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Weaknesses of “Artificial sweeteners and cancer risk: Results from the NutriNet-Sante’ ‎population-based cohort study”

March 24, 2022

The study entitled, “Artificial Sweeteners and Cancer Risk: Results from the NutriNet-Sante´ Population-Based Cohort ‎Study,” attempted to evaluate any association between low- and no-calorie sweetener (LNCS) intake and cancer risk. However, the reported findings of this study are in contradiction to the totality of evidence and the numerous global health organizations who have regarded each of the named sweeteners as safe, following rigorous assessments.  

Despite its longitudinal design and large sample size, the current study has several weaknesses. Self-reported intake data subjects the study to recall bias, misreporting and under-reporting. Further, given the observational nature of this study design, causal links cannot be established and the likelihood of residual confounding bias must be considered when interpreting ‎these results.‎ Lastly, the results of this study cannot and should not be extrapolated to the general population, as ‎those who volunteer to participate in such research activities often exhibit unique ‎characteristics (i.e., lifestyle and socioeconomic factors, etc.) not typical of the broader ‎population. ‎All of these considerations significantly limit the strength of the reported findings.

In conclusion, CCC emphasizes LNCS remain safe and effective tools in weight management, sugar reduction and blood glucose management.

For more information on the safety of low- and no- calorie sweeteners, review the frequently asked questions below:

Is there any evidence that low- and no-calorie sweeteners cause cancer?
The overall body of scientific evidence regarding low-and no-calorie sweeteners (LNCS) does not support an association between consumption and cancer risk. Global scientific authorities and food safety agencies have assessed the totality of available evidence and have concluded that each of the approved sweeteners are safe.
Is aspartame safe?
Regulatory agencies in more than 100 countries have all affirmed aspartame’s safety. The scientific evidence overwhelmingly supports the safety of aspartame even in amounts far greater than people typically consume.

With more than 200 studies attesting to its safety, aspartame is one of the most researched food additives in the world and has a long history of safe use. A thorough review of the research by The European Food Safety Authority released in 2013 concluded that aspartame is safe for the general population including infants, children and pregnant women. Scientists from the U.S. Food & Drug Administration (FDA) have also reviewed the scientific data regarding the safety of aspartame in food and concluded that it is safe for the general population. According to the U.S. Department of Agriculture, aspartame is one of the most exhaustively studied substances in the human food supply.

Since aspartame contains phenylalanine, aspartame is not recommended for individuals with phenylketonuria (PKU), a rare hereditary disease, who have difficulty in metabolizing phenylalanine.

In 2012 Academy of Nutrition and Dietetics (AND) stated, “Consumers can safely enjoy a range of nutritive sweeteners and nonnutritive sweeteners (NNS) when consumed within an eating plan that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans and the Dietary Reference Intakes, as well as individual health goals and personal preference.” In reference to any adverse effects aspartame related to aspartame consumption, AND concluded, “Aspartame consumption is not associated with adverse effects in the general population.”

Does Ace-K cause cancer?
No. All substances that are intended to be added to food must undergo extensive tests to ensure their safety. At the center of these studies are tests to determine whether the substances have any carcinogenic or cancer-promoting effect. Only substances not suspected of having such an effect are approved for use in food by the relevant agencies.
What are some of the lifestyle and socioeconomic factors that make this study inapplicable to the general population?
In general, individuals who participate in volunteer-based cohorts tend to be women, have higher educational and socio-professional levels, and tend to exhibit more health-conscious lifestyle behaviors.
What is residual confounding bias, and why does it apply to the results of this study?
“Residual confounding” is a term that refers to the relationship between exposure (in this case, LNCS consumption) and an outcome (i.e., cancer risk). Whereas typically, exposure proceeds an outcome, in some cases, this is reversed. In observational studies, conclusions regarding causality are not possible.
Why should I use an low or no-calorie sweetener instead of regular sugar?
Low-calorie products provide consumers with many benefits. Whether by choice or necessity, millions of Americans restrict their intake of calories, carbohydrates and fats. According to opinion research, most people consume low-calorie products to stay in better overall health, eat or drink healthier foods and beverages, maintain weight, reduce weight or maintain an attractive physical appearance. Most people use low-calorie products as part of an overall healthy lifestyle. Research also shows that health professionals believe low-calorie sweeteners are especially beneficial to obese individuals and those with diabetes. Low-calorie sweeteners also do not promote dental cavities.

For more aspartame FAQs, click here.

For more Ace-K FAQs, click here.

faq2Do you have questions about low-calorie sweeteners? Want to learn more about maintaining a healthy lifestyle? You asked and we listened. Our resident Registered Dietitians answered the most popular questions about low-calorie sweeteners.

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