New developments in the so-called sugar-free paradox have further called into question whether artificial sweeteners represent a healthy way to cut calories or a potentially dangerous option. Recent findings have explored connections between various sugar alternatives and cardiovascular health risks and anxiety, among other concerns.

Perhaps most notably, a recent multi-part study found the following adverse effects:

It’s fueling anxiety specially aspartame, Cardiovascular (Heart) Diseases, Nonfatal Mayocardial Infarction, Stroke, Increasing HBa1c Level, Colorectal Cancer and Inflammatory bowel disease, Diarrhea, Bloating, Toxic Kidneys and Liver, Altered taste buds.

Over an average 9 years of follow-up, artificial sweetener intake was associated with a 9% increased risk for cardiovascular or cerebrovascular events. These included myocardial infarction, acute coronary syndrome, angioplasty, angina, stroke, or transient ischemic attack.

For some experts, the best advice is to employ moderation all around, avoiding excess sugar and artificial sweeteners. Embracing simple, proven advice, like drinking more water and less processed beverages, may be the best strategy. However, the popularity of this week’s top trending clinical topic may suggest that people are still quite interested in hearing just what the evidence has to say about sugar alternatives.