling, responsible marketing practices and smaller package sizes,” Smotkin said.

A growing body of research

Not having more definitive studies in place is a major limitation, researchers have said, as it’s impossible to determine whether the association is due to a specific artificial sweetener, a type of beverage or another hidden health issue.

“We know that people who consume diet sodas sometimes are already overweight or obese, so you have to wonder what other confounders and lifestyle may already exist,” Freeman said.

“We also know that you know when you take in something sweet your body triggers insulin release and a number of other things that can sometimes even lead to weight gain.”

Still, this is not the first time diet beverages have been associated with heart issues.

Risks were highest for women with no history of heart disease or diabetes and women who were obese or African American, that study found.

Drinking four or more artificially sweetened beverages, according to another 2019 study, increased the risk of premature death from cardiovascular disease in women. The same effect was not seen for men.

Previous research has also shown a link between diet beverages and stroke, dementia, Type 2 diabetes, obesity and metabolic syndrome, which can lead to heart disease and diabetes.

“What is it about these diet drinks?” asked Yasmin Mossavar-Rahmani, an associate professor of clinical epidemiology and population health at the Albert Einstein College of Medicine in the Bronx, New York, who was the lead author for the 2019 study.

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Journal of Food and Clinical Nutrition