People are tempted to buy food products that taste sweet and this has led food producers, over the years, to add sugar to almost every processed food and beverage on the supermarket shelves. Since the public has become aware of the calorific consequences of this added sugar, and links between sugar and several diseases have become clearer, manufacturers have tended to replace the sugar with non-nutritive artifical sweeteners instead.
The safety of artificial sweeteners has been debated, and several experimental studies have indicated that some of them may be carcinogenic. However, robust epidemiological studies on the association between use of artificial sweeteners and disease incidence in human populations have not been undertaken.
With this in mind, Charlotte Debras and Mathilde Touvier of the French National Institute for Health and Medical Research (Inserm) and Sorbonne Paris Nord University, France, along with colleagues, undertook a study to evaluate the potential carcinogenicity of artificial sweeteners. The research was focused on 102,865 French adults who were participants in the NutriNet-Santé study – an ongoing web-based study initiated in 2009 by the Nutritional Epidemiology Research Team (EREN).
This study requires participants to enroll voluntarily and to self-report their medical history, sociodemographic, diet, lifestyle, and health data. The researchers gathered data about dietary intake and use of artificial sweeteners using repeated 24-hour dietary records from the French population-based cohort. The brand names of foods and beverages were recorded as well, to enable the consumption of artificial sweeteners to be quantified. The participants were followed up with between 2009 and 2021, which represented a mean follow-up period of 7.8 years.
After collecting cancer diagnosis information during follow-up monitoring, the researchers carried out statistical analyses to investigate the associations between artificial sweetener intakes and cancer risk. They adjusted the data for a range of variables including age, sex, education level, physical activity, smoking, body mass index, height, weight-gain during follow-up, diabetes, family history of cancer, as well as baseline intakes of energy, alcohol, sodium, saturated fatty acids, fiber, sugar, whole-grain foods, and dairy products.
The results of the analyses, published in the journal PLOS Medicine, show that participants who consumed larger quantities of artificial sweeteners, particularly aspartame and acesulfame-K, had a higher risk overall of developing cancer, when compared to those who did not consume artificial sweeteners. In particular, there was an increased risk of developing breast cancer associated with the use of aspartame. There was also an increased risk of developing obesity-related cancers with overall high intake of artificial sweeteners, and with the use of aspartame specifically.
Although the study had several important limitations, such as the fact that dietary intakes were self-reported and participants were more likely to be women, have higher educational levels and show health-conscious behaviors, it highlights the need for future research into the effects of using artificial sweeteners in foods and beverages. Additional research will also be needed to establish the mechanisms whereby these sweeteners may affect health in this way.
“Our findings do not support the use of artificial sweeteners as safe alternatives for sugar in foods or beverages, and provide important and novel information to address the controversies about their potential adverse health effects,” said the study authors. “While these results need to be replicated in other large-scale cohorts and underlying mechanisms clarified by experimental studies, they provide important and novel insights for the ongoing re-evaluation of food additive sweeteners by the European Food Safety Authority and other health agencies globally.”
“Results from the NutriNet-Santé cohort (n=102,865) suggest that artificial sweeteners found in many food and beverage brands worldwide may be associated with increased cancer risk, in line with several experimental in vivo and in vitro studies,” said Debras. “These findings provide novel information for the re-evaluation of these food additives by health agencies.”
By Alison Bosman, Earth.com Staff Writer