Artificial Sweeteners: Good for Weight Loss but Possible Increased Cancer Risk

J. L. Sievenpiper, MD, PhD of St. Michaels Hospital in Toronto, Canada and his associates published a review article in the Journal of the American Medical Association Network Open which looked at 17 controlled studies aimed at showing that using artificial sweeteners led to loss of weight, lower Body Mass Index (BMI) and reduction in cardiovascular risk factors. One week later, Charlotte Debras, a PhD candidate at the Sorbonne, and her colleagues published in PLoS Medicine a study showing that several of these products result in an increased risk of cancer. They noted that aspartame and acesulfame potassium carried the increased risk while sucralose did not.

Consumption of certain artificial sweeteners caused a 13% increased risk for developing obesity-related malignancies including colorectal, stomach, oral, liver, esophageal, breast, ovarian and prostate cancers. A 15% higher risk of obesity-related cancers was seen for aspartame alone and a 22% increased risk for breast cancer. They then looked at those consuming low doses of these sweeteners. They still faced a higher risk of cancers. Sucralose products did not carry a higher cancer risk at any dosage.

The message is clear. If you must consume artificial sweeteners, Sucralose is the best choice. Sucralose is used in Splenda and NutraSweet. The authors, from Paris, made it clear that they hoped a larger study of this issue would be undertaken to confirm their findings.

Artificial Sweeteners and Your Health

An article published in the online version of Primary Care brings up the issue of whether artificial sweeteners are a positive, helping people lose weight, or is there more to the story. Editor David Rakel MD, FAAFP discusses a recent article in the neurologic journal STROKE showing an association between the number of artificially sweetened beverages consumed per day and the onset of a stroke. This relationship was seen only with artificially sweetened beverages not with sugar sweetened beverages.

Dr Rakel goes on to discuss the ongoing public health concern of consuming nonnutritive sweeteners and its effects on weight gain and insulin resistance. Recent studies known as observational studies have linked high consumption of beverages with nonnutritive sweeteners with weight gain, increased visceral adiposity and a 22 % higher incidence of diabetes despite consuming less energy.

The reasons for consuming fewer calories but gaining weight are considered to be many. Sweet tasting compounds including NNS activate sweet “taste receptors” that were once thought to be only located in the mouth but are now known to be throughout the body. This activation results in release of insulin. The continued release of insulin by the pancreas, without energy producing calories present to be metabolized, may lead to insulin resistance. Insulin resistance involves insulin being released in response to food being consumed but is becoming ineffective in moving sugar into the cell where it can be metabolized into energy.

There is additional belief that supplying sweetness without calories may result in disturbances to appetite regulation and communication within the body about when we are full. Products such as aspartame, saccharin and sucralose have been found to have negative effect on the intestinal bacteria or microbiome potentially having an effect on glucose tolerance and metabolism.

We see artificial sweeteners on tables in every setting. Aspartame produces a sweetening effect 200x sugar. Saccharin produces a sweetening effect 500x sugar. Sucralose is 600x sugar sweetening and Advantame 20,000x sweeter.

A teaspoon of sugar only contains 16 calories. Portion control of products made with real sugar may be the safest and healthiest way to eat sweets as the holiday season approaches. A level teaspoon of sugar in your coffee or tea may be far healthier for you than that packet of artificial sweetener.