Concern on artificial sweeteners: A wolf in sheep’s clothing?

(Conclusion)

Medical experts like Dr. David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia, and Dr. Hannah Gardener, researcher from the University of Miami in Florida, have expressed grave concern about the potential long-term harm of artificial sweeteners contained in diet sodas and other common drinks and foods.

Many doctors and patients alike have the impression that artificial sweeteners are an ideal alternative to sugar since they impart a sweet taste to drinks and foods with a negligible number of calories. The sweetening effect of artificial sweeteners is really much more than sugar, such that only 30 milligram of aspartame would already have the sweet taste obtained with 5 grams (5,000 mg) of sugar.

It’s therefore common practice that overweight individuals and diabetic patients replace sugar with these high-intensity sweeteners to avoid raising their blood sugar or gaining more calories that add to their weight. Ingesting these sweeteners intermittently or on a short-term basis does not appear to pose any serious harm, but based on the results of observational studies, long-term regular intake of drinks and foods containing artificial sweeteners has been linked to cardiovascular events or complications including strokes. A few papers link them to cancer such as lymphomas.

Circumstantial evidence

What is to be emphasized though is that these are just observational studies, which only shows an association, but not a conclusive causal relationship between artificial sweeteners and strokes. Lawyers would probably label it as circumstantial evidence, which may not be strong enough to implicate artificial sweeteners.

But as they say, if there’s smoke, there could be fire. Researchers should do well-designed prospective clinical trials powered enough either to determine (rule in) or to rule out a causal relationship between artificial sweeteners and cardiovascular complications. But again, the big question is—who will fund this research?

With the strong lobby of industries raking in huge money from various drink and food products using artificial sweeteners, such a research is likely not going to happen. Not unless the government regulators (food and drug administration and other regulatory agencies) would show a strong political will and require the manufacturers to conduct a clinical trial showing safety of long-term usage of these artificial sweeteners.

No conclusive risks

A few years ago, the Agence Nationale de Sécurité Sanitaire (Anses) in France convened a working group which evaluated all available scientific evidences to determine the benefits and nutritional risks of high-intensity sweeteners. The Anses study showed no conclusive risks of using high-intensity sweeteners, but it also reported that there was no remarkable health benefit from consuming them. More properly designed studies are still needed to see if artificial sweeteners are a boon or a bane.

Meanwhile, it would be wise to exercise moderation in drinking diet sodas and juices, or eating low-calorie cookies and food products that contain artificial sweeteners. We should disabuse our minds of the belief that they are part of a healthy diet. The good old natural way of limiting our caloric intake and exercising regularly remain the mainstay of a truly-healthy-lifestyle practice.