Associação entre consumo de adoçantes artificiais e risco cardiometabólico evidências de estudos de coorte prospectivos.
DOI:
https://doi.org/10.47224/revistamaster.v11i21.852Keywords:
Artificial sweeteners, Cardiometabolic risk, Type 2 diabetes mellitus., Cardiovascular disease., Prospective cohort.Abstract
The aim of this integrative review was to analyze evidence from prospective cohorts, published between 2020 and 2025, regarding the association between habitual consumption of artificial sweeteners and the risk of cardiometabolic outcomes in adults. The research question was structured using the PECO framework, considering the population as adults from the general population and risk subgroups followed in prospective cohorts; as exposure, higher consumption of artificial/non-sugar sweeteners; as comparison, non-consumers or consumers with lower intake; and as outcomes, the incidence of type 2 diabetes mellitus, total cardiovascular disease and its subtypes, and other cardiometabolic outcomes. The search was conducted in electronic databases (PubMed/MEDLINE, LILACS, SciELO, BVS, and Embase) using 14 search terms in English, Portuguese, and Spanish, resulting in the identification of 1,960 records. After screening by title and abstract and evaluation of the full text, seven prospective cohorts were selected for detailed analysis. The results indicated a positive association between higher consumption of artificial sweeteners and an increased risk of type 2 diabetes (HR 1.69; 95% CI 1.45–1.97), total cardiovascular disease (HR 1.09; 95% CI 1.01–1.18), and cerebrovascular disease (HR 1.18; 95% CI 1.06–1.31), as well as increased visceral and subcutaneous adiposity and thrombotic events associated with erythritol. Heterogeneity was observed by molecule and by outcome subtype. No significant association was found between artificially sweetened beverages and mortality. The evidence is consistent; however, the observational nature of the studies, the risk of reverse causality, and residual confounding preclude definitive causal inferences.
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