Artificial sweeteners are low- or no-calorie additives often found in sodas and other highly processed foods like yogurt, granola bars, cereal, or microwaveable meals (Bendix, 2022). They are also sold as “tabletop sweeteners” like Splenda and Sweet ‘N Low. Originally, such sweeteners were promoted as healthier replacements for sugar, which has been implicated as a promoter of obesity, diabetes, and other chronic diseases (Rippe, 2016). New research, however, adds to growing concerns that artificial sweeteners may have harmful effects on health.
In early September, the BMJ published a study in which French researchers identified a potential link between consumption of artificial sweeteners and heart disease (Debras et al., 2022). More than 100,000 French adults participated in the cohort study, which used surveys to assess participants’ dietary intakes and artificial sweetener consumption at different points in time (Debras et al., 2022). The research team defined a “large amount of sweetener” as around 77 milligrams per day, on average (Debras et al., 2022). The study’s results showed that participants who consumed high quantities of aspartame – found in diet soda, yogurt, and cereal – had a higher risk of stroke compared to people who didn’t consume the artificial sweetener (Debras et al., 2022). Similarly, people who consumed large amounts of sucralose – found in Splenda, canned fruit, and ice cream – had a higher risk of coronary heart disease compared to their counterparts (Debras et al., 2022). The study’s findings suggest a potential direct association between higher artificial sweetener consumption (especially aspartame and sucralose) and increased cardiovascular disease risk (Debras et al., 2022). In short, “artificial sweeteners may not be a safe alternative to sugar,” said Mathilde Touvier, the study’s author and a research director at the French National Institute for Health and Medical Research (Bendix, 2022). Previous research has linked artificial sweeteners to other health concerns as well, including diabetes, high blood pressure, obesity, and increased cancer risk (Purohit and Mishra, 2018; Azad et al., 2017; Debras et al., 2022).
Dr. Katie Page, an associate professor of medicine at the University of Southern California, noted that “the more data that comes out showing these adverse health effects, the less we’re going to want to encourage people to switch from added sugars to non-nutritive sweeteners” (Bendix, 2022). Still, she warned that opting for regular sugar isn’t the healthiest course of action. Instead, Page said that “we really need to encourage people to eat sugar in more moderation and try to decrease sugar consumption” (Bendix, 2022). The World Health Organization (WHO) recommends that adults and children reduce their daily intake of free sugars (such as glucose, fructose, and table sugar found in foods and drinks) to less than 10% of their total energy intake (WHO, 2015).
Artificial sweeteners are present in tens of thousands of food and drink products worldwide; the global market size was valued around $7.2 billion USD 2021, with a projected annual growth rate of 5% (Market Data Forecast, 2022). The European Food Safety Authority (EFSA), the United States Food and Drug Administration (USFDA), and other health authorities have set guidelines for the daily intake of artificial sweeteners, in addition to existing guidelines for sugar. The recent spate of research highlighting new concerns about the potentially adverse health effects of artificial sweeteners, however, may signal for re-evaluation by relevant health authorities (WHO, 2022).
References
Azad, Meghan B., Ahmed M. Abou-Setta, Bhupendrasinh F. Chauhan, Rasheda Rabbani, Justin Lys, Leslie Copstein, Amrinder Mann, et al. “Nonnutritive Sweeteners and Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies.” CMAJ 189, no. 28 (July 17, 2017): E929–39. https://doi.org/10.1503/cmaj.161390.
Bendix, Aria. “Spate of New Research Points to the Potential Harms of Artificial Sweeteners.” NBC News, September 8, 2022. https://www.nbcnews.com/health/health-news/artificial-sweeteners-health-risks-heart-disease-blood-sugar-rcna46717.
Debras, Charlotte, Eloi Chazelas, Bernard Srour, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaësse, et al. “Artificial Sweeteners and Cancer Risk: Results from the NutriNet-Santé Population-Based Cohort Study.” PLoS Medicine 19, no. 3 (March 2022): e1003950. https://doi.org/10.1371/journal.pmed.1003950.
Debras, Charlotte, Eloi Chazelas, Laury Sellem, Raphaël Porcher, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, et al. “Artificial Sweeteners and Risk of Cardiovascular Diseases: Results from the Prospective NutriNet-Santé Cohort.” BMJ 378 (September 7, 2022): e071204. https://doi.org/10.1136/bmj-2022-071204.
Market Data Forecast. “Artificial Sweetener Market Size, Growth, Share | 2022-2027.” Market Data Forecast, January 2022. http://www.marketdataforecast.com/.
Purohit, Vikas, and Sundeep Mishra. “The Truth about Artificial Sweeteners – Are They Good for Diabetics?” Indian Heart Journal 70, no. 1 (2018): 197–99. https://doi.org/10.1016/j.ihj.2018.01.020.
Rippe, James M., and Theodore J. Angelopoulos. “Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding.” Nutrients 8, no. 11 (November 4, 2016): 697. https://doi.org/10.3390/nu8110697.
World Health Organization. “WHO Calls on Countries to Reduce Sugars Intake among Adults and Children.” World Health Organization, March 4, 2015. https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children.
World Health Organization. “Health Effects of the Use of Non-Sugar Sweeteners: A Systematic Review and Meta-Analysis.” Geneva, April 12, 2022. https://www.who.int/publications-detail-redirect/9789240046429.