Link between use of artificial sweeteners and increased risk of cancer: Study

Artificial sweeteners lower the amount of added sugar and calories while preserving sweetness. According to a study published March 24 in PLOS Medicine by Charlotte Debras and Mathilde Touvier of the French National Institute for Health and Medical Research (Inserm) and Sorbonne Paris Nord University, France, and colleagues, some artificial sweeteners are associated with an increased risk of cancer.

Millions of individuals eat artificial sweetener-containing food and beverages on a regular basis. However, the safety of these additions has been questioned. Researchers examined data from 102,865 French people who took part in the NutriNet-Santé trial to assess the possible carcinogenicity of artificial sweeteners.

The Nutritional Epidemiology Research Team launched the NutriNet-Santé research in 2009 as an ongoing web-based cohort (EREN). Participants freely enrol and self-report their medical history, sociodemographic information, nutrition, lifestyle, and health data. Researchers acquired information about artificial sweetener consumption from 24-hour dietary records. The researchers conducted statistical analyses after collecting cancer diagnostic information during follow-up to evaluate the links between artificial sweetener use and cancer risk. They also controlled for age, gender, education, physical activity, smoking, body mass index, height, weight increase during follow-up, diabetes, cancer family history, and baseline intakes of energy, alcohol, salt, saturated fatty acids, fibre, sugar, whole-grain meals, and dairy products.

The researchers discovered that participants who consumed more artificial sweeteners, notably aspartame and acesulfame-K, had a greater risk of total cancer than non-consumers (hazard ratio 1.13, 95 percent confidence interval 1.03 to 1.25). Breast cancer and obesity-related malignancies were shown to have higher risks.

The study had numerous significant limitations, including the fact that food intakes were self-reported. Participants were more likely to be women, to have better educational levels, and to engage in health-conscious behaviours, suggesting that selection bias may have had a role. Because the study is observational, residual confounding is likely, and reverse causation cannot be ruled out. More study will be needed to validate the findings and understand the underlying processes.

“Our findings do not support the use of artificial sweeteners as safe substitutes for sugar in meals or beverages,” the authors write, adding that they “offer crucial and innovative information to address the disputes over their possible harmful health consequences.” While these findings need to be replicated in other large-scale cohorts and the underlying mechanisms clarified through experimental studies, they provide important and novel insights for the European Food Safety Authority and other health agencies around the world in their ongoing re-evaluation of food additive sweeteners.”

“Results from the NutriNet-Santé cohort (n=102,865) imply that artificial sweeteners available in numerous food and beverage brands throughout the world may be related with increased cancer risk, consistent with several experimental in vivo / in vitro investigations,” Debras says. Certain findings give new information for health officials to re-evaluate these food additives.”