Two reports released this week have raised concerns about the sweetener aspartame, suggesting a possible link to liver cancer. This comes after the World Health Organization (WHO) advised against the use of most “non-sugar sweeteners” due to their lack of long-term weight control benefits and potential risks such as diabetes, heart attacks, and death.
Which sweeteners are of concern?
The WHO stated that most sweeteners, both artificial (such as aspartame and saccharin) and plant-based (such as stevia), are problematic. The exception is sweeteners made from sugar alcohols called polyols, which were not included in the review and do not fall under the category of “non-sugar sweeteners.”
Does aspartame carry additional risks?
There are conflicting reports regarding the safety of aspartame. The WHO’s International Agency for Research on Cancer (IARC) has classified aspartame as “possibly carcinogenic” based on limited evidence suggesting a potential link to liver cancer. However, a separate report from the Food and Agriculture Organization’s Joint Expert Committee on Food Additives, as well as the WHO, concluded that there is no reason to change their existing recommendations on aspartame consumption. They state that it is safe for individuals to consume up to 40 milligrams of aspartame per kilogram of their body weight, which would be equivalent to consuming up to 14 cans of diet soft drinks per day for someone weighing 70 kilograms.
Would it be safer to avoid all sweeteners?
The goal of using sweeteners in food and drinks is to help reduce sugar intake, as excessive sugar consumption is linked to various health issues such as weight gain, type 2 diabetes, and heart disease. However, the evidence supporting this strategy is mixed. Some short-term studies have shown that consuming drinks with sweeteners instead of full-sugar versions can lead to reduced weight gain in children, while others have shown no significant benefit. Population studies indicate that sweetener consumption is associated with higher rates of diabetes and heart disease, but this may be due to the fact that people who are already overweight are more likely to use sweeteners. The WHO states that using non-sugar sweeteners does not provide any long-term benefits in reducing body fat.
What about managing diabetes?
The WHO’s recommendations do not apply to individuals with diabetes, as the review did not include studies on this population. However, people with type 2 diabetes, who need to control their blood sugar levels, generally need to limit their sugar intake.
Are there other concerns about sweeteners?
Some research has suggested potential risks associated with specific types of sweeteners, based on small studies involving humans or animals. For example, it was found that saccharin and sucralose may raise blood sugar levels, and preliminary evidence suggests that a common polyol sweetener called erythritol may promote blood clots. However, these concerns were not included in the WHO’s review. Despite these findings, official health advice in most countries still recommends choosing artificial sweeteners over sugar.
Do experts agree on whether we should avoid sweeteners?
There is no consensus among researchers. While the WHO advises against the use of sweeteners, some experts believe that they still have their uses. They suggest that the WHO’s recommendation could have acknowledged the potential benefits of non-sugar sweeteners in supporting short-term weight loss when used appropriately.
Avoiding sweeteners completely may also be challenging, as many foods and drinks now contain sweeteners without being marketed as diet products. This is especially true in countries with “sugar taxes” that have prompted manufacturers to use more sweeteners. However, some experts argue that it is still better to choose a drink with less sugar and more sweeteners if consuming a soft drink, although water is considered the ideal choice.
What happens next?
While countries are not obligated to follow the WHO’s recommendations, the reports may influence national policies. Due to the uncertainties in the evidence, the WHO describes these recommendations as “conditional,” meaning that different countries may implement them differently. Some nations may choose to disregard the WHO guidelines entirely, which could lead to disagreements and debates.
