Comprehensive study links artificial sweeteners to heightened cancer risk

Artificial sweeteners have been used for the last few decades to replace sugar content in food and drinks, cutting back on calorie intake while maintaining sweetness. Yet they may not be innocuous.

A study published in PLOS Medicine by Charlotte Debras and Mathile Touvier at the French National Institute for Health and Medical Research (Inserm) and Sorbonne Paris Nord University, suggests that artificial sweeteners may heighten the risk of developing cancer.

The authors write that “[artificial sweeteners’] carcinogenicity has been suggested by several experimental studies, but robust epidemiological evidence is lacking.” They therefore decided to “investigate the associations between artificial sweetener intakes (total from all dietary sources, and most frequently consumed ones: aspartame [E951], acesulfame-K [E950], and sucralose [E955]) and cancer risk (overall and by site).”

Many food products and beverages include artificial sweeteners, either for calorie control purposes or for use by diabetics to control sugar intake, and are consumed by millions of people daily. Yet these sweeteners are not necessarily good for your health, and their health risks have been subject to debate.

In this paper, researchers analysed data from 102,865 French adults (age 18 or older, mean age 42) that were participants in the NutriNet-Sante study. According to France’s Nutritional Epidemiology Research Team (EREN), the NutriNet Sante study “was set up to investigate nutrition and health relationships.”

Participants in NutriNet Sante were followed up for a median of 7.8 years. They enrol voluntarily and self-report their medical history, diet, lifestyle, sociodemographic and health data.

The researches also assessed associations between sweeteners and cancer incidence by Cox proportional hazards models, “adjusted for age, sex, education, physical activity, smoking, body mass index, height, weight gain during follow-up, diabetes, family history of cancer, number of 24-hour dietary records, and baseline intakes of energy, alcohol, sodium, saturated fatty acids, fibre, sugar, fruit and vegetables, whole grain foods, and dairy products.”

The researchers write that they observed “higher risk of overall cancer” in enrollees who used sweeteners compared to non-consumers, especially with aspartame (sold under names of Nutrasweet and Equal) and acesulfame-K (a slightly bitter tasting sweetener blended with other sweeteners).

They write that higher risks were also observed “for breast cancers … and obesity-related cancers.”

It should be noted that the study had “several important limitations,” such as the fact that the dietary intakes were self-reported. Moreover, there may also be a selection bias at work, as participants were “more likely to be women, to have higher educational levels, and to exhibit health-conscious behaviours.”

The authors still point out that the 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.”

“Results from the NutriNet-Sante 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,” Debras adds. 

The researchers conclude that their findings “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.”