A new study published in PLOS Medicine has found associations between consumption of artificial sweeteners, particularly aspartame and acesulfame potassium, and increased risk of overall cancer as well as breast and obesity-related cancers.
Key findings:
- Higher consumers of artificial sweeteners had a 13% increased risk of overall cancer compared to non-consumers.
- Aspartame intake was associated with a 15% higher risk of overall cancer.
- Acesulfame potassium intake was linked to a 13% higher overall cancer risk.
- Aspartame consumption was associated with a 22% increased risk of breast cancer.
- Artificial sweeteners were associated with a 13% higher risk of obesity-related cancers.
Background on Artificial Sweeteners
Artificial sweeteners like aspartame, acesulfame potassium, and sucralose are used in thousands of food products worldwide as no- or low-calorie sugar substitutes.
While previous studies have looked at consumption of artificially sweetened beverages in relation to cancer risk, this new study is the first to directly examine total dietary intake of specific artificial sweeteners and cancer incidence.
The Safety of Artificial Sweeteners
The safety of artificial sweeteners is controversial, with some studies in rodent models suggesting they may be carcinogenic.
However, human data has been conflicting.
While health authorities have deemed artificial sweeteners safe under current acceptable daily intake (ADI) levels, their role in cancer and other diseases remains debated.
This new study aimed to clarify the association between artificial sweetener intake and cancer risk.
About the NutriNet-Santé Cohort Study
The study analyzed data from 102,865 French adults participating in the NutriNet-Santé study, an ongoing web-based cohort study launched in 2009 investigating associations between nutrition and health.
Participants completed multiple 24-hour dietary records including names of products and brands consumed.
This allowed researchers to estimate intake amounts of total artificial sweeteners, aspartame, acesulfame potassium, and sucralose.
Cancer cases were verified through participant reports, health insurance data, and mortality registries.
Over a median 7.7 years of follow up, 3,358 first incident cancers were diagnosed.
Findings: Artificial Sweeteners Linked to Higher Cancer Risk
After adjusting for confounders like BMI, lifestyle factors, and other dietary intakes, key findings included:
- Higher total artificial sweetener intake (above the median amount) was associated with a 13% increased risk of overall cancer compared to non-consumers.
- Aspartame intake was associated with a 15% higher risk of overall cancer.
- Higher acesulfame potassium intake was linked to a 13% increased overall cancer risk.
- No association was found between sucralose and cancer risk, but sucralose consumption was very low in the cohort.
- Aspartame intake was associated with a 22% increased risk of breast cancer.
- Total artificial sweetener consumption was linked to a 13% higher risk of obesity-related cancers like colorectal, breast, and prostate cancers.
Artificial Sweeteners, Sugar, and Cancer Risk
The researchers also looked at artificial sweetener consumption and sugar intake in relation to cancer risk.
They found no difference in risk between participants who consumed higher amounts of artificial sweeteners but limited sugar compared to those who consumed high sugar but no artificial sweeteners.
This suggests sugar and artificial sweeteners may carry similar associations with cancer risk.
Mechanisms Linking Artificial Sweeteners to Cancer
This observational study cannot prove causation.
However, there are potential mechanisms that could explain the observed link between artificial sweeteners and cancer:
- Artificial sweeteners may disrupt the gut microbiome and promote glucose intolerance, inflammation, and DNA damage.
- Animal studies suggest aspartame specifically may be carcinogenic, triggering tumors.
- Artificial sweeteners may promote weight gain, which could indirectly increase cancer risk.
- Toxicity to human cells and inhibition of apoptosis (programmed cell death) have been observed in vitro.
Study Limitations & Next Steps
While this large cohort study had detailed dietary assessment methods, limitations include the volunteer-based cohort not being representative of the general population and the possibility of residual confounding.
These concerning findings warrant further investigation in large population cohorts and mechanistic studies on artificial sweeteners and cancer.
The results add to growing concerns about the safety of artificial sweeteners, which are consumed daily by millions worldwide.
The findings may inform ongoing re-evaluation of artificial food additives by health agencies.
Based on this new data, artificial sweeteners should not be considered a healthy or safe alternative to sugar intake.
Limiting consumption of both refined sugars and artificial sweeteners appears prudent until more research is conducted on their potential health impact.
Research
- Study: Artificial sweeteners and cancer risk
- Authors: Charlotte Debras et al. (2022)
