It’s a feud that has been brewing for decades.
Fueled by studies showing that sweeteners may be linked to some cancers, anxiety and cardiovascular disease, some experts have sounded the alarm about their use.
But the alternative, sugar, poses a risk of type 2 diabetes, heart disease and stroke in addition to weight gain and tooth decay.
The debate was revived yesterday after a shocking report revealed that the artificial sweetener aspartame would be listed as a potential human cancer risk by the World Health Organization (WHO) in the coming weeks.
WHO’s subordinate body, the International Agency for Research on Cancer (IARC), is expected to rule that it is ‘possibly carcinogenic to humans’.
The sugar alternative is used in a variety of soft drinks, including Diet Coke and Dr Pepper, as well as some juices, yogurt, and even certain over-the-counter medications.
But is artificial sweetener really worse than consuming sugar? MailOnline asked the experts.
Fueled by studies showing that sweeteners may be linked to some cancers, chronic anxiety and cardiovascular disease, some experts have sounded the alarm about their use. But sugar, in addition to weight gain and tooth decay, also puts you at risk for type 2 diabetes, heart disease and stroke
Aspartame, an artificial sweetener used in products such as Diet Coke, could be classified as a ‘possibly carcinogenic to humans’ by the WHO. The sugar alternative is used in a variety of soft drinks, including Diet Coke and Dr Pepper, as well as some juices, yogurt, and even certain over-the-counter medications
‘The main advantage of sweeteners is that they are non-caloric and therefore can provide a sweet taste without sugar,’ Professor Gunter Kuhnle, professor of food and nutrition science at the University of Reading, told MailOnline.
“They make it possible to provide a source of sweetness that does not affect blood sugar levels and is therefore important for people with diabetes.”
“Whether there are any harms to using sweeteners is a tricky question: the effect on health has been very carefully assessed by various regulatory bodies and these assessments have found no evidence of an adverse health effect at the permitted levels.”
He added: ‘That doesn’t necessarily mean they’re unsafe at higher levels – it could very well be that there’s just no data to prove safety or harm.
‘In that respect, there is therefore no concern about its use.
“Whether they have an effect on the microbiome and whether this effect is detrimental or not has been debated in the past, but there is currently not enough data to suggest a problem.”
However, sweeteners are unable to replace the “functionality of sugar,” including the preservation of some foods such as jam or cake, or the texture and feel in the mouth, he noted.
“As far as I know, there is no risk involved as long as it is used within recommended amounts,” he added.
Current recommendations for safe daily consumption of aspartame are 50mg per kg of body weight in the US and 40mg per kg of body weight in the UK.
This brings the UK recommendation to about 2800mg for a 70kg adult.
Given that the average can of Diet Coke contains 180 mg of real aspartame, the British Dietetic Association outlines how an adult would need to consume 15 cans a day before being at risk of health consequences from the sweetener.
However, Professor Kuhnle noted that ‘aspartame contains phenylalanine’, making it unsuitable for people with phenolic ketonoria – a rare but potentially serious condition in which the body is unable to break down proteins.
According to the International Sweeteners Association, zero- and low-calorie sweetened foods have been associated with improved nutritional quality, are helpful in reducing calorie intake, and are “tooth-friendly ingredients” because they do not promote tooth decay.
Evidence from some short-term trials of drinks sweetened with zero-calorie sweeteners show that when consumed in place of sugary drinks, they may help lower energy intake and weight gain.
Public health organizations around the world have also largely accepted the benefits of sweeteners.
‘Sweeteners that do not raise blood glucose can be used as part of a healthy diet for diabetes,’ says the NHS.
This is because they do not affect blood glucose levels.
All sweeteners in the UK undergo a rigorous safety assessment before they can be used in food and drink, the NHS also advises.
Public health organizations around the world have also largely accepted the benefits of sweeteners. ‘Sweeteners that don’t raise blood glucose can be used as part of a healthy diet for diabetes,’ says the NHS
All approved sweeteners are considered a safe and acceptable alternative to using sugar.
The law determines how much sweetener may be used and in which products.
However, other experts are more concerned about the effects of aspartame.
But Professor Erik Millstone, a science policy expert at the University of Sussex who has been studying the effects of sweeteners on human health for nearly 40 years, told MailOnline: ‘There is evidence available to show that we cannot be sure are that aspartame is safe. since the mid-eighties.
‘Reliable evidence that it can cause cancer in laboratory animals emerged in 2005 and has since become stronger.’
He added: “It is sad that several major food and beverage companies and their trade associations have tried to discredit IARC.
“They attack the messenger because he delivered a message that they do not welcome.
“IARC is more reliable than almost all other official agencies because it excludes individuals with commercial conflicts of interest, while many governments do not.”
A 2017 study published in the Canadian Medical Association Journal examined a decade of data from more than 400,000 people and found that those who drank one or more artificially sweetened beverages per day had a significantly higher risk of weight gain and obesity, and related diseases such as type 2 diabetes.
And in 2018, a study from George Washington University reported that sucralose increases levels of a protein called GLUT4 that promotes the accumulation of fat in our cells.
These changes are associated with an increased risk of obesity, the scientists said.
After the soft drinks industry levy was launched in the UK in 2018 – as part of plans to tackle childhood obesity – the tax was manufacturers charge 24p per liter for any drink containing 8g or more of added sugar per 100ml.
Almost all of the UK’s major soft drink brands have reduced the sugar content of their products and replaced the missing sweetness with an artificial alternative.
Dr. However, Vicky Sibson, a public health nutritionist and director of the First Steps Nutrition Trust charity, warned of the dangers of sweeteners in children’s diets.
She told MailOnline the more children consume sweeteners, the more they develop a sweet palate and crave sweets in all its forms, with or without sugar.
She said: ‘Sugar-containing foods and drinks cause tooth decay, which is a major public health problem, and cause excessive energy intake and weight gain.
“But an important reason to avoid both artificially sweetened and sugary foods and drinks – as many products contain a cocktail – is that taste preferences form in the early years and we don’t want to stimulate a sweet palate.”
She added, “This can mean a lifelong preference for sweet foods. With that in mind, it’s important to note how much sweeter artificial sweeteners are than sugar.”
A recent report co-authored by Dr. Sibson also includes a list of recommendations for artificial sweeteners and infant formulas.
‘Public Health England should explicitly discourage the addition of sweeteners as part of product reformulation under the Childhood Obesity Action Plan, and the use of sweeteners should be monitored and reported,’ read one.
A second also noted, “Public health posts should not promote artificially sweetened foods and drinks as “healthy” options.
“Messages should actively encourage minimal consumption of all sweet products, especially in young children, to prevent a sweet palate from developing.”
Meanwhile, Dr Duane Mellor, a registered dietitian and senior lecturer at Aston University, told MailOnline: ‘Non-sugar sweeteners could have a place in providing an option for a low-sugar alternative in beverages and foods.’
But “it should perhaps be clearer that they are not necessarily biologically inert,” he added.
‘There is some evidence that some sweeteners such as aspartame and sucralose have an effect on our gut microbiome and this may affect their ability to metabolize glucose – blood sugar – in some people.
“Sweeteners are lower in calories than sugar, although without other dietary changes it probably won’t help people lose weight,” he said.