Put down the Diet Coke, pull up a chair and reconsider the role of zero-sugar anything in your life.

A study from researchers in France analyzing data from 102,865 participants from a longitudinal study beginning in 2009 identified a link between the consumption of artificial sweeteners and a 13% higher risk of developing cancer, especially breast cancer or obesity-related cancers.

Although there’s been some evidence of the carcinogenic properties of artificial sweeteners in animal studies, this is the first study to directly investigate the relationship between the cumulative intake of artificial sweeteners (sorted by type, from all dietary sources) and cancer risk.

And, although the researchers looked at several kinds of artificial sweeteners, two of them, aspartame and Ace-K, were among the most widely consumed. An earlier study found that 41.4% of U.S. adults end up consuming artificial sweeteners by way of some commercial product.

Of course, correlation does not imply causation, and further research will be needed to confirm that cancer is definitively caused by artificial sweeteners. The study, published in the Public Library of Science (PLOS) MEDICINE requires replication among different countries, participants and settings in order to answer another pressing question: Is there a specific dose at which the risks of consuming artificial sweetener begin to manifest?

Until we know for sure, it’s best to follow the old adage of “everything in moderation.” Eat a balanced diet with room for things sweetened with, well, sugar, in addition to the often-unavoidable artificial sweeteners, and you should be good to go.