Will artificial sweeteners be healthier than sugar?

April 30, 2024

Artificial sweeteners reduce the added sugar content and corresponding calories while maintaining sweetness. A study published in PLOS Medicine by Charlotte Debras and Mathilde Touvier of Inserm, as well as Sorbonne Paris Nord University and colleagues, suggests that some artificial sweeteners are associated with increased cancer risk.
Millions of people consume these foods and beverages containing artificial sweeteners every day, however, the safety of these additives has always been controversial. To evaluate the potential carcinogenicity of artificial sweeteners, researchers analyzed data from 102865 French adults who participated in the NutriNet Sant é study. The NutriNet Sant é study is a web-based cohort study initiated by the Nutrition Epidemiology Research Team (EREN) in 2009. Participants voluntarily register and self report their medical history, social demographics, diet, lifestyle, and health data.

Researchers collected data on artificial sweetener intake from 24-hour dietary records. After collecting cancer diagnosis information during follow-up, researchers conducted statistical analysis to investigate the association between artificial sweetener intake and cancer risk. They also adjusted for a range of variables, including age, gender, education, physical activity, smoking, body mass index, height, weight gain during follow-up, diabetes, family history of cancer, and baseline intake of energy, alcohol, sodium, saturated fatty acids, fiber, sugar, whole grain foods, and dairy products.

Researchers have found that compared to non users, subjects who consume a large amount of artificial sweeteners (especially aspartame and acetaminophen-K) have a higher risk of cancer (hazard ratio 1.13, 95% confidence interval 1.03 to 1.25). The risk of breast cancer and obesity related cancer is higher.

This study has several important limitations; The dietary intake is self-reported. Choice bias may also be a factor, as participants are more likely to be female, have higher levels of education, and exhibit healthy behavior. The observational nature of this study also suggests that residual confounding is possible, and reverse causal relationships cannot be ruled out. Further research is needed to confirm these findings and elucidate their potential mechanisms.

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According to the author, the research findings do not support the use of artificial sweeteners as a safe alternative to sugar in food or beverages, and provide important and novel information to address controversies about their potential adverse health effects. Although these results need to be replicated in other large-scale groups and elucidated through experimental studies to elucidate their underlying mechanisms, they provide important and novel insights for the food additive sweeteners that are being reassessed by the European Food Safety Agency and other global health agencies.

The study authors added, "The results of the NutriNet Ant é cohort (n=102865) suggest that artificial sweeteners found in many food and beverage brands around the world may be associated with increased cancer risk, consistent with several in vivo/in vitro experimental studies. These findings provide new information for health agencies to reassess these food additives."

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2024-04-30

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