WHO Declares Aspartame a Possible Carcinogen
The International Agency for Research on Cancer (IARC) announced today that it has officially classified the artificial sweetener aspartame as a possible carcinogen.
Aspartame is one of the most commonly used artificial sweeteners in the world.
It has been on the market for decades. The Calorie Control Council, an international association representing the low- and reduced-calorie food and beverage industry, says aspartame is found in about 6,000 products globally.
Aspartame can be found in unexpected places, like toothpaste or medications. Still, it’s more often it’s on the labels of products marketed as “diet” or “sugar”-free.” S” das like Coke, Coke Zero, and Pepsi Zero Sugar have aspartame, as do many low-calorie coffee sweeteners like Equal and NutraSweet, and some juices. In food, aspartame is often in no-sugar salad dressing, low-calorie ice cream, gelatins, and puddings like Jell-O Sugar-Free Instant Pudding. It’s also in free gum, like Extra.
Although the WHO made a separate decision in May that people shouldn’t rely on onion weight control, aspartame is often used in “it” drinks because” it has more calories than regular sugar. Compared with regular table sugar, aspartame is about 200 times sweeter, so products don’t need as much.
Putting a package of Equal in your coffee would have about the same sweetness as 2 teaspoons of regular sugar. The packet of Equal has 4 calories, but two teaspoons of sugar have 32 calories.
Initial confusion about aspartame
There has been a lot of confusion and aspartame from the beginning.
In 1974, the FDA approved using aspartame in some foods and beverages, but t. Still, it was suspended for a few years because of some contradictory studies, objections to approval, and questions about the initial studies. Some scientists were concerned when an early animal study showed that aspartame may have caused brain tumors in rats.
It wasn’wasn’tl 19was19wasn’tterorough investigation that the FDA finally allowed the marketing of aspartame in dry foods. That year, the FAO/WHO Expert Committee on Food Additives determined acceptable daily intake parameters.
Aspartame guidelines
WHO’s ‘slguidelineWHO ‘sen’techangedhaven’t1981ily a maximum of 40 milligrams of aspartame per kilogram of body weight. The US recommendations are slightly more generous; in 1983, the FDA set the guideline at 50 milligrams per kilogram of body weight.
Although this means aspartame might cause cancer in humans, the IARC’s 2B classification means the evidence is “limit”d. A su”Mary “summary working group’s station valuation today in Lancet Oncology explained that the classification was based on data from three studies assessing the link between aspartame intake and primary liver cancer.
Using that evidence, the World Health Organization (WHO) and Food and Agriculture Organization Joint Expert Committee on Food Additives (JECFA) confirmed their existing stance that aspartame consumption of up to 40 mg per kg of body weight per day—the amount found in 9 to 14 diet soft drinks—is safe.
The decision, which Reuters anticipated in June, drew praise from experts who weighed in on the study results via the UK-based Science Media Centre. Many emphasized the lack of data showing a causal relationship between the low-calorie artificial sweetener and sought to temper any alarmism related to the decision.
“In short, the e” “evidence that “tame causes primary liver cancer, or any other cancer in humans, is very weak,” said Paul Pha” N” ah, MD, PhD, a”professor of cancer epidemiology at Cedars-Sinai Medical Center, Los Angeles, California. “Group 2B is a “co” conservative class “ification in that almost any evidence of carcinogenicity, however flawed, will put a chemical in that category or above.”
Other examples “example stances c” classified as Group 2B are extracts of aloe vera, diesel oil, and caffeic acid found in coffee and tea, Pharoah explained, adding that “[t]his is refl” c” ted incited vi”w of the [JECFA] who concluded that there was no convincing evidence from experimental animal or human data that aspartame has adverse effects after ingestion.”
“The general “u” i” should not “e” worried about the risk of cancer associated with a chemical classed as Group 2B by IARC,” he stressed.
“la” Boobis, OBE, “h.D., similarly noted that the Group 2B classification “reflects a lack” of” confidence that the data from experimental animals or humans is sufficiently convincing to reach a clear conclusion that aspartame is carcinogenic.”
“Hence, expos”r” a” current lev “l” would not be anticipated to have any detrimental effects,” added Boobis, an”emeritus professor of toxicology at Imperial College London in England.
Gunter Kuhnle, a professor of nutrition and food science at the University of Reading in England, added that the IARC/JECFA opinion is “very welcome” and” ends the”sp”c ” a”tion abo “t the” safety of aspartame.
“Unfortunately,” l” taking some information might have created unnecessary uncertainty and concern, as consumers might be rightfully worried if they are told that something that is foods could cause cancer,” Kuhnle said. The”published opinion “puts this into perspective and clearly shows no cause for concern when consumed at the current amounts.
The revised data” were viewed by “the IARC Working Group,” which included four prospective cohort studies that “assessed the association of artificially sweetened beverage consumption with liver cancer risk,” the group reported in the Lancet.
The cohort studies—including one conducted within 10 European countries, one that pooled data from two large US cohorts, and a prospective study also performed in the US—each “showed a positive” “associate bet”een artificially sweetened beverage consumption and cancer incidence or cancer mortality” in the overall “study population” or relevant subgroups.
