Supplements · Sweeteners · Metabolic & Cardiometabolic
non-nutritive sweeteners increases cardiovascular disease
Part of: • non-nutritive sweeteners
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
Cohort meta-analyses fairly consistently associate high artificially-sweetened-beverage intake with cardiovascular events and stroke — but the evidence is observational, heterogeneous, and confounded: a Women's-Health-Initiative network meta-analysis found *no consistent pattern*, umbrella reviews call it inconclusive, and bias-adjusted analyses flip toward benefit. A real association worth watchi
The evidence (9)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Beigrezaei et al. 2025 · Nutr Rev | meta-analysis | mixed | moderate | Umbrella review of meta-analyses: evidence on non-sugar-sweetened beverages and chronic-disease/mortality risk inconclusive. |
| Debras et al. 2022 · BMJ | observational | supports | moderate | NutriNet-Santé: artificial sweeteners (esp. aspartame, sucralose) associated with higher cardiovascular disease risk (coronary + cerebrovascular). |
| Meng 2021 · Nutrients | meta-analysis | supports | moderate | Dose-response MA: ASB associated with higher CVD and all-cause mortality per serving/day. |
| Qin et al. 2020 · Eur J Epidemiol | meta-analysis | supports | moderate | Dose-response MA: ASB associated with higher all-cause mortality. |
| Yang 2022 · Nutrients | meta-analysis | mixed | moderate | WHI cohort + network MA: large between-study heterogeneity, no consistent pattern implicating ASB (or SSB/added sugar) in CVD outcomes. |
| Ayoub-Charette et al. 2025 · Appl Physiol Nutr Metab | meta-analysis | contradicts | high | Bias-adjusted cohort analyses: NNS associated with LOWER coronary heart disease and cardiovascular/all-cause mortality. |
| Bhandari et al. 2024 · Curr Dev Nutr | meta-analysis | mixed | moderate | 6-beverage long-term MA: associations for ASB and cardiovascular mortality inconsistent across sexes/studies. |
| Queiroz et al. 2025 · Curr Probl Cardiol | meta-analysis | supports | moderate | MA: high ASB consumption associated with increased long-term cardiovascular events. |
| Narain et al. 2016 · Int J Clin Pract | meta-analysis | supports | moderate | MA: sweetened soft drinks (incl. artificially sweetened) associated with higher CVD events/mortality. |
Disagree, or know a study we missed?
We grade by evidence, not opinions. The way to weigh in is to point us to a study we haven't cited (check the evidence table above first), or to flag a problem with one we have. Every submission is reviewed; if it holds up, the grade updates and shows in Science Changes Its Mind.
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Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.