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The author is a science commentator.
There may be concerning news about diet drinks soon. The International Agency for Research on Cancer (IARC), a research branch of the World Health Organization (WHO), is expected to classify aspartame, an artificial sweetener commonly used in low-calorie drinks and 200 times sweeter than sugar, as “possibly carcinogenic to humans”.
On the same day, another WHO committee will assess the risk the additive poses to human health. The intention of these announcements is to resolve decades of scientific controversy, but they might only create confusion regarding the safety of artificial sweeteners. The food and drinks industry, known for downplaying risks associated with its products, would likely welcome any lingering uncertainty among the public.
It may seem counter-intuitive, but a substance can be both a possible carcinogen and pose a low risk to health. The IARC’s role is to establish the potential hazard, focusing solely on identifying substances that might induce tumors. This assessment relies on three types of data: studies on humans, studies on animal exposure, and analysis of the physical mechanisms by which a substance acts.
Based on this data, substances are classified into four categories: carcinogenic, probably carcinogenic, possibly carcinogenic, or not classifiable. Reuters has reported that aspartame will be categorized as “possibly carcinogenic,” placing it in the same category as gasoline and aloe vera extract. The official announcement is scheduled for July 14, along with a paper in Lancet Oncology.
However, the IARC’s pronouncement is not the most critical one. The determination of whether a hazard becomes a health risk depends on factors such as exposure, dosage, and preventive measures. The second WHO-affiliated committee, responsible for evaluating food additives, plays a crucial role in this regard. Their statements on acceptable daily intake and dietary exposure will be the ones to watch.
In 1981, this committee previously assessed aspartame, also known as E951, and set the acceptable consumption limit at 40mg per kg of body weight per day. This limit translates to approximately 12 cans of Diet Coke per day for a 60kg person. The limit provided reassurance to food safety agencies in the US, UK, and EU. However, doubts have arisen since then, partly due to observational studies indicating slightly higher cancer rates among consumers of artificial sweeteners, including aspartame.
Observational studies can only establish associations, not cause and effect, and other factors might be involved. There is also the possibility of “reverse causality,” where individuals who are already at a higher risk of cancer, such as those who are obese, are more likely to choose artificial sweeteners. The wide variety of non-sugar sweeteners, such as sucralose, saccharin, and stevia, further complicates the interpretation of scientific studies.
Animal studies can provide additional evidence. More than a decade ago, Italy’s non-profit Ramazzini Institute reported that rats fed with aspartame developed tumors in a dose-related manner. However, it is important to note that rats are not humans. Both Cancer Research UK and the UK’s Food Standards Agency maintain that aspartame is safe for consumption.
Nevertheless, the IARC conducted its latest re-evaluation as a high priority due to the emerging evidence of cancer in humans and laboratory animals. The International Sweeteners Association criticized the IARC, emphasizing that it is not a food safety body and that aspartame has been extensively researched.
These criticisms skillfully avoid the inconvenient truth that evidence can change, and non-sugar sweeteners, including aspartame, may not be as healthy as many consumers believe. In May, the WHO recommended that non-diabetics avoid non-sugar sweeteners due to evidence suggesting they do not reduce body fat and may be linked to an increased risk of type 2 diabetes, cardiovascular disease, and death. The WHO advocates for a less sweet diet overall.
Furthermore, these additives are common in ultra-processed foods, which have been associated with obesity and health issues by experts such as Dr. Chris van Tulleken. By reducing consumption of sweeteners, there is little to lose and potentially much to gain in terms of health.
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