POTENTIAL HEALTH RISKS
Several health concerns were highlighted by the recent systematic review published by the World Health Organization on artificial sweeteners, Ms Seto said.
Longer-term observational studies revealed that higher intakes of artificial sweeteners were associated with higher BMI and increased risk of incident obesity, type 2 diabetes, heart disease, all-cause deaths, and bladder cancer (from saccharin), she added.
“There is some evidence that suggests higher consumers of artificial sweeteners tend to have a greater appetite and desire to eat, compared to lower consumers,” the dietician said.
A study published in 2020 in the National Library of Medicine found that artificial sweeteners can trigger the release of insulin from the pancreas as they are mistaken for glucose due to their sweet taste. This can increase insulin levels in the blood, potentially contributing to reduced receptor activity and insulin resistance.
The development of resistance to insulin by the body can increase the risk for type 2 diabetes.
Another study published in February this year in the journal Nature Medicine and funded in part by the US National Heart, Lung, and Blood Institute, reported that erythritol, a common type of artificial sweetener, is linked to an increased risk of heart attack and stroke.
The researchers studied more than 4,000 people in the United States and Europe and found those with higher blood erythritol levels were at an elevated risk of experiencing an adverse cardiovascular event such as heart attack, stroke, or death.
Both studies noted that further research is required to conclude a direct correlation between artificial sweeteners and increased risks of diabetes and cardiovascular diseases.
“(It’s) important to understand that the current research on artificial sweeteners is derived from observational studies, which compared higher consumers of artificial sweeteners – who already tend to have poor diet quality and higher disease risk – to those with lower intakes of artificial sweeteners,” said Ms Seto.
“Therefore, these studies could have exaggerated the negative association between artificial sweeteners and chronic disease, and must be interpreted with caution in light of other evidence.”
The WHO said that its recommendation on non-sugar sweeteners was “conditional”, given that the link observed in the evidence between sweeteners and disease outcomes “might be confounded by baseline characteristics of study participants and complicated patterns” of sweetener use.
“The current position from the World Health Organization is that artificial sweeteners should not be used as a means to achieve weight control, erring on the cautious side as they are unable to fully reconcile the discordant findings between the shorter-term trials (which showed benefits) and the longer-term studies (which showed harm),” Ms Seto noted.