Artificial Sweeteners Under Scrutiny: 30-Year Study Links Saccharin, Diet Drinks to Elevated Diabetes Risk

The study aimed to explore the long-term metabolic implications of artificial sweeteners (ArtSw), especially in light of their widespread use as sugar substitutes. Although these sweeteners are marketed as healthier alternatives, emerging data suggest they may have unintended health consequences.

The analysis included 4,654 adults who were on average 24.9 years old at the outset of the study in 1985–86. Participants were racially diverse (50.1% White) and included more women than men (54.4%). Researchers gathered dietary data at baseline (year 0), year 7, and year 20 to calculate cumulative average intakes of artificial sweeteners, including diet drinks, aspartame, sucralose, and saccharin.

Over a median follow-up period of three decades, 691 participants developed diabetes. Diabetes diagnoses were based on fasting blood glucose levels, oral glucose tolerance test (OGTT) results, hemoglobin A1C thresholds, or use of diabetes medications.

The study employed time-dependent multivariable Cox regression models to assess risk. These models were carefully adjusted for several factors that might influence diabetes risk, such as age, sex, race, education, energy intake, physical activity, smoking habits, alcohol use, diet quality, and family history of diabetes.

Based on the study, the researchers reported the following:

• Individuals in the highest quintile of diet beverage consumption had more than double the risk of developing diabetes compared to those in the lowest quintile (HR: 2.29).
• Saccharin intake was also associated with an increased risk of diabetes (HR: 2.10).
• There was no significant link between total artificial sweetener intake and diabetes risk.
• Specific sweeteners such as sucralose and aspartame showed no significant association with diabetes incidence.
• Adjusting for waist circumference slightly reduced the strength of the associations but did not change the overall finding that higher consumption of saccharin and diet beverages increases diabetes risk.

Commenting on the research, co-author Dr. Lyn Steffen, Professor of Epidemiology and Community Health at the University of Minnesota, noted that further investigations—including mediation analyses—are underway to better understand these links.

The authors emphasized that these findings underscore the importance of evaluating the long-term effects of artificial sweeteners on glucose metabolism. Previous analyses from the CARDIA study had already suggested a relationship between long-term sweetener use and increased visceral and subcutaneous fat levels.

With artificial sweeteners deeply embedded in many people’s diets, these findings bring renewed attention to their potential health risks, especially over extended periods.