At first glance, sweeteners seem like an interesting alternative: they reduce the sugar content of foods (and the corresponding calories), while giving them a sweet taste. Every day, millions of people consume these so-called “light” products. However, the safety of these additives is still debated among the scientific community. To definitively eliminate the doubt, French researchers have analyzed the health and sweetener consumption data of 100,000 French people participating in the NutriNet-Santé cohort study, which since 2009 aims to establish links between nutrition and health. Their results have just been published in the journal PLOS Medicine.
Additives consumed mainly through sugar-free soft drinks
Scientists have studied the effects of all sweeteners, and in particular aspartame [E951]acesulfame-K [E950] and sucralose [E955], which are the most consumed. Aspartame has an energy value similar to that of sugar (4 kcal / g), for a sweetening power 200 times higher; therefore, much less is needed to achieve the same result, which is of great interest to manufacturers. Similarly, acesulfame-K and sucralose have a 200- and 600-fold higher sweetening power, respectively (for zero calories).
The data reviewed in this study included a total of 102,865 adults (78.5% of whom were women). Dietary intake was obtained through participants ’online self-report, which specified, over several 24-hour periods, all foods and beverages they consumed during main meals and other snacks (including portion sizes).
>> Read also: Can you die from a sugar overdose?
Similarly, their exposure to artificial sweeteners was assessed through food records, which included brands of industrial products. Keep in mind that these food additives are not only used in traditionally sweet products – they are also widely used in other sugar-free products to enhance their flavor (usually in snacks).
Relative contribution of each food group to the total consumption of artificial sweeteners (in percentage) according to NutriNet-Santé, France, 2009-2021 (n = 102,865). ** Artificial sweeteners used in tablets, liquids or powders, added by participants in yogurts, hot drinks, etc. or for baking. *** Foods rich in protein, sweets, cookies, cakes, pastries, breakfast cereals, sauces, savory products and ultra-processed fish products. Credits: C. Debras et al., PLOS Medicine (2022)
37% of participants consumed artificial sweeteners; the most consumed was aspartame, which contributed 58% of the intake, followed by acesulfame-K (29%) and sucralose (10%). Sugar-free soft drinks, table-top sweeteners and yogurt / cottage cheese were the main contributors to the total consumption of artificial sweeteners, accounting for 53%, 29% and 8% of intake, respectively, the researchers specify in PLOS Medicine.
The researchers also collected information on how participants’ health changed during the follow-up period (2009-2021). During this period, 3,358 cases of cancer were diagnosed (including 982 breast cancers, 403 prostate cancers, and 2,023 obesity-related cancers); the mean age at diagnosis was 59.5 ± 12.2 years.
>> Read also: Why fruit sugar is good for your health and processed sugar is not
13% higher risk of developing cancer
For this analysis, the researchers obviously considered many potentially confusing factors (age, gender, level of education, physical activity, smoking, BMI, family history of cancer, type of diet, etc.) so that the risk of cancer should only be evaluated in relation to the intake of sweeteners.
The result: high consumers of artificial sweeteners, that is, those above average consumption, had a 13% higher risk of developing cancer than non-consumers. Aspartame and acesulfame-K, which are used by many food and beverage brands, were associated with higher risk. Aspartame use was associated in particular with an increased risk of breast cancer (estimated at 22%) and obesity-related cancers (15%).
>> Read also: Colorectal cancer: study confirms link to high consumption of red meat
Before establishing a direct causal relationship, these results should be confirmed with other large-scale cohort studies and other metabolic measures; but in the meantime, they come to confirm the suspicions: These results do not support the use of sweeteners as safe alternatives to sugar. “Mathilde Touvier, Inserm’s research director and study coordinator, said in a press release.”
” These results provide important and new information for the ongoing re-evaluation of sweetening food additives by the European Food Safety Authority and other health agencies around the world. “, conclude the authors of the study.