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Diet soda drinkers, beware. Recent epidemiological studies have confirmed that the sweeteners used in diet sodas and other lite drinks increase the risk of type 2 diabetes. Often asymptomatic, type 2 diabetes is the most common form of diabetes, and is most often found among people who are overweight and sedentary. Just published research results out of France show that people who “always or almost always” add sweeteners to their drinks – in sachet or tablet form – had an 83% higher risk of developing diabetes than those who use them “never or rarely”. Aspartame, the most commonly used sweetener, and, more recently, sucralose (aka Splenda), have been used to replace sugar in so-called “diet” sodas for over 30 years. Even though the quantity of artificial sweeteners in our diet has increased massively in recent years as industrial manufacturers add them with growing abandon to not just drinks but also cereals, biscuits, cakes, low-calorie yogurts and even certain medicines, reliable and precise data on their health impacts are rare. Such products are marketed as low-calorie alternatives that are therefore healthy. This perception encourages consumers to overuse sweeteners to avoid putting on weight. But, even in moderation, these additives can have negative effects on health. Today, sweeteners are increasingly controversial, and suspected of contributing to weight gain and being carcinogenic. This has independent researchers across the world seeking to measure their real effects on health, particularly their impact on metabolic diseases. Increase Risk of Diabetes and Cancer Our team at France’s Centre for Research in Epidemiology and Population Health at Inserm, has been contributing to this growing body of health knowledge since 2012 through a research program on the risk factors for type 2 diabetes. The program’s findings suggest that sugar substitutes should be treated with the utmost caution. In February, we published a study showing that the risk of diabetes increases with the consumption of artificial sweeteners. We had already shown that this risk was higher with so-called “diet” drinks than with regular sodas. Our research is based on data from a cohort of nearly 100,000 French women in the Epidemiological Study of Women in National Education or E3N, one of the world’s few cohorts of this size. This prospective cohort study has been monitoring the health of women who belong to the mutual health insurance company for French national education staff for the past 27 years. Initiated by epidemiologist Françoise Clavel-Chapelon, the study aims to improve understanding of women’s health and their risks of developing chronic conditions, such as cancer or type 2 diabetes. Participants have completed detailed questionnaires on their diets since 1993, giving full details of each food intake, including snacks and appetisers prior to the three main meals and evening snacks. This gives researchers precise information, including pictures, of both the foods and drinks consumed and the average nutritional intake for each woman. The study ended in 2007. Want a soda? Avoid diet Studying this data in 2013, our team was able to demonstrate for the first time a