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Sweet Surprises: An In-depth Systematic Review of Artificial Sweeteners and Their Association with Cerebrovascular Accidents

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Abstract

Purpose of Review

Artificial sweeteners have become increasingly popular in today’s dietary trends as a healthier and sweeter alternative to sugar. As studies emerge regarding artificial sweeteners, concerns are arising about their side effects, particularly linking them to strokes. This systematic review aims to assess the relationship between artificial sweeteners (AS) and cerebrovascular accidents (CVAs). A systematic search of studies indexed in PubMed and Google Scholar was conducted using the keywords “ASB” (artificially sweetened beverage), “Artificial Sweeteners,” “Stroke,” etc. These studies were screened and filtered according to our exclusion criteria. We reviewed 55 studies published in various journals and further boiled down to finalizing 12 studies for analysis using the PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020.

Recent Findings

Most studies suggest that there is a positive association between artificial sweetener consumption and CVAs including all types of strokes, particularly ischemic strokes. Poorer outcomes are seen with higher ASB intake. Increased risk is notable among women and black populations. Some studies show no association between ASB consumption and hemorrhagic stroke, however, most suggest a strong link.

Summary

The current literature shows a degree of variation so it is crucial to consider possible confounders and eliminate them in future studies. Further research is necessary to determine the underlying mechanisms, especially in individuals with comorbidities. The results obtained play a role in forming dietary guidelines and alarming the public about the possible health implications, prompting caution regarding excessive consumption of artificial sweeteners, in their daily lives.

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Data Availability

No datasets were generated or analysed during the current study.

Abbreviations

ASB:

Artificially sweetened beverages

SSB:

Sugar-sweetened beverages

GRAS:

Generally Regarded as Safe

DALY:

Disability-adjusted life years

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Acknowledgements

I extend my gratitude to Indu Etta, who substantially contributed to the conception and design of the study, drafting the manuscript, and agreed to be accountable for all aspects of the work and for her involvement in the final approval of the version to be submitted. I would also like to thank Kambham Saisravika for her contributions to the analysis/interpretation of data, critically reviewing the manuscript for important intellectual content, agreeing to be accountable for all aspects of the work, and for her approval in the final version to be submitted. A sincere gratitude to Binay K. Panjiyar who contributed substantially to the concept and design of the study, critically reviewed the manuscript for important intellectual content, agreed to be accountable for all aspects of the work, reviewed the final version to be submitted, and supervised the work.

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Authors and Affiliations

  1. Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Maharashtra University of Health Sciences, Nashik, Maharashtra, India

    Khushal B. Girigosavi

  2. Kakatiya Medical College, Warangal, Telangana, India

    Indu Etta

  3. Dr. B. R. Ambedkar Medical College Hospital, Bengaluru, Karnataka, India

    Saisravika Kambham

  4. Harvard Medical School, Boston, MA, USA

    Binay K. Panjiyar

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  1. Khushal B. Girigosavi
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Contributions

K.G. substantially contributed to the concept and design of the study; acquisition, analysis, or interpretation of the data; drafting of the manuscript; and critical review of the manuscript and agreed to be accountable for all aspects of the work and will be involved in the final approval of the version to be submitted. I.E. substantially contributed to the conception and design of the study, drafting of the manuscript, and critical review of the manuscript and agreed to be accountable for all aspects of the work and will be involved in the final approval of the version to be submitted. K.S. contributed substantially to the analysis/interpretation of data, critically reviewed the manuscript for important intellectual content, agreed to be accountable for all aspects of the work, and will review the final version to be submitted. B.P. contributed substantially to the concept and design of the study, critically reviewed the manuscript for important intellectual content, agreed to be accountable for all aspects of the work, reviewed the final version to be submitted, and supervised the work.

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Correspondence to Binay K. Panjiyar.

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Girigosavi, K.B., Etta, I., Kambham, S. et al. Sweet Surprises: An In-depth Systematic Review of Artificial Sweeteners and Their Association with Cerebrovascular Accidents. Curr Nutr Rep (2024). https://doi.org/10.1007/s13668-024-00537-9

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