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Pavanello S, Moretto A, La Vecchia C, Alicandro G. Non-sugar sweeteners and cancer: Toxicological and epidemiological evidence. Regul Toxicol Pharmacol 2023; 139:105369. [PMID: 36870410 DOI: 10.1016/j.yrtph.2023.105369] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Several toxicological and epidemiological studies were published during the last five decades on non-sugar sweeteners (NSS) and cancer. Despite the large amount of research, the issue still continues to be of interest. In this review, we provided a comprehensive quantitative review of the toxicological and epidemiological evidence on the possible relation between NSS and cancer. The toxicological section includes the evaluation of genotoxicity and carcinogenicity data for acesulfame K, advantame, aspartame, cyclamates, saccharin, steviol glycosides and sucralose. The epidemiological section includes the results of a systematic search of cohort and case-control studies. The majority of the 22 cohort studies and 46 case-control studies showed no associations. Some risks for bladder, pancreas and hematopoietic cancers found in a few studies were not confirmed in other studies. Based on the review of both the experimental data on genotoxicity or carcinogenicity of the specific NSS evaluated, and the epidemiological studies it can be concluded that there is no evidence of cancer risk associated to NSS consumption.
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Affiliation(s)
- Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università degli Studi di Padova, Padua, Italy; University Hospital of Padova, Padua, Italy
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università degli Studi di Padova, Padua, Italy; University Hospital of Padova, Padua, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Li X, Dong G, Han G, Du L, Li M. Zebrafish Behavioral Phenomics Links Artificial Sweetener Aspartame to Behavioral Toxicity and Neurotransmitter Homeostasis. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:15393-15402. [PMID: 34874711 DOI: 10.1021/acs.jafc.1c06077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Artificial sweeteners (ASs) are extensively used as food additives in drinks and beverages to lower calorie intake and prevent lifestyle diseases such as obesity. Although clinical and epidemiological data revealed the link between the chronic overconsumption of ASs and adverse health effects, there still exist controversies over the potential adverse neural toxic effect of ASs such as aspartame (APM), with acceptable daily intake (ADI) for a long time, on human health. In addition, whether APM and its metabolites are neurotoxic remains debatable due to a lack of data from an animal experiment or clinical investigation. Herein, to fully describe the potential neurological effect of APM, adult zebrafish served as the animal model to assess neurophysiological alteration induced by APM exposure within the range of the ADI (1, 10, and 100 mg/L) for 2 months. A cohort of standardized neurobehavioral phenotyping assays was conducted, including light/dark preference tests (LDP), novel tank diving tests, novel object recognition tests, social interaction tests, and color preference tests. For instance, in the LDP test, saccharin remarkably decreased the swimming time of zebrafish in the DARK part from 111 ± 10.8 (control group) to 72.2 ± 11.4 (100 mg/L groups). Besides, brain chemistry involved in the alteration of total neurotransmitters was determined by LC-MS/MS to confirm the behavioral results. Overall, current research studies revealed that APM within the range of the ADI altered the total behavioral profiles of zebrafish and disturbed the homeostasis of neurotransmitters in the brain. The present study has established a set of experimental paradigms, revealing the standardized procedure of using adult zebrafish to determine the neural activity or toxicity of AS molecules phenotypically. Zebrafish behavioral phenotyping methods, which were characterized by a cohort of behavioral fingerprints, can link the phenotypical alteration to changes in neurotransmitters in the brain, so as to provide a predictive reference for the further exploration of the molecular mechanism of phenotypic changes induced by ASs.
