Artificial Sweeteners and Cardiovascular Risk in Hungary: Beyond Traditional Risk Factors

Abstract

Background/Objectives: Cardiovascular disease (CVD) remains a leading cause of mortality in Hungary, with rising obesity and diabetes rates exacerbating the burden. Artificial sweeteners, promoted as healthier alternatives to sugar, have been linked to CVD risk in other populations, but evidence in Hungary is limited. This study aims to investigate the association between artificial sweetener use and CVD prevalence in a Hungarian population, independent of traditional risk factors, using data from the 2019 European Health Interview Survey (EHIS). Methods: This cross-sectional study analyzed EHIS data (n = 5603), categorizing participants by self-reported CVD diagnoses (hypertension, coronary artery disease, myocardial infarction, or stroke). Variables included artificial sweetener use, age, sex, education, income, smoking, alcohol consumption, physical activity, diabetes, and body mass index (BMI). Chi-square tests and multivariate logistic regression, adjusted for sampling weights, were employed to assess associations. Results: Of 5603 participants, 38.7% had CVD and 16.4% used artificial sweeteners. Older age, female sex, lower education, long-term smoking cessation, obesity, diabetes, and physical inactivity increased CVD risk, while moderate alcohol consumption and sports were protective. Artificial sweetener use was significantly associated with higher CVD prevalence (OR: 1.21, 95% CI: 1.01-1.46, p = 0.01), independent of other risk factors. Conclusions: Artificial sweetener use is associated with increased CVD risk in Hungary, suggesting a need for further research and public health strategies to address this potential risk.

Keywords: European Health Interview Survey; Hungary; artificial sweetener; cardiovascular disease; risk factors.