“Sugar-free” used to sound like a magic spell. No calories! No guilt! No dentist side-eye!
But in the last few years, artificial sweeteners and other low/no-calorie sweeteners have been catching more headlines
for a very different reason: some research suggests that higher intakes may be linked to a higher risk of heart disease.
Not guaranteed doom. Not “one packet and your arteries file a complaint.” But enough signals that it’s worth paying attention
especially if “diet” drinks and “zero sugar” snacks have become daily staples.
This article breaks down what studies are actually finding, why the results can look confusing, and what you can do if you want
to lower your risk without turning your life into a sad glass of plain water. (No offense, water. You’re essential. You’re just not… dessert.)
First, what counts as an “artificial sweetener”?
People often say “artificial sweeteners” when they really mean “anything that tastes sweet but isn’t regular sugar.”
In real life, there are a few big buckets:
High-intensity sweeteners (very sweet, tiny amounts)
- Aspartame
- Sucralose
- Saccharin
- Acesulfame potassium (Ace-K)
- Neotame
- Advantame
These are commonly used in diet soda, flavored waters, “light” yogurt, protein powders, sugar-free syrups, and tabletop packets.
In the U.S., these sweeteners are regulated and permitted for specific uses in foods.
“Natural” low-calorie sweeteners (still not sugar)
You’ll also see stevia, monk fruit, and allulose in lots of products.
They’re often marketed with a plant-powered vibe, but your body still experiences them as “sweet input.”
“Natural” doesn’t automatically mean “do whatever you want forever.” (Poison ivy is also natural. Just saying.)
Sugar alcohols (polyols) like erythritol and xylitol
These show up in keto snacks, sugar-free candy, “clean” ice creams, protein bars, and gum.
They aren’t always called artificial sweeteners, but they’re absolutely part of the sweetener conversationespecially when it comes to heart health headlines.
So… do artificial sweeteners cause heart disease?
Here’s the honest, non-clickbait answer: we don’t have definitive proof that artificial sweeteners directly cause heart disease in humans.
What we do have is a growing body of research showing associations between higher intake (or higher blood levels, for some sweeteners)
and higher rates of cardiovascular problems.
That matters because heart disease doesn’t show up overnight. It builds over years through blood pressure, cholesterol patterns,
inflammation, blood sugar regulation, clotting risk, and lifestyle behaviors. If sweeteners influence any of those pathwaysdirectly or indirectly
they could theoretically nudge risk in the wrong direction.
What the research is finding (in plain English)
1) Large observational studies: higher intake sometimes tracks with higher cardiovascular risk
One of the most-cited pieces of evidence is a large cohort study that looked at artificial sweetener intake and cardiovascular outcomes.
Researchers observed that people consuming more artificial sweeteners had a slightly higher risk of cardiovascular disease events overall,
with some signals stronger for certain outcomes like stroke.
Key point: studies like this can’t fully prove cause and effect. They can only show that two things move together.
People who consume more diet products may already have higher risk (for example, they may be trying to cut sugar due to weight, diabetes,
or metabolic concerns). That’s called reverse causation, and it’s one reason scientists stay cautious.
2) Artificially sweetened beverages (diet soda, “zero” drinks): a pattern emerges in meta-analyses
When researchers pool multiple studies together (a systematic review and meta-analysis),
higher intake of artificially sweetened beverages often correlates with higher rates of cardiovascular mortality.
This doesn’t mean diet soda is “worse than sugar soda” in every situationbut it does suggest that relying on artificially sweetened drinks as a daily habit
may not be the heart-health upgrade people hope it is.
3) Atrial fibrillation (AFib): more sweetened drinks, more rhythm risk
Some recent research has linked higher consumption of both sugar-sweetened beverages and artificially sweetened beverages with a higher risk of atrial fibrillation,
an irregular heart rhythm that can raise stroke risk. The signal appears strongest at higher weekly intakes.
Translation: if your “hydration” routine is basically a rotating cast of soda cansdiet or regularyour heart may not be applauding.
(Your recycling bin might be, though. Mixed feelings.)
4) Erythritol (and the “blood level” story): a different kind of warning sign
Erythritol is a sugar alcohol often used in low-carb and keto products. A major study found that people with higher blood levels of erythritol
had higher rates of major adverse cardiovascular events. Researchers also explored possible mechanisms and observed that erythritol exposure could be linked
to changes in platelet activity and clot-related processesbiological pathways that matter a lot for heart attacks and strokes.
This is one reason experts often say: it’s not just “artificial sweeteners” as a single category.
Different sweeteners may act differently in the body. Some may be relatively neutral in moderate use; others may deserve more caution,
especially at high intakes or in higher-risk populations.
Why might sweeteners affect heart health?
Scientists are still mapping the “how,” but there are several plausible explanations. None of these are guaranteed,
and more research is neededbut together, they help explain why the relationship isn’t as simple as “sweet but harmless.”
1) The “health halo” effect (aka: diet soda math)
Humans are not spreadsheets. If we choose a “zero sugar” drink, we sometimes feel licensed to eat more later.
Or we pair diet soda with a meal that’s higher in sodium, saturated fat, or ultra-processed ingredients.
Over time, that pattern can raise blood pressure, worsen cholesterol profiles, and increase cardiovascular risk.
2) Appetite and cravings: sweetness without calories can confuse your brain
Sweet taste is a powerful signal. Some researchers suggest that frequent exposure to intense sweetnessespecially without the calories that normally follow
may affect appetite regulation, cravings, and food reward. If sweeteners keep your “sweetness thermostat” turned up,
whole foods (fruit, plain yogurt, oats) can start to taste less satisfying, and ultra-sweet products become the default.
3) Gut microbiome changes
A growing area of research looks at whether some non-sugar sweeteners alter gut bacteria in ways that influence glucose control,
inflammation, and metabolic health. Since cardiometabolic risk factors (blood sugar, insulin resistance, inflammation) connect directly to heart disease risk,
this pathway is getting a lot of attention.
4) Vascular effects and clotting pathways (especially for certain sugar alcohols)
For sweeteners like erythritol (and possibly others), researchers have explored whether high exposure might affect clot formation,
platelet activity, or blood vessel function. These mechanismsif confirmedwould offer a more direct connection between “sweetener exposure”
and cardiovascular events.
5) Confounding factors: the “who drinks diet drinks?” problem
Observational studies try to adjust for lifestyle differences, but no adjustment is perfect.
People who consume more low-calorie sweeteners may also be more likely to have existing risk factors (higher BMI, diabetes, hypertension),
or they may be changing their diet after a health scare. That can make sweeteners look guilty even when they’re just “present at the scene.”
What “increased risk” actually means (and why it can sound scarier than it is)
Many headlines don’t explain that an “increased risk” in these studies is often modest.
It’s not usually a doubling of risk from one diet soda. It’s more like: higher habitual intake is associated with a higher probability of cardiovascular events over time.
That’s still importantbecause heart disease is common, and small risk increases can affect a lot of people.
But it also means you don’t need to panic if you occasionally use a packet in coffee or sip a diet drink at a party.
The bigger question is whether sweeteners have become your main strategy for healthespecially if the rest of your diet is heavy on ultra-processed foods.
Who should be extra cautious?
If you’re in any of these groups, it may be smart to keep artificial sweeteners and sugar alcohols as “sometimes foods,”
not daily habitsunless your clinician recommends a specific approach:
- People with a history of heart disease, stroke, or blood clots
- People with diabetes or metabolic syndrome
- People with high blood pressure or high LDL cholesterol
- People who consume large amounts of keto/low-carb packaged foods (often high in sugar alcohols)
This doesn’t mean sweeteners are “banned.” It means your risk/benefit balance may be differentespecially if you’re using sweeteners heavily
instead of shifting toward a more heart-friendly eating pattern overall.
Smarter ways to reduce sweeteners without feeling deprived
Step 1: Find the “invisible sweeteners” in your day
Many people think, “I don’t use sweeteners,” and then realize their protein powder, flavored water, gum, electrolyte drinks, yogurt, and coffee syrup
are all sweetened. Start by scanning labels for a week. Not to judge yourselfjust to learn your baseline.
Step 2: Use a “sweetness taper,” not a cold-turkey meltdown
Your taste preferences adapt. If you go from “triple-sweet” to “unsweetened everything” overnight,
you might feel like you’re chewing cardboard and drinking sadness. Try this instead:
- Week 1: swap one sweetened drink per day for water or unsweetened tea
- Week 2: cut sweetener packets in half (or reduce to every other cup)
- Week 3: switch one “diet dessert” snack to fruit + nuts or yogurt + berries
- Week 4: keep sweeteners as an occasional tool, not the main event
Step 3: Replace the habit, not just the ingredient
If your afternoon diet soda is really a “break + caffeine + something fun” ritual, replace it with something that still feels like a treat:
sparkling water with citrus, iced tea with mint, cold brew with a splash of milk, or even a smaller portion of something sweet that you truly enjoy.
Step 4: Focus on the big heart-health levers
Sweeteners are one piece of the puzzle. The strongest evidence for heart protection still points to overall patterns:
more vegetables, beans, whole grains, nuts, fish (if you eat it), adequate fiber, and fewer ultra-processed foods.
Also: sleep, stress management, and regular movement. The boring basics win championships.
Are artificial sweeteners ever helpful?
Yescontext matters. For some people, low-calorie sweeteners can be a bridge away from high sugar intake,
especially from sugar-sweetened beverages, which are strongly linked to weight gain and cardiometabolic risk.
If switching from multiple regular sodas a day to fewer diet sodas helps you reduce added sugar while you build healthier habits,
that can be a practical step.
The caution flag goes up when “diet” becomes a permanent substitute for a nutrient-dense diet.
If the end goal is better heart health, the long-term destination is usually:
less sweetness overall, not “endless sweetness, different chemical.”
Bottom line
The evidence does not say “all artificial sweeteners automatically cause heart disease.”
But it does suggest that higher, habitual intakeespecially from sweetened beverages and heavily sweetened ultra-processed foods
may be associated with higher cardiovascular risk in some populations.
If you want a heart-friendly strategy that doesn’t rely on scary headlines, try this:
use sweeteners sparingly, reduce your overall preference for intense sweetness, and build your diet around minimally processed foods.
Your heart doesn’t need perfection. It needs fewer daily stressorson your plate and in your lifestyle.
Real-life experiences: what cutting back can look like (and feel like)
People rarely change habits because of one study headline. They change when the new routine is realistic, repeatable, and doesn’t make them miserable.
Below are common, true-to-life experiences many people report when they try to reduce artificial sweetenersespecially diet drinks and “zero sugar” snacks.
Think of these as relatable scenarios, not one-size-fits-all rules.
The “diet soda was my personality” phase
A lot of folks start with a simple realization: the diet soda isn’t just a beverage, it’s a companion.
It’s there during deadlines, traffic, awkward family gatherings, and “I deserve a little treat” moments.
The first few days of cutting back can feel oddly emotionallike your brain is asking, “Wait, what do we do with our hands now?”
The most successful swaps usually keep the ritual: a cold can, bubbles, and a strong flavor.
Sparkling water with lime, unsweetened iced tea, or seltzer mixed with a splash of 100% juice often works because it still feels special.
The surprise: food starts tasting sweeter (in a good way)
After a couple of weeks, a common experience is sensory recalibration.
Strawberries taste more like strawberries. Peanut butter tastes nuttier. Cinnamon tastes louder.
People often realize they weren’t “addicted to sugar”they were used to a high sweetness volume.
When that volume comes down, naturally sweet foods stop feeling boring.
This is one of the best arguments for tapering instead of quitting overnight: your taste buds actually adapt,
and the change feels less like punishment and more like a quiet upgrade.
The “keto snack trap” and label detective era
Another common moment: noticing how many “healthy” bars, cookies, and protein treats rely on sugar alcohols like erythritol.
People who live in the low-carb aisle often discover that they weren’t having “a little sweetener”
they were stacking it: a bar at breakfast, a protein shake at lunch, sugar-free candy at night.
The fix isn’t necessarily to ban every product, but to create boundaries:
one sweetened item per day, or sweetened items only on training days, or only on weekends.
Learning the ingredient list becomes a mini game: “Where are you hiding, Ace-K?”
It’s oddly satisfying when you spot it like a level-up in a video game.
The energy dip that wasn’t about caffeine
Some people expect cravings for sweetness, but they’re surprised by an energy slump.
Not because sweeteners “create fatigue” directly, but because cutting diet drinks sometimes reveals a bigger issue:
inconsistent meals, low protein at breakfast, not enough fiber, and dehydration.
When they replace the sweetened drink with water but keep skipping meals, their afternoon crash still happensjust with less excitement.
The win is when they pair the beverage change with a snack that stabilizes blood sugar:
Greek yogurt, fruit with nuts, hummus with whole-grain crackers, or a sandwich that actually has enough calories to be a meal.
Suddenly the craving for “something sweet” is lower, because the body isn’t begging for quick comfort.
The social side: “Are you okay?” (Yes. You’re just holding water.)
People also underestimate how social sweeteners are. Ordering water at a fast-food place can feel like you broke a secret handshake.
The easiest workaround is to make “heart-friendly” feel normal: sparkling water, an unsweetened iced tea, or water with lemon.
You don’t need to announce a new identity. You can just quietly change what you sip.
And if someone asks, you can keep it simple: “I’m cutting back on sweet stuff for a while.”
No PowerPoint required.
The most common takeaway from these experiences is this: reducing artificial sweeteners works best when it’s part of a bigger, kinder plan.
Not fear. Not perfection. Just steady changes that lower your daily dependence on ultra-sweet foods and drinkswhile building habits your heart will appreciate.
Conclusion
If you’ve been leaning hard on “zero sugar” everything, the research is a good reminder that heart health isn’t only about calories.
It’s about patternswhat you drink, what you eat, how processed your diet is, and whether “diet” products are helping you build healthier habits
or keeping you stuck in a loop of intense sweetness.
Keep sweeteners in perspective: useful sometimes, not a free pass. If you want the most heart-friendly approach,
slowly reduce your overall sweetness level, prioritize whole foods, and treat diet drinks and sugar-free snacks as occasional toolsnot daily essentials.