In an effort to address the increasing incidence of poor cardiometabolic health, leading health agencies around the world advocate the consumption of foods and beverages containing non-nutritive sweeteners as healthy alternatives to those containing added sugars. However, several epidemiological studies have reported significant, counterintuitive associations between the consumption of non-nutritive sweeteners and weight gain, an increased incidence of type 2 diabetes, and cardiovascular events (e.g. heart attacks). Additionally, mice studies indicate that non-nutritive sweeteners, like excess sugar, may have a direct role in the impairment of vascular reactivity; findings that raise serious concerns over the assumed physiological inactivity of non-nutritive sweeteners. Indeed, rather than helping improve cardiometabolic health outcomes, as promoted, consuming non-nutritive sweeteners may be as harmful to vascular and metabolic health as is excess sugar consumption; thus, contributing to one of the greatest, preventable burdens to health care systems, economies, and societies both in Europe and abroad. Considering this, the SWEETENED HEARTS study aimed to, for the first time in vivo, assess the effect of non-nutritive sweetener consumption on vascular and metabolic function in humans. As a result of the COVID-19 pandemic, the clinical research centre in which the project was hosted was instructed to redirect of 100% research resources to conducting clinical trials for COVID-19 vaccines. This delayed the implementation of the project and, as a consequence, data collection is still ongoing. Results from this study have the potential to indicate if non-nutritive sweeteners can contribute to the development of CVD, obesity and insulin resistance; findings that may encourage health authorities to revisit the regulatory status of non-nutritive sweeteners.
