Can consuming artificial sweeteners increase cancer risk?

Can consuming artificial sweeteners increase cancer risk?
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A new study discovers that some artificial sweeteners are associated with increased cancer risk.

Artificial sweeteners are low-calorie or calorie-free chemical substances used as an alternative to sugar to sweeten foods and drinks. They are added to many products, including drinks, desserts, chewing gum and toothpaste.

Previous studies have stated that artificial sweeteners cannot cause cancer; however, new research suggests that some of these sweeteners could be associated with increased cancer risk.

The study was published in PLOS Medicine by Charlotte Debras and Mathilde Touvier at the French National Institute for Health and Medical Research (Inserm) and Sorbonne Paris Nord University, France and colleagues.

The danger of artificial sweeteners

The safety of artificial sweeteners is strongly debated and the research team set out to decipher this. To evaluate the potential carcinogenicity of artificial sweeteners, the researchers analysed data from 102,865 French adults participating in the NutriNet-Santé study.

NutriNet-Santé study is an ongoing web-based cohort initiated in 2009 by the Nutritional Epidemiology Research Team (EREN). The study is completely voluntary and participants self-report their medical history, sociodemographic, diet, lifestyle and health data.

Gathering this data, the research team collated the statistics concerning artificial sweetener intake from 24-hour dietary records. After collecting cancer diagnosis information during follow-up, the researchers conducted statistical analyses to investigate the associations between artificial sweetener intakes and cancer risk. Furthermore, the researchers adjusted for a range of variables, including:

  • age,
  • sex,
  • education,
  • physical activity,
  • smoking,
  • body mass index,
  • height,
  • weight-gain during follow-up,
  • diabetes,
  • family history of cancer,
  • baseline intakes of energy, alcohol, sodium, saturated fatty acids, fibre, sugar, whole-grain foods, and dairy products.

The researchers’ findings

The researcher’s analysis uncovered that the participants consuming large quantities of artificial sweeteners, particularly aspartame and acesulfame-K, had a higher risk of overall cancer compared to non-consumers (hazard ratio 1.13, 95% confidence interval 1.03 to 1.25). Higher risks were observed for breast cancer and obesity-related cancers.

The study illuminated important limitations such as self-reported dietary intakes, the possibility of selection bias as participants were most likely to be women, to have higher education levels and to exhibit health-conscious behaviours. Additionally, the observational nature of the study means that residual confounding is possible and reverse causality cannot be ruled out. Additional research will be required to confirm the findings and clarify the underlying mechanisms.

According to the authors, “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. 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.”

Debras added, “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 / in vitro studies. These findings provide novel information for the re-evaluation of these food additives by health agencies.”

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