Ef­fects of ar­ti­fi­cial sweet­en­ers lack re­search


New study sug­gests need for ev­i­dence on long-term im­pact of sugar sub­sti­tutes on health

Or­der­ing a diet soda as a “health­ier” choice may be back­fir­ing.

Anew study pub­lished in the Cana­dian Med­i­cal As­so­ci­a­tion Jour­nal (CMAJ) has high­lighted the need for more re­search into the po­ten­tial ad­verse ef­fects of ar­ti­fi­cial sweet­en­ers.

Re­searchers from the Univer­sity of Man­i­toba’s George and Fay Yee Cen­tre for Health­care In­no­va­tion found an as­so­ci­a­tion be­tween ar­ti­fi­cial sweet­en­ers and long-term weight gain, in­creased risk of obe­sity, di­a­betes, high blood pres­sure and heart dis­ease. But they did not find con­crete proof of cau­sa­tion.

Meghan Azad, head author of the study and as­sis­tant pro­fes­sor in the depart­ment of Pe­di­atrics and Child Health and Com­mu­nity Health Sciences at the Univer­sity of Man­i­toba, said there is a lack of sci­en­tific-based ev­i­dence on the long-term im­pact of con­sum­ing ar­ti­fi­cial sweet­en­ers.

Azad’s re­search sug­gests that “long term con­sump­tion of sweet­en­ers may have ad­verse ef­fects.”

The study high­lights the fact that more re­search needs to be con­ducted be­fore “the long-term risks and ben­e­fits of these prod­ucts are fully char­ac­ter­ized.” For in­stance, the ef­fects of syn­thetic ver­sus nat­u­ral low calo­rie sweet­en­ers have not been thor­oughly ex­plored.

This is es­pe­cially im­por­tant as the num­ber of peo­ple us­ing ar­ti­fi­cial sweet­en­ers, such as As­par­tame and Su­cralose, is in­creas­ing, Azad said.

The re­searchers as­sessed 938 full­text ar­ti­cles, be­fore nar­row­ing that to con­duct a sys­tem­atic review of 37 stud­ies that fol­lowed more than 400,000 peo­ple for an av­er­age of 10 years.

“The re­sults showed a sta­tis­ti­cally sig­nif­i­cant as­so­ci­a­tion be­tween con­sump­tion of ar­ti­fi­cial sweet­en­ers and higher risks of di­a­betes and heart dis­ease, as well as in­creased weight gain,” she said.

But fol­low­ing a ro­bust search for tri­als those avail­able that fit the pa­ram­e­ters of the study had some lim­i­ta­tions. Seven of the stud­ies were ran­dom­ized con­trolled tri­als, “the gold standard of re­search,” said Azad. But for the most part they didn’t fol­low mem­bers of the gen­eral pop­u­la­tion, in­stead fol­low­ing those who were al­ready obese, and only for an av­er­age of about six months.

Thirty of the stud­ies were ob­ser­va­tional, which have a greater risk of bias be­cause ar­ti­fi­cial sweet­ener use is not ran­domly as­signed and peo­ple who choose to con­sume sweet­en­ers may be dif­fer­ent from those who don’t, in terms of so­cioe­co­nomic, lifestyles and health-re­lated fac­tors.

David Ma, a pro­fes­sor in the depart­ment of Hu­man Health and Nu­tri­tional Sciences at the Univer­sity of Guelph, said, “It is im­por­tant to note, the study se­lec­tively as­sessed risk com­par­ing ex­treme in­takes of non­nu­tri­tive sweet­en­ers.”

“There­fore, the study high­lights, very in­tu­itively, that high in­takes of any­thing (even wa­ter) may have un­in­tended con­se­quences,” he said. “It would be help­ful for the au­thors to have com­mented fur­ther on usual in­takes to put things in con­text.”

He agrees with Azad’s call for more re­search into the mat­ter.

“Good sci­ence oc­curs when the state of our knowl­edge con­tin­ues to be eval­u­ated,” he said. “Over­all, I agree with the au­thors that more work is needed, given the lim­i­ta­tions of stud­ies con­ducted to date.”

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