2023-07-14 00:30:00
A woman holds several cubes of sugar in one hand and pills of an artificial sweetener in the other. Antonio Guillem (Getty Images/iStockphoto)
The sweetener aspartame is at the center of the debate. The International Agency for Research on Cancer (IARC) The World Health Organization (WHO) has just classified it as a “possibly carcinogenic” for humans and, although it admits that the scientific evidence is “limited” on its carcinogenic potential, there are indications of its ability to cause harm. The Joint FAO/WHO Expert Committee on Food Additives (JECFA), which is in charge of establishing these risks on the population and establishing an acceptable daily intake dose, maintains, however, the established maximum consumption thresholds: 40 milligrams per kilo of weight per day. Here we answer the main questions about where aspartame now stands and its potential to cause cancer.
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What is aspartame?
It is an artificial sweetener up to 200 times sweeter than sugar. It is made up of three components: a methanol molecule and two amino acids, which are phenylalanine and aspartic acid.
Where can it be found?
On thousands of products. It is used as a table sweetener or to sweeten low-calorie soft drinks, chewing gum, jellies, breakfast cereals, yogurt, ice cream, toothpaste, or in some drugs. A 100-milligram chewable tablet of Viagra, for example, barely has 8.6 aspartame, biodramine gum contains three milligrams, and an ibuprofen sachet contains about 30. A bottle of diet soda, on the other hand, can have about 200 or 300 milligrams, according to WHO experts.
What has the WHO announced?
At IARC, The WHO body that is in charge of identifying the carcinogenic potential of substances has concluded, after studying the available scientific evidence, that this sweetener is “possibly carcinogenic” to humans. On the IARC hazard identification scale, aspartame would be at a level 2B. This implies there is limited, but not conclusive, evidence for cancer in humans or convincing evidence for cancer in experimental animals, but not both. Or it may also be that only the evidence on the mechanisms of action of this agent to cause cancer is robust. In this case, the IARC found limited evidence in the three streams of study (humans, experimental animals, and mechanistic evidence), but it did see indications that invite raising a red flag.
For its part, JECFA, which is in charge of evaluating the risks to determine the probability that, under certain conditions and levels of exposure, damage to health (cancer) will occur, also reviewed the available scientific literature and concluded that no there is reason to reduce the permissible daily intake of aspartame that was established: 40 milligrams per kilo of weight per day.
What harm can aspartame do to health?
The WHO experts found data that associated the consumption of beverages containing this sweetener with a type of liver cancer, but these studies had many limitations. Other reviewed research pointed to a relationship between the intake of this substance with hepatocellular, breast and some hematological tumors, but also in this case limitations were found on how exposure to aspartame was measured and it was concluded that it could not “demonstrate an association consistent”. Francesco Branca, director of the Department of Nutrition and Food Safety of the WHO, admitted, on the other hand, that another reported effect was a relationship with cardiovascular diseases, but pointed out: “Once again, these are associations that are difficult to interpret. We have not clearly identified a possible mechanism of action.” Another association was with type 2 diabetes, but this was a single study in a single country and the results were not considered “convincing” by the JEFCA experts.
What does the WHO assessment entail?
IARC’s role is to identify hazards, not to assess risk in a given context. Aspartame is on the same level than lead or the exhaust of a gasoline engine. That is, the scientific evidence on its potential to cause cancer is similar, but that does not imply that the risk is the same. Since this classification does not indicate the degree of risk of developing cancer at a given level or route of exposure, “the risk of cancer (at typical exposure levels) associated with two agents classified in the same IARC Group may be very different,” he warns. the body of the WHO. Thus, tobacco and processed meat, for example, are at the highest level of the scale —they are “carcinogenic”—, but the real risk from their regular exposure is not the same.
The head of IARC Monographic Programs, Mary Schubauer-Berigan, specified that this scientific review and the classification of this substance as a possible carcinogen can serve as “a call to the research community to try to clarify and better understand the carcinogenic danger that can or not represent the consumption of aspartame”. Regarding the specific risk to citizens, JECFA concluded that, precisely because of this lack of consistency in the results of the studies, it was going to maintain the recommendation of the permissible daily intake that has been in force since the eighties: 40 milligrams per kilo of weight. up to date.
What does an intake of 40 milligrams per kilo of weight per day mean?
WHO experts consider this threshold already high. And they give an example: if an adult weighs 70 kilos, their acceptable daily intake of aspartame would be about 2,800 milligrams; and if the presence of this sweetener in a common soft drink is between 200 or 300 milligrams a day, this means that this adult, if he does not ingest the sweetener from any other food source, will have to consume between nine and 14 cans of soft drinks per day. day to exceed the threshold recommended by JECFA.
Do I have to worry if I take aspartame?
No, as long as the daily intake is within the limits recommended by the health authorities. In this case, 40 milligrams per kilo of weight per day, which is an amount, according to experts, difficult to exceed in a normal diet. Speaking to the Science Media Centre, Alan Barclay, nutritionist and honorary associate at the University of Sydney (Australia), said that the average Australian “consume less than 10% of the acceptable daily intake and even the largest consumers consume less than 25% “. . For his part, Gunter Kuhnle, Professor of Nutrition and Food Science at the University of Reading (United Kingdom), also insisted that “there is no cause for concern when consumed in current amounts” and stressed the importance of distinguishing between danger and risk: “Sunlight is a danger, since it can cause cancer, but the risk depends on the amount of sunlight and whether we use protection.”
Do the WHO conclusions have repercussions for citizens?
In practice, there is no change in the consumption recommendations for citizens. But the WHO experts have taken advantage of the publication of their results to remind consumers that moderate the intake of artificial sweeteners. Especially now that the use of these substances is on the rise to avoid sugar. The researchers emphasized the protection of minors, so that they do not get used to the intake of these substances and clarified that, although there is no safety problem for occasional consumers of this sweetener, people who border on or exceed the intake recommended daily intake, you should moderate your intake.
Is aspartame the first additive to be analyzed by the WHO?
No. The IARC specifies that, since it was launched, more than half a century ago, it has already analyzed around 70 food additives. Among them, other sweeteners, such as saccharin or cyclamate, both classified at level 3, the last in the classification and which indicates that there is no evidence that they are carcinogenic to humans.
That aspartame has now been studied is explained by the fact that it was so recommended by the independent advisory group of international experts that makes recommendations on which agents suspected of causing cancer should be evaluated by IARC. According to the WHO body, “The evaluation of agents is recommended when there is evidence that people may be exposed and when there is also available scientific evidence that can lead to a determination of carcinogenicity.” In the case of aspartame, the advisory group listed it in 2019 as a “high priority” agent to test.
What is the best alternative to avoid aspartame?
Experts recommend completely reducing sweeteners in products or, failing that, consume foods that have other forms of sweet taste, such as fruit, which can be used as a dessert instead of other products that have added sugars or sweeteners.
In both adults and children, the WHO recommends reducing the consumption of free sugars (refined sugars and those naturally present in juices, honey or syrups) to less than 10% of total energy intake. In addition, it suggests that sweeteners not be used to try to control weight or reduce disease because evidence suggests that “their use does not help control weight long-term and may increase the risk of type 2 diabetes, cardiovascular disease, and premature mortality.”
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