Artificial sweeteners and potential cancer risks: what you need to know

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A new study suggests there may be a potential link between artificial sweeteners and an increased risk of cancer. Catherine Falls Publicity/Getty Images
  • Millions of Americans use artificial sweeteners to reduce sugar and calories.
  • However, a new study has found a link between them and an increased risk of cancer.
  • Aspartame and acesulfame-K in particular were linked to an increased risk of cancer.
  • The types of cancer most strongly linked to artificial sweeteners were breast cancer and those linked to obesity.
  • Experts recommend limiting foods with added sugars or artificial sweeteners.

Millions of Americans use artificial sweeteners as an alternative to sugar.

In fact, according to data analysis by statista, 141.18 million Americans used sugar substitutes in 2020 alone.

Artificial sweeteners contain no or very few calories, so they are often added to foods and drinks with the idea that they will aid in weight loss. They are also used in toothpastes, candies and chewing gum to add sweetness without the risk of contributing to tooth decay.

While people generally seek to be healthier when consuming artificial sweeteners, a large cohort study of over 100,000 French adults suggests they may not be as good for us as we hope .

This study, written by Charlotte Debras, Mathilde Touvier and their colleagues from the National Institute of Health and Medical Research (Inserm) and Sorbonne Paris Nord University, established a link between certain artificial sweeteners and an increased risk of cancer.

Because the safety of artificial sweeteners has long been a matter of debate, researchers decided to examine their potential link to cancer.

They analyzed 102,865 French adults who participated in the NutriNet-Santé study.

This study is an ongoing web-based cohort that was initiated in 2009 by the Nutritional Epidemiology Research Team.

Participation is voluntary, with people self-declaring their medical history as well as socio-demographic, diet, lifestyle and health data.

Information on artificial sweetener consumption was gleaned from participants’ 24-hour food records.

During follow-up, the team gathered information about cancer diagnoses and analyzed it to see if there was a link between artificial sweetener consumption and cancer risk.

They adjusted the data for age, sex, education, physical activity, smoking status, body mass index, height, weight gain, diabetes and family history of cancer. They also adjusted it for baseline intakes of energy, alcohol, sodium, saturated fat, fiber, sugar, whole grains, and dairy.

In a joint email between Debras, Touvier and Healthline, the authors said their work suggests that regular consumption of artificial sweeteners may be associated with an increased risk of cancer.

They noted that previous observational studies had found links between these two variables. Additionally, animal studies have suggested that artificial sweeteners may be carcinogenic.

However, their study is the first to investigate associations between the amount of artificial sweetener intake and cancer risk, as well as to consider different types of artificial sweeteners.

Debras and Touvier said in particular they found that the sweeteners aspartame and acesulfame-K were linked to an increased risk of cancer.

Additionally, they saw increased risks, particularly for breast cancer and a group of cancers linked to obesity, including breast, colorectal and prostate cancers.

So what does this study mean for consumers? Should we give up all artificially sweetened foods? It may be too early to tell.

Dr. Mary-Jon Ludy, chair of the Department of Public Health and Paramedic at Bowling Green State University and associate professor of food and nutrition, who was not part of the study, warned that the correlation does not equal causation.

“With an observational study design, it is not possible to determine whether high levels of artificial sweetener intake cause cancer, or whether people with cancer consume excessively high levels of artificial sweeteners,” said Ludy said. “To determine cause and effect, experimental studies are needed.”

Dr. Andrew Odegaard, associate professor of epidemiology and biostatistics at the University of California, Irvine Program in Public Health, who was also not part of the study, had similar concerns.

He said that certain types of biases are inherent in this type of study, so it is not possible to discern whether these results were due to bias or artifacts in the data.

He also pointed out that, overall, only about 3.3% of participants were diagnosed with cancer during follow-up, so the relative risks appear “modest.”

“I wouldn’t be too excited one way or the other,” Odegaard said.

Ludy said there is currently no consensus on which artificial sweeteners are safest to use, however, she advises people to use moderation and focus on overall dietary quality.

In order to maintain a healthy level of sugar intake, she recommends making foods like vegetables, fruits, and dairy your priority.

These foods contain natural sugars as well as vitamins, minerals and fiber.

Additionally, she recommends limiting added sugars in food preparation and processing.

Ludy said dietary guidelines recommend consuming less than 10% of total calories from added sugars.

For someone on a 2,000 calorie diet, this would translate to a maximum of 200 calories or 50g of sugars.

Ludy suggests drinking plain water or milk instead of sugary drinks and using moderation when it comes to sugary snacks and desserts.

Finally, she suggests comparing labels when grocery shopping.

“Look at the ‘added sugars’ content on the Nutrition Facts panel,” Ludy says. “Choosing products with lower amounts can be a great way to make healthier choices.”

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