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A new research study has suggested a 20% higher risk of irregular heart rhythm, known as atrial fibrillation, among adults who consume two litres or more of artificially sweetened beverages per week. The study, published this week in the American Heart Association journal Circulation: Arrhythmia and Electrophysiology, also found a 10% increased risk among participants who reported drinking two litres or more per week of sugar-sweetened beverages. It found that drinking one litre or less per week of pure, unsweetened juice – such as orange or vegetable juice – was associated with a lower risk of atrial fibrillation (AFib). Researchers reviewed data from the UK Biobank, taken from dietary questionnaires and genetic data, for more than 200,000 adults who were free of AFib at the time they enrolled in the Biobank. During the nearly ten-year follow-up period, there were 9,362 cases of AFib among the participants. The study is among the first to assess a possible link between sugar- or artificially-sweetened beverages and AFib. The condition, in which the heart beats irregularly, increases the risk of stroke by five-fold. Lead study author Ningjian Wang, a researcher at the Shanghai Ninth People's Hospital and Shanghai Jiao Tong University School of Medicine in Shanghai, China, said that the study’s findings cannot “definitively conclude that one beverage poses more health risk than another” due to complexity of consumers’ diets. The observational study cannot prove causation between consumption of certain types of beverages and AFib risk – it relied on participants to recall their own diets, leaving it open to memory errors or bias, and it is also unknown if the sugar- or artificially-sweetened beverages contained caffeine. Wang continued: “However, based on these findings, we recommend that people reduce or even avoid artificially sweetened and sugar-sweetened beverages whenever possible”. Researchers also evaluated whether a genetic susceptibility to AFib was a factor in the association with sweetened beverages. The analysis found the AFib risk was high with the consumption of more than two litres of artificially sweetened drinks per week regardless of genetic susceptibility. Wang added: “Although the mechanisms linking sweetened beverages and atrial fibrillation risk are still unclear, there are several possible explanations, including insulin resistance and the body’s response to different sweeteners”. Artificial sweeteners – such as sucralose, aspartame, saccharin and acesulfame – are used in many popular low- and no-calorie soft drinks. A 2018 science advisory from the American Heart Association noted that there is a scarcity of large, long-term and randomised trials on their efficacy and safety. CEO of natural energy drink brand Tenzing, Huib van Bockel, commented: “This latest research confirms what I’ve been following for years – that artificial sweeteners should never have been created as an alternative to sugar. In the same way that people tend to think vaping is better than smoking, the long-term effects are still unknown.” American Heart Association nutrition committee member Penny M. Kris-Etherton described the new findings as surprising “given that two liters of artificially sweetened beverages a week is equivalent to about one 12oz diet soda a day.” Tom Sanders, professor emeritus of Nutrition and Dietetics at King’s College London, said that it is “difficult to comprehend how artificially sweetened drinks could have such an effect, as the amounts of sweeteners are typically concentrations 300-800 times lower than sugar”. He commented: “The main sweeteners used in drinks are aspartame, acesulfame K and sucralose. These molecules are pharmacologically inactive. It seems more likely that the selection of the artificially sweetened drinks is associated with another factor that increases risk of . As this is the first study that has reported such an effect, the finding needs replication before any conclusions can be drawn.” Sanders also added that it “remains good dietary advice” to recommend the consumption of low-calorie artificially-sweetened beverages in place of sugar-sweetened and alcoholic beverages. You might also like to read: