This systematic review and meta-analysis evaluated the association between artificially sweetened beverage (ASB) consumption and mortality outcomes based on 11 prospective cohort studies, involving 2,196,503 participants over a median follow-up period of 7 to 28.9 years. The findings indicated that higher ASB intake was linked to an increased risk of all-cause mortality (pooled RR: 1.13) and cardiovascular disease (CVD) mortality (pooled RR: 1.26), with a non-linear relationship for all-cause mortality and a linear association for CVD mortality. Additionally, substituting one serving of sugary sweetened beverages with ASB resulted in a 4-6% reduction in all-cause and CVD mortality risk. However, no significant connection was found between ASB consumption and cancer mortality. The overall quality of evidence was rated as moderate.
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