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Affiliation(s)
- Xiang Li
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Gaopan Dong
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- School of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453002, China
| | - Guangxi Han
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Lupei Du
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Minyong Li
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
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Li H, Liang H, Yang H, Zhang X, Ding X, Zhang R, Mao Y, Liu Z, Kan Q, Sun T. Association between intake of sweetened beverages with all-cause and cause-specific mortality: a systematic review and meta-analysis. J Public Health (Oxf) 2021; 44:516-526. [PMID: 33837431 DOI: 10.1093/pubmed/fdab069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Conclusions remain controversial between the consumption of sugar and artificially sweetened beverages (SSBs and ASBs) and mortality. METHODS We systematically searched the PubMed, Embase, Cochrane Library and Web of Science databases from their inception date to 1st January 2020, prospective cohort studies researching the mortality risk and SSBs or ASBs consumption were included. Random effects meta-analyses and dose-response analyses were performed to measure the association. Subgroup analyses and sensitivity analyses were further performed to explore the source of heterogeneity. Publication bias was assessed by Funnel plots and Egger's regression test. RESULTS Across all 15 cohorts, 1211 470 participants were included. High SSB consumption was associated with a higher risk of all-cause mortality (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.06-1.19, P < 0.001; and cardiovascular disease [CVD] mortality [HR 1.20, 95% CI, 1.05-1.38, P < 0.001]), and high ASBs consumption showed similar result (HR 1.12, 95% CI, 1.04-1.21, P = 0.001 for all-cause mortality and HR 1.23, 95% CI, 1.00-1.50, P = 0.049 for CVD mortality), both showed a linear dose-response relationship. CONCLUSIONS High consumption of both ASBs and SSBs showed significant associations with a higher risk of CVD mortality and all-cause mortality. This information may provide ideas for decreasing the global burden of diseases by reducing sweetened beverage intake.
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Affiliation(s)
- Hongyi Li
- General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University; Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis; Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450052, China.,Translational Medicine Platform, Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, China
| | - Huoyan Liang
- General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University; Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis; Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450052, China.,Translational Medicine Platform, Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, China
| | - Han Yang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Henan Key Laboratory of Critical Care Medicine, Zhengzhou 450052, China
| | - Xiaojuan Zhang
- General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University; Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis; Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450052, China
| | - Xianfei Ding
- General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University; Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis; Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450052, China.,Translational Medicine Platform, Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, China
| | - Ruifang Zhang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yimin Mao
- Department of Respiratory Medicine, First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, China
| | - Zhangsuo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Quancheng Kan
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Tongwen Sun
- General Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University; Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis; Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450052, China.,Translational Medicine Platform, Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, China
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Singh N, Singh Lubana S, Arora S, Sachmechi I. A Study of Artificial Sweeteners and Thyroid Cancer Risk. J Clin Med Res 2020; 12:492-498. [PMID: 32849937 PMCID: PMC7430875 DOI: 10.14740/jocmr4258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background In recent decades, data from certain observational studies have stirred controversy over artificial sweeteners by linking them with certain malignancies. As the incidences of artificial sweetener consumption and thyroid cancer are both increasing, our study aimed to determine any possible association between them. Methods This retrospective observational study enrolled 50 patients (group 1) with proven diagnosis of well-differentiated thyroid cancer (WDTC) and 50 control subjects (group 2) diagnosed as having benign thyroid nodule by fine-needle aspiration. The survey questionnaire included the total amount and duration of intake of artificial sweeteners. Results Increased consumption of artificial sweeteners was noted in group 1 as compared to group 2, which was statistically significant (76% vs. 24%, P < 0.01). This study suggested that the use of an average of four packets (4 g) per day of artificial sweetener for an average duration of 5 years is associated with WDTC. Conclusions Our study emphasizes the significance of artificial sweetener consumption as a potential risk factor for WDTC and increase in public awareness regarding this association if other studies in future report similar findings.
