By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
Cancer is rampant in my family. Particularly in my parents’ and grandparents’ generations. All four of my grandparents had cancer. My Dad is a cancer survivor, and my Mom passed away from cancer. Every single one of my aunts and uncles on my Dad’s side are either cancer survivors or died of cancer.
Knowing my family history means whenever something hits the news as a cancer risk, my radar automatically goes off. And it certainly did that with aspartame this past week when the World Health Organization declared aspartame as “possibly carcinogenic to humans.”
There is so much controversy regarding artificial sweeteners, and this declaration certainly doesn’t make the choice to use or not to use them any easier. Because while they have found a possible link, what they aren’t doing is changing the guidelines on use. It very much reminds me of the old warning on the pink saccharine packages, “Use of this product may be hazardous to your health. This product contains saccharin which has been determined to cause cancer in laboratory animals.” That warning was removed in 2000 because researchers found that the doses that caused cancer in the lab animals was equivalent to a human drinking about 800 saccharine containing diet sodas a day. While there still is a possible link, it’s just that, it’s possible. But it’s not probable at those quantities.
Aspartame is one of the most widely used artificial sweeteners. It’s found in thousands of products like diet sodas, “zero sugar” foods, and sugar free gum. It’s the blue packet wherever you purchase beverages that might need sweetening. It is also one of the most studied food additives in existence and has been found to be safe for human consumption under certain guidelines. It has been so studied in fact, that the US Food and Drug Administration (FDA) issued a statement that disagreed with the WHO finding, which in my experience is very unusual. Even the WHO admits their research is not conclusive and recommended that it’s guidelines for use of aspartame not change.
The WHO based its conclusions on research done by the International Agency for Research on Cancer (IARC), a branch of the WHO that does hazards assessments on chemicals, viruses, and food additives to determine if they can cause cancer.
The main two studies that led to the “possible carcinogenic” statement were a study from 2022 in France that looked at 100,000 adults who consumed food or beverages with artificial sweeteners versus sugar and found those who consumed “a lot” of artificial sweeteners had a slightly higher cancer risk than those who consumed fewer artificial sweeteners. But that study had several limitations such as not eliminating other cancer risk factors and relying on the study subject’s memory to recall what they ate or drank.
In another 2020 study of mice and rats found a link between aspartame and leukemia and lymphoma. But as seen in the studies with saccharine, mice and rat studies do not always reflect what happens to humans. Research by the National Toxicology Program did not find the same link from aspartame to humans. Those limitations are why it’s “possible risk” and the guidelines aren’t changing.
I have a nursing cartoon that I keep on my desk. It is a signpost that has the word “practice” pointing in one direction, and the word “theory” pointing in the other direction. A nurse is at the bottom of the sign saying, “Which way do I go?” For me, that cartoon is a reminder that practice and theory need to go in the same direction, or we get lost. This warning from the WHO made me think about that cartoon. The theory and the practice certainly aren’t aligning with this announcement. Which means we as consumers can get lost.
All of this brings me to the same conclusion as several researchers. If you chose aspartame, or any artificial sweetener, use it in moderation. Not just because of the possibility of cancer, but because of all the issues with artificial sweeteners in general. One researcher, Dr. Allison Sylvetsky from the Milken Institute School of Public Health, summed up all the issues with artificial sweeteners nicely. She said, “Even if they’re safe, there’s a lot of questions about whether they’re really helpful for their intended use in terms of helping with weight management or helping with preventing a variety of diseases. I think if people are concerned, the most prudent option is just choose unsweetened alternatives. Aspartame is not something you need to have as part of your diet. It doesn’t have any nutritional value.”
As always, please remember you are your own best advocate for your health. If you are not sure of the direction you need to go in when it comes to the theory and practice of aspartame and other artificial sweeteners, please speak to your health care provider about what is best for you and your loved ones.