The safety of artificial sweeteners has been debated for decades, but new research is renewing concerns about their potential health impacts.
Researchers behind a large-scale nutrition study out of France say they have found associations between consumption of artificial sweeteners, such as aspartame and sucralose, and cardiovascular disease and cancer.
The NutriNet-Santé study, which included more than 100,000 participants, is one of the largest of its kind and the first to quantify the amount of sweeteners consumed, they say.
“It’s an important step, a new brick in the wall, in terms of the weight of evidence we would train together regarding artificial sweeteners and health,” said Mathilde Touvier, head of the research team at ‘nutritional epidemiology of the National Institute of Health and Medicine of France. Research and one of the authors of the study.
Non-nutritive sweeteners, as they’re known in nutritional science, are intensely sweet, hundreds of times sweeter than sugar, and are favored by many to offer the taste of sugar without the calories. And as the long-term effects of too much sugar become known, artificial sweeteners are also seen as an alternative.
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While diet soda may be the most obvious source, artificial sweeteners are found in all kinds of common foods, including yogurts, baked goods, and even ketchup.
Previous studies have found that sugar substitutes can alter the intestinal microbiomes i raise blood sugar. Other studies have even suggested that they can cause weight gain, although this has been debated.
“There’s really growing evidence to challenge the assumption that artificial sweeteners are metabolically inert substances. And I think these findings should give us pause,” Leslie Beck, a dietitian and health columnist, said in an interview with Dr. Brian Goldman from The Dose. .
International health agencies that review sweeteners
The most recent The NutriNet-Santé study on cardiovascular health was published last month in the British Medical Journal.
He classified the participants into three groups: lower, higher and non-consumers of artificial sweeteners. Those in the highest cohort consumed about 77 milligrams of artificial sweeteners a day, about two packets of sweetener or less than 200 milliliters of diet soda.
Compared to non-consumers, higher consumers tend to be younger, have a higher body mass index, more likely to smoke, and less likely to exercise.
What the study found is that aspartame intake was associated with higher rates of cerebrovascular events such as stroke, and acesulfame potassium and sucralose were associated with higher rates of coronary heart disease, in participants with high consumption compared to non-consumers.
The NutriNet-Santé study is the first to quantify artificial sweetener consumption from all sources, not just artificially sweetened beverages, the researcher says. (SpeedKingz/Shutterstock)
A separate study that also uses data from the NutriNet-Santé group, published last March in the journal PLOS Medicine, found an association between artificial sweeteners (aspartame and acesulfame potassium in particular) and cancer risk.
Touvier points out that the World Health Organization (WHO) is currently researching the safety of artificial sweeteners.
In a meta-analysis of nearly 300 studies published in April, the WHO found that there may be short-term benefits for weight loss when sugar-based drinks are replaced with artificially sweetened drinks, but not when compared to water. It also found that studies suggest “the potential for long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular disease and mortality,” but warned that further research is needed.
“We hope this new work will provide important evidence and help [the WHO] to potentially revise their opinion and regulation on artificial sweeteners,” Touvier said.
In Canada, sugar substitutes are regulated and approved after a safety assessment by Health Canada.
Less consumption of sweet foods
David Ma, a professor and researcher in nutrition at the University of Guelph, says that while the results of the most recent NutriNet-Santé study found an increased risk of cardiovascular health in a relatively small number of people, they suggest that there has a “signal” for potential long-term health. effects
However, this does not indicate an immediate danger to most consumers.
“I would say, you know, the sky is not going to fall because we have artificial sweeteners in our diet,” said Ma, who is also the director of the Guelph Family Health Study.
“But we certainly need to be vigilant about everything in our diet, including artificial sweeteners, in terms of short-term and long-term effects.”
As with everything in nutrition, researchers say moderation is key. And Touvier says that, based on his study’s findings, occasional consumption of artificial sweeteners has a fairly low risk.
Canada’s Food Guide states that sugar substitutes are not necessary for a healthy diet. In fact, using them can lead to less healthy food choices and increase the preference for sweet foods.
Whether it’s sweetness from artificial sweeteners or sugar, Beck said cutting back is key. She recommends:
- Gradually reducing the use of sweetener, using a quarter packet less each week, for example.
- Switch to flavored and carbonated waters for those who crave pop.
- Considering plain yogurt naturally sweetened with fresh fruit instead of sugary yogurts.
“It is entirely possible to adjust your taste buds and come to prefer a less sweet taste,” said the dietitian.