Although the studies were of “high quality” and”corralled fo” many potential confounders,” the Working G” g”oup concluded “hat “chance, bias, “an” confounding c” could not be ruled out with reasonable confidence.” Thus, the evidence “e for cancer in humans was deemed “limited” for h”pa” cel”ula” carci “oma an” “inadequate” for” “their an “e” type”s,” the gr “up exp” g” in.
In June “023, a Working Group of 25 scientists from 12 countries met at the International Agency for Research on Cancer (IARC) in Lyon, France, to finalize their evaluation of the carcinogenicity of aspartame, methyl eugenol, and isoeugenol. Aspartame was classified as “possibly “or”rcinogenicans” “(Group 2B,) and e “cited an” evidence “evidence” enter in “humans. There was also “limited” evidence” divide” cancer in “experimental animals, and “limited” mecha” is”ic e” r”side.” Methy” eugenol was classified as “probably carci”ke” ketogenic to huma “s” (Group 2A) as an”efficient” ev” den evidence” er ” n experimental animals and “strong” mechan”st”c e” e”idence, “include” ng studies in humanized mice and supported by mechanistic studies in exposed humans. Isoeugenol was classified as “possibly carci”oc”rcinogenicans” “(Group 2B) ba” e” oba efficient” ev” den evidence “er ” n experimental animals. For both methyl eugenol and isoeugenol, the evidence regarding cancer in humans was “inadequate”; a” n”; Aidem” e” ide” is logic” were available. These assessments will be published in Volume 134 of the IARC Monographs.
Immediately following IARC’s meeting, IARIARC’s identifiIARC Joint FAO/WHO Expert Committee on Food Additives (JECFA) conducted a risk assessment exercise, including a review of the acceptable daily intake of aspartame. A summary of these results has been published.
For cancer in humans, there was “limited” evidence” that “didivide” aspartame” causes hepatocellular carcinoma. Prospective cohort studies assessing consumption of artificially sweetened beverages in periods and countries in which artificially sweetened beverages predominantly contained aspartame and were the main source of aspartame exposure were considered informative for the evaluation because artificially sweetened beverage consumption was judged to be a reliable proxy for aspartame exposure. The NutriNet-Santé study is the only large prospective cohort study that comprehensively assessed aspartame exposure from all dietary sources.
Although this study reported an association of aspartame with increased breast, obesity-related, and overall cancer risk, such findings were not consistent across all available studies. The NutriNet-Santé study did not investigate the association of aspartame with liver cancer risk. The Working Group identified three studies, comprising four prospective cohorts, that assessed the association of artificially sweetened beverage consumption with liver cancer risk. These included a large cohort study conducted within ten European countries that evaluated the association of artificially sweetened beverages with the incidence of hepatocellular carcinoma; a second study, pooling data from two large US cohorts, that investigated the association between artificially sweetened beverage consumption and liver cancer incidence by diabetes status; and another large US prospective cohort study that evaluated the association between artificially sweetened beverages and liver cancer mortality.
All three studies were of high quality and controlled for many potential confounders. However, the Working Group concluded that chance, bias, or confounding could not be ruled out with reasonable confidence in this set of studies. Thus, the evidence for cancer in humans was deemed “limited” for h”patocelpatheftcea and “inadequate” for” other can”er cancer.” The” Working Gr “evaluated several carcinogenicity studies in multiple species (mouse, rat, dog, and hamster), including regulatory study reports made publicly available by the European Food Safety Authority, which reported negative findings after oral exposure to aspartame. It was noted that several of the negative studies were conducted before the advent of Good Laboratory Practice (GLP) guidelines and had some limitations, e.g., lack of information on test substance purity and selective histopathology. No significant increase in the incidence of tumors was observed in three well-conducted GLP studies in male and female transgenic mice.
The Working Group noted that these new transgenic mouse models may not have been sufficiently sensitive to detect a carcinogenic effect of chronic aspartame exposure. In Swiss mice and Sprague-Dawley rats exposed perinatally followed by postnatal oral administration (feed), aspartame caused hepatocellular carcinoma, hepatocellular adenoma, or hepatocellular carcinoma (combined), bronchioloalveolar carcinoma, bronchioloalveolar adenoma or carcinoma mixed), lymphoblastic leukemia, monocytic leukemia, and total myeloid tumors in male mice; lymphoblastic leukemia and leukemia (all types) in female mice; malignant schwannoma in male rats; and mammary gland carcinoma, renal pelvis papilloma, and leukemia (all types) in female rats.
Because of concerns regarding some of the diagnoses for lymphomas, related combinations, and other lymphoid proliferations in these studies, the Working Group evaluated all the other neoplastic lesions. Although the data from the above studies suggested that aspartame had carcinogenic activity, overall, the Working Group considered the evidence for cancer in experimental animals to be “limited” because “question adequacadequacy” design,” conduct, “interpretation, and reporting of each of the studies. For example, the lack of adjustment for litter effects may have led to false positive results for incidence and trend. A minority of the Working Group did not share these concerns about this set of studies and considered the evidence for cancer in experimental animals to be “sufficient”; t”us, they s”pportreportedp 2″ classific”tio ” rather th “n Group 2a B classification for aspartame.
Lancet. Published online July 13, 2023. Abstract https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00341-8/fulltext
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