Artificial Sweeteners: could these be associated with increased cardiovascular risk?

Zero and low-calorie sweeteners are often considered to be the healthy option, as it were, for people who want to reduce their sugar intake. But you've just published two papers that link these two sweeteners with cardiovascular risk. So what is your opinion here? What is the story? There's growing evidence indicating that artificial sweeteners may not provide the intended benefits, but instead change our gut microbiome, reduce glycemic control, or induce a prothrombotic state. This is why the WHO recently advised against their use for weight loss. And most importantly, artificial sweeteners are marketed towards the most vulnerable patients at cardiovascular risk. So we carefully need to assess the cardiovascular safety. So how did you as a cardiologist get involved in this field? What sparked your interest? This was coincidence. We initially performed a metabolomic screening to identify chemicals in the blood of patients that predict incident risk of cardiovascular complications. And among our top risk-associated metabolites, we identified the two sweeteners erythritol and xylitol. Subsequently, we measured the levels in two independent large validation cohorts, both from the United States and Europe. And there we could confirm that patients with higher levels of both sweeteners were at higher risk for major adverse cardiovascular events.