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Affiliation(s)
- Navdeep Singh
- Department of Internal Medicine, North Shore University Hospital, Manhasset, NY 11030, USA
| | - Sandeep Singh Lubana
- Department of Hematology/Oncology, State University of New York (SUNY) Downstate Medical School, 450 Clarkson Ave., Brooklyn, NY 11203, USA
| | - Saurabh Arora
- Department of Endocrinology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab 141001, India
| | - Issac Sachmechi
- Department of Endocrinology, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, 82-68 164th St., Jamaica, NY 11432, USA
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MALULY HDB, JOHNSTON C, GIGLIO ND, SCHREINER LL, ROBERTS A, ABEGAZ EG. Low- and No- Calorie Sweeteners (LNCS): critical evaluation of their safety and health risks. FOOD SCIENCE AND TECHNOLOGY 2020. [DOI: 10.1590/fst.36818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Wikoff D, Chappell G, Fitch S, Doepker C, Borghoff S. Lack of potential carcinogenicity for aspartame – Systematic evaluation and integration of mechanistic data into the totality of the evidence. Food Chem Toxicol 2020; 135:110866. [DOI: 10.1016/j.fct.2019.110866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/24/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022]
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Haighton L, Roberts A, Jonaitis T, Lynch B. Evaluation of aspartame cancer epidemiology studies based on quality appraisal criteria. Regul Toxicol Pharmacol 2019; 103:352-362. [PMID: 30716379 DOI: 10.1016/j.yrtph.2019.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 11/30/2022]
Abstract
Given the widespread use of the low-calorie sweetener aspartame over the last 30 years, the current work was undertaken to evaluate aspartame epidemiology studies looking at cancer endpoints against quality appraisal criteria. The quality appraisal tool used was from the National Heart, Lung and Blood Institute (NHLBI) of the National Institute of Health. Studies identified included nine case-control studies and five prospective cohort studies. Most studies assessed low-calorie or diet beverages rather than aspartame intake specifically; however, common use of aspartame in diet sodas does allow for some general extrapolation of results. Following consideration of study quality, two case-control and five prospective studies were considered to meet the majority of the NHLBI criteria. The primary limitation of the other case-control studies was an inadequate sample size. Overall, the results of the studies do not support that exposures to low and no-calorie sweeteners and beverages, and by extension aspartame, are associated with an increased risk of cancer in humans.
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Affiliation(s)
- Lois Haighton
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada.
| | - Ashley Roberts
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
| | - Tomas Jonaitis
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
| | - Barry Lynch
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
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Toews I, Lohner S, Küllenberg de Gaudry D, Sommer H, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ 2019; 364:k4718. [PMID: 30602577 PMCID: PMC6313893 DOI: 10.1136/bmj.k4718] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the association between intake of non-sugar sweeteners (NSS) and important health outcomes in generally healthy or overweight/obese adults and children. DESIGN Systematic review following standard Cochrane review methodology. DATA SOURCES Medline (Ovid), Embase, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and reference lists of relevant publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies including generally healthy adults or children with or without overweight or obesity were eligible. Included study designs allowed for a direct comparison of no intake or lower intake of NSS with higher NSS intake. NSSs had to be clearly named, the dose had to be within the acceptable daily intake, and the intervention duration had to be at least seven days. MAIN OUTCOME MEASURES Body weight or body mass index, glycaemic control, oral health, eating behaviour, preference for sweet taste, cancer, cardiovascular disease, kidney disease, mood, behaviour, neurocognition, and adverse effects. RESULTS The search resulted in 13 941 unique records. Of 56 individual studies that provided data for this review, 35 were observational studies. In adults, evidence of very low and low certainty from a limited number of small studies indicated a small beneficial effect of NSSs on body mass index (mean difference -0.6, 95% confidence interval -1.19 to -0.01; two studies, n=174) and fasting blood glucose (-0.16 mmol/L, -0.26 to -0.06; two, n=52). Lower doses of NSSs were associated with lower weight gain (-0.09 kg, -0.13 to -0.05; one, n=17 934) compared with higher doses of NSSs (very low certainty of evidence). For all other outcomes, no differences were detected between the use and non-use of NSSs, or between different doses of NSSs. No evidence of any effect of NSSs was seen on overweight or obese adults or children actively trying to lose weight (very low to moderate certainty). In children, a smaller increase in body mass index z score was observed with NSS intake compared with sugar intake (-0.15, -0.17 to -0.12; two, n=528, moderate certainty of evidence), but no significant differences were observed in body weight (-0.60 kg, -1.33 to 0.14; two, n=467, low certainty of evidence), or between different doses of NSSs (very low to moderate certainty). CONCLUSIONS Most health outcomes did not seem to have differences between the NSS exposed and unexposed groups. Of the few studies identified for each outcome, most had few participants, were of short duration, and their methodological and reporting quality was limited; therefore, confidence in the reported results is limited. Future studies should assess the effects of NSSs with an appropriate intervention duration. Detailed descriptions of interventions, comparators, and outcomes should be included in all reports. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42017047668.
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Affiliation(s)
- Ingrid Toews
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Centre of the University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
| | - Daniela Küllenberg de Gaudry
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Centre of the University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - Harriet Sommer
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Centre of the University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
- Institute for Medical Biometry and Statistics, Medical Centre of the University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Centre of the University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
- Centre of Epidemiological and Statistical Research, Sorbonne Paris Cité, Inserm/Université Paris Descartes, Cochrane France, Paris, France
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Choudhary AK, Lee YY. The debate over neurotransmitter interaction in aspartame usage. J Clin Neurosci 2018; 56:7-15. [DOI: 10.1016/j.jocn.2018.06.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/25/2018] [Indexed: 12/26/2022]
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Lohner S, Toews I, Meerpohl JJ. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutr J 2017; 16:55. [PMID: 28886707 PMCID: PMC5591507 DOI: 10.1186/s12937-017-0278-x] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 09/04/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Food products containing non-nutritive sweeteners (NNSs) instead of sugar have become increasingly popular in the last decades. Their appeal is obviously related to their calorie-free sweet taste. However, with the dramatic increase in their consumption, it is reasonable and timely to evaluate their potential health benefits and, more importantly, potential adverse effects. The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent, range, and nature of research activity in this area. METHODS We systematically searched Ovid MEDLINE, EMBASE and the Cochrane CENTRAL databases for studies on NNSs (artificial sweeteners or natural, non-caloric sweeteners, either used individually or in combination) using text terms with appropriate truncation and relevant indexing terms. All human studies investigating any health outcomes of a NNS intervention or exposure were eligible for inclusion. No studies were excluded based on language, study design or methodological quality. Data for each health outcome were summarized in tabular form and were discussed narratively. RESULTS Finally, we included 372 studies in our scoping review, comprising 15 systematic reviews, 155 randomized controlled trials (RCTs), 23 non-randomized controlled trials, 57 cohort studies, 52 case-control studies, 28 cross sectional studies and 42 case series/case reports. In healthy subjects, appetite and short term food intake, risk of cancer, risk of diabetes, risk of dental caries, weight gain and risk of obesity are the most investigated health outcomes. Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes. Numerous health outcomes including headaches, depression, behavioral and cognitive effects, neurological effects, risk of preterm delivery, cardiovascular effects or risk of chronic kidney disease were investigated in fewer studies and further research is needed. In subjects with diabetes and hypertension, the evidence regarding health outcomes of NNS use is also inconsistent. CONCLUSIONS This scoping review identifies the needs for future research to address the numerous evidence gaps related to health effects of NNSs use.It also specifies the research questions and areas where a systematic review with meta-analyses is required for the proper evaluation of health outcomes associated to regular NNSs consumption.
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Affiliation(s)
| | - Ingrid Toews
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, Freiburg, 79110 Germany
| | - Joerg J. Meerpohl
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, Freiburg, 79110 Germany
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité – U1153, Inserm / Université Paris Descartes, Cochrane France, Hôpital Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris, Cedex 04 France
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Bernardo WM, Simões RS, Buzzini RF, Nunes VM, Glina F. Adverse effects of the consumption of artificial sweeteners - systematic review. Rev Assoc Med Bras (1992) 2017; 62:120-2. [PMID: 27167540 DOI: 10.1590/1806-9282.62.02.120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - V M Nunes
- Associação Médica Brasileira, Brazil
| | - Fpa Glina
- Associação Médica Brasileira, Brazil
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Balgobind K, Kanchi S, Sharma D, Bisetty K, Sabela MI. Hybrid of ZnONPs/MWCNTs for electrochemical detection of aspartame in food and beverage samples. J Electroanal Chem (Lausanne) 2016. [DOI: 10.1016/j.jelechem.2016.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mishra A, Ahmed K, Froghi S, Dasgupta P. Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants. Int J Clin Pract 2015. [PMID: 26202345 DOI: 10.1111/ijcp.12703] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The effect of artificial sweetener consumption on cancer risk has been debated in animal models for over four decades. To further investigate this relationship, this study aims to synthesise results from several of the most recent studies in humans. METHODS An online literature search was performed in MEDLINE from 2003 to 2014 using Ovid, PubMed, Web of Science, and Scopus using keywords 'artificial', 'sweetener' and 'cancer'. Ninety-two results were then manually assessed for eligibility. Studies were included if the relationship between artificial sweeteners and cancer was their central hypothesis, and if they adjusted for age, gender, smoking status and body mass index. Extracted data included study design, patient characteristics, outcome measure and results. RESULTS In the five publications that satisfied the inclusion criteria, significant direct associations with artificial consumption were found for laryngeal (odds ratio, OR 2.34, 95% CI: 1.20-4.55), urinary tract tumours (OR 2.12, 95% CI: 1.22-3.89), non-Hodgkin lymphoma in men (RR 1.31, 95% CI: 1.01-1.72), multiple myeloma in men (RR 2.02, 95% CI: 1.20-3.40) and leukaemia (RR 1.42, 95% CI: 1.00-2.02). Inverse relationships were found in breast (OR 0.70, 95% CI: 0.54-0.91, p trend = 0.015) and ovarian (OR 0.56, 95% CI: 0.38-0.81, p trend < 0.001) cancers. CONCLUSION The statistical value of this review is limited by the heterogeneity and observational designs of the included studies. Although there is limited evidence to suggest that heavy consumption may increase the risk of certain cancers, overall the data presented are inconclusive as to any relationship between artificial sweeteners and cancer.
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Affiliation(s)
- A Mishra
- GKT School of Medical Education, King's College London, London, UK
| | - K Ahmed
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
| | - S Froghi
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
| | - P Dasgupta
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
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Kim JY, Park KH, Kim J, Choi I, Cho KH. Modified High-Density Lipoproteins by Artificial Sweetener, Aspartame, and Saccharin, Showed Loss of Anti-atherosclerotic Activity and Toxicity in Zebrafish. Cardiovasc Toxicol 2014; 15:79-89. [DOI: 10.1007/s12012-014-9273-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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A review of the genotoxic and carcinogenic effects of aspartame: does it safe or not? Cytotechnology 2014; 66:875-81. [PMID: 24510317 DOI: 10.1007/s10616-013-9681-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022] Open
Abstract
The objective of this article is to review genotoxicologic and carcinogenic profile of the artificial sweetener aspartame. Aspartame is a synthetic dipeptide, nearly 180-200 times sweeter than sucrose. It is the most widely used artificial sweetener especially in carbonated and powdered soft drinks, beverages, drugs and hygiene products. There is a discussion ongoing for many years whether aspartame posses genotoxic and carcinogenic risk for humans. This question led to many studies to specify the adverse effects of aspartame. Therefore, we aimed to review the oldest to latest works published in major indices to gather information within this article. With respect to published data, genotoxicity and carcinogenicity of aspartame is still confusing. So, consumers should be aware of the potential side effects of aspartame before they consume it.
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Horio Y, Sun Y, Liu C, Saito T, Kurasaki M. Aspartame-induced apoptosis in PC12 cells. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 37:158-165. [PMID: 24355796 DOI: 10.1016/j.etap.2013.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 11/13/2013] [Accepted: 11/20/2013] [Indexed: 06/03/2023]
Abstract
Aspartame is an artificial sweetner added to many low-calorie foods. The safety of aspartame remains controversial even though there are many studies on its risks. In this study, to understand the physiological effects of trace amounts of artificial sweetners on cells, the effects of aspartame on apoptosis were investigated using a PC12 cell system. In addition, the mechanism of apoptosis induced by aspartame in PC12 cells and effects on apoptotic factors such as cytochrome c, apoptosis-inducing factor, and caspase family proteins were studied by Western blotting and RT-PCR. Aspartame-induced apoptosis in PC12 cells in a dose-dependent manner. In addition, aspartame exposure increased the expressions of caspases 8 and 9, and cytochrome c. These results indicate that aspartame induces apoptosis mainly via mitochondrial pathway involved in apoptosis due to oxigen toxicity.
