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A new study found a link between artificial sweeteners of all sources with this common disease in America.

We’ve long known that artificial sweeteners are bad for our health, but a new study reveals why and what diseases arise when people consume them in high amounts. Published in the BMJ, the study involved more than 100,000 participants in France and found a link between artificial sweeteners and heart disease.

Researchers examined participants’ dietary intakes, which included the names and contents of everything they consumed. Those who consumed large amounts of aspartame and sucralose, which are found in some of the most popular sweeteners such as Equal, Splenda, and Nutra Sweet, led to higher odds of stroke and coronary heart disease when compared to people who didn’t consume them.

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“The findings from this large-scale prospective cohort study suggest a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease risk,” concluded the study.

These findings show that sweeteners might not be a safe alternative to sugar. “The more data that comes out showing these adverse health effects, the less we’re going to want to encourage people to switch from added sugars to non-nutritive sweeteners,” said Dr. Katie Page to NBC News. Still, replacing sweeteners with sugar isn’t a healthy option, instead, experts recommend for people to decrease the amount of sugar that they consume.

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Research also showed that a lot of artificial sweeteners that are consumed don’t come directly from a packet — they’re present in diet sodas and healthy snacks such as yogurt and ice cream, making it easy for people to consume more of these chemicals without knowing it.

As more and more evidence shows, artificial sweeteners, which are billed as healthier than sugar, also come with a batch of risks that are worth thinking over.

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