Low-calorie sweeteners (sometimes referred to as non-nutritive sweeteners, artificial sweeteners, or sugar substitutes) play a safe and healthful role in providing a variety of foods, beverages, and other products for consumers all over the world. In today’s age of increasing rates of obesity and obesity-related illness, low-calorie sweeteners can play a role as a weight management tool. The U.S. Food and Drug Administration (FDA) approved the use of acesulfame-K (Ace-K), aspartame, neotame, saccharin, and sucralose as sweeteners in the United States through evaluation of extensive research and safety and dietary intake assessments. All FDA-approved sweeteners are safe for consumption by the general population, including children and pregnant women. As always, the advice of a physician or health care or dietetics professional is prudent to ensure that dietary plans that include low-calorie sweeteners, meet desired calorie and nutrient goals.
The following “Myths & Facts” information is intended to set the record straight regarding conflicting reports and internet rumors about the safety and use of low-calorie sweeteners.
MYTH: Low-calorie sweeteners increase the risk of cancer in humans.
FACT: There is no scientific evidence of a link between low-calorie sweeteners and cancer in humans. Questions arose when early studies indicated a possible (bladder) cancer link between cyclamate in combination with saccharin in laboratory animals. However, according to the National Cancer Institute, recent research results from subsequent studies on these and other approved low-calorie sweeteners have not provided any evidence of a link. Additional research and evaluation conclusions are available from the following resources:
MYTH: Low-calorie sweeteners increase the risk of other diseases or adverse health conditions.
FACT: There is no scientific evidence that the consumption of foods sweetened with low-calorie sweeteners increases the risk of other diseases or adverse health conditions. The majority of individual accounts of adverse health conditions, rashes, or other diseases are purely anecdotal and are not based upon respected medical evaluations.
However, individuals with an extremely rare hereditary disease known as phenylketonuria (PKU), must restrict their intake of phenylalanine from all sources including aspartame. Foods sweetened with aspartame must include a statement (label) advising these individuals that phenylalanine is present in a product.
MYTH: Low-calorie sweeteners have an effect on appetite and promote weight gain.
FACT: Research on the effect of consuming foods and beverages containing aspartame, for example, has not been shown to increase food intake or hunger in children, nor does it indicate an increase in food intake in normal weight or overweight adults. (Blackburn GL World Rev Nutr Diet 1999;85:77-87). Additional studies in overweight individuals showed improved body weight when they consumed a diet that included foods sweetened with low-calorie sweeteners instead of foods sweetened with sugar. (Raben A, Vasilaras TH, Moller AC, Astrup A Am J Clin Nutr 2002;76:721-9). In fact, low-calorie sweeteners can be an essential tool in weight management for the general population and help to fulfill the caloric needs of diabetics.
The Bottom Line: Safety
- Acesulfame-K (Ace-K)—FDA first approved Ace-K in 1988 as a tabletop sweetener and by 2003 approved its use in foods and beverages. The FDA also concluded that the safety of Ace-K is consistent with research findings from other countries. The European Scientific Committee on Food (SCF) re-examination of the sweetener in 2000, reaffirmed its safety. No human health problems associated with the consumption of Ace-K have been reported in the literature, despite more than 15 years of extensive use in many countries.
- Aspartame—Discovered in 1965, FDA approved its use in dry foods in 1981 and its use in beverages in 1983. In 1996, FDA approved aspartame as a general purpose sweetener concluding that it could be used in all categories of foods and beverages. Due to anecdotal reports and unscientific allegations, the safety of aspartame was re-evaluated and confirmed again in 2002 by both the French Food Safety Agency and the European Food Safety Agency. The FDA has not received any evidence to date to reassess the safety of aspartame based on the widely available safety studies.
Additionally, in 2006, the panel on food additives, flavourings, processing aids and materials in contact with food (AFC) Panel of the European Food Safety Authority (EFSA) evaluated a long-term study on the carcinogenicity of aspartame and concluded that based on the current safety assessments available, there is no reason to further review the safety of aspartame. - Neotame—The newest of the low-calorie sweeteners, neotame was approved by FDA in July 2002 as a general-purpose sweetener. Prior to its approval for use as a general purpose sweetener, neotame was subjected to more than 100 extensive scientific studies. These studies included toxicity, developmental and reproductive, and carcinogenicity research. Human studies were also conducted and “no significant effects of neotame were observed.”
- Saccharin—Originally discovered in 1878, saccharin is perhaps the oldest of all low-calorie sweeteners approved for use in the marketplace today. The National Toxicology Program of the National Institutes of Health concluded in its “Report on Carcinogens, 9th Edition” that saccharin be removed from the list of potential carcinogens. The California Environmental Protection Agency also removed saccharin from its Proposition 65 list of carcinogens. Subsequently, based on federal legislation in 2001, saccharin no longer has to carry a warning label.
- Sucralose—In 1999, the FDA approved sucralose as a general purpose sweetener concluding that it could be used in all categories of foods and beverages. Sucralose does not promote dental caries and is safe for all segments of the population including people with diabetes. The FDA and the European SCF both reviewed studies conducted with people with diabetes. These studies showed that sucralose has no adverse health effects on blood glucose control. Additionally, FDA and other experts have found no adverse health effects in regards to sucralose use by the general population including children and pregnant women.