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Affiliation(s)
- Yukari Horio
- Environmental Adaptation Science, Division of Environmental Science Development, Graduate School of Environmental Science, Hokkaido University, Sapporo 060-0810, Japan
| | - Yongkun Sun
- Environmental Adaptation Science, Division of Environmental Science Development, Graduate School of Environmental Science, Hokkaido University, Sapporo 060-0810, Japan
| | - Chuang Liu
- Environmental Adaptation Science, Division of Environmental Science Development, Graduate School of Environmental Science, Hokkaido University, Sapporo 060-0810, Japan
| | - Takeshi Saito
- Laboratory of Environmental Health Sciences, Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan
| | - Masaaki Kurasaki
- Environmental Adaptation Science, Division of Environmental Science Development, Graduate School of Environmental Science, Hokkaido University, Sapporo 060-0810, Japan; Group of Environmental Adaptation Science, Faculty of Environmental Earth Science, Hokkaido University, Sapporo 060-0810, Japan.
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Cuomo R, Andreozzi P, Zito FP. Alcoholic beverages and carbonated soft drinks: consumption and gastrointestinal cancer risks. Cancer Treat Res 2014; 159:97-120. [PMID: 24114477 DOI: 10.1007/978-3-642-38007-5_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Alcoholic beverages (ABs) and carbonated soft drinks (CSDs) are widely consumed worldwide. Given the high consumption of these beverages, the scientific community has increased its focus on their health impact. There is epidemiological evidence of a causal association between AB intake and digestive cancer, but the role of alcohol in determining cancer is not fully defined. Experimental studies have so far identified multiple mechanisms involved in carcinogenesis; ethanol itself is not carcinogenic but available data suggest that acetaldehyde (AA) and reactive oxygen species-both products of ethanol metabolism-have a genotoxic effect promoting carcinogenesis. Other carcinogenetic mechanisms include nutritional deficits, changes in DNA methylation, and impaired immune surveillance. As CSDs are often suspected to cause certain gastrointestinal disorders, consequently, some researchers have hypothesized their involvement in gastrointestinal cancers. Of all the ingredients, carbon dioxide is prevalently involved in the alteration of gastrointestinal physiology by a direct mucosal effect and indirect effects mediated by the mechanical pressure determined by gas. The role of sugar or artificial sweeteners is also debated as factors involved in the carcinogenic processes. However, several surveys have failed to show any associations between CSDs and esophageal, gastric, or colon cancers. On the other hand, a slight correlation between risk of pancreatic cancer and CSD consumption has been found.
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Affiliation(s)
- Rosario Cuomo
- Department of Clinical & Experimental Medicine, Hospital School of Medicine, Federico II University, Via S. Pansini 5, Building no. 6, 80131, Naples, Italy,
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Aspartame, low-calorie sweeteners and disease: Regulatory safety and epidemiological issues. Food Chem Toxicol 2013; 60:109-15. [DOI: 10.1016/j.fct.2013.07.040] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/09/2013] [Accepted: 07/14/2013] [Indexed: 12/15/2022]
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Shankar P, Ahuja S, Sriram K. Non-nutritive sweeteners: review and update. Nutrition 2013; 29:1293-9. [PMID: 23845273 DOI: 10.1016/j.nut.2013.03.024] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/02/2013] [Accepted: 03/31/2013] [Indexed: 11/27/2022]
Abstract
Obesity has become an epidemic, not just in the United States, but also across the globe. Obesity is a result of many factors including poor dietary habits, inadequate physical activity, hormonal issues, and sedentary lifestyle, as well as many psychological issues. Direct and indirect costs associated with obesity-related morbidity and mortality have been estimated to be in the billions of dollars. Of the many avenues for treatment, dietary interventions are the most common. Numerous diets have been popularized in the media, with most being fads having little to no scientific evidence to validate their effectiveness. Amidst this rise of weight loss diets, there has been a surge of individual products advertised as assuring quick weight loss; one such product group is non-nutritive sweeteners (NNS). Sugar, a common component of our diet, is also a major contributing factor to a number of health problems, including obesity and increased dental diseases both in adults and children. Most foods marketed towards children are sugar-laden. Obesity-related health issues, such as type 2 diabetes mellitus, cardiovascular diseases, and hypertension, once only commonly seen in older adults, are increasing in youth. Manufacturers of NNS are using this as an opportunity to promote their products, and are marketing them as safe for all ages. A systematic review of several databases and reliable websites on the internet was conducted to identify literature related to NNS. Keywords that were used individually or in combination included, but were not limited to, artificial sweeteners, non-nutritive sweeteners, non-caloric sweeteners, obesity, sugar substitutes, diabetes, and cardiometabolic indicators. The clinical and epidemiologic data available at present are insufficient to make definitive conclusions regarding the benefits of NNS in displacing caloric sweeteners as related to energy balance, maintenance or decrease in body weight, and other cardiometabolic risk factors. Although the FDA and most published (especially industry-funded) studies endorse the safety of these additives, there is a lack of conclusive evidence-based research to discourage or to encourage their use on a regular basis. While moderate use of NNS may be useful as a dietary aid for someone with diabetes or on a weight loss regimen, for optimal health it is recommended that only minimal amounts of both sugar and NNS be consumed.
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Affiliation(s)
- Padmini Shankar
- Department of Health and Kinesiology, Georgia Southern University, Statesboro, GA, USA.
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Canimoglu S, Rencuzogullari E. The genotoxic and teratogenic effects of maltitol in rats. Toxicol Ind Health 2012; 29:935-43. [PMID: 22585934 DOI: 10.1177/0748233712446727] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the present study, the genotoxic and cytotoxic effects of the low-caloric artificial sweetener maltitol, which is a sugar alcohol (polyol), were investigated in the bone marrow cells of rats using the chromosome aberration (CA) test. In addition, the teratogenicity and embryotoxicity of maltitol was also investigated in rats. To reveal the genotoxicity and cytotoxicity of maltitol, rats were intraperitoneally administered 2.5, 5 and 10 g/kg body weight (bw) concentrations of maltitol for 6, 12 and 24 h treatment period. The pregnant females were intraperitoneally treated with 1, 2 and 4 g/kg bw/day concentrations of maltitol during the first 7 days of gestation (first trimester) to investigate the teratogenicity of maltitol. The embryos were collected after killing the dams by cervical dislocation under ether anaesthesia on gestation day 19. Maltitol did not induce the CA and did not decrease the mitotic index in bone marrow cells of rats at all concentrations and treatment periods. In addition, maltitol was not teratogenic; however, it decreased the foetuses weight and at the highest dose (4 g/kg bw) caused growth retardation.
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Affiliation(s)
- Semir Canimoglu
- 1Department of Biology, Natural and Applied Science Institute, Cukurova University, Adana, Turkey
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Abstract
Aspartame (a-Laspartyl-L-phenylalanine 1-methylester) is a dipeptide low-calorie artificial sweetener that is widely used as a nonnutritive sweetener in foods and drinks. The safety of aspartame and its metabolic breakdown products (phenylalanine, aspartic acid and methanol) was investigated in vivo using chromosomal aberration (CA) test and sister chromatid exchange (SCE) test in the bone marrow cells of mice. Swiss Albino male mice were exposed to aspartame (3.5, 35, 350 mg/kg body weight). Bone marrow cells isolated from femora were analyzed for chromosome aberrations and sister chromatid exchanges. Treatment with aspartame induced dose dependently chromosome aberrations at all concentrations while it did not induce sister chromatid exchanges. On the other hand, aspartame did not decrease the mitotic index (MI). However, statistical analysis of the results show that aspartame is not significantly genotoxic at low concentration.
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Hendriksen MA, Tijhuis MJ, Fransen HP, Verhagen H, Hoekstra J. Impact of substituting added sugar in carbonated soft drinks by intense sweeteners in young adults in the Netherlands: example of a benefit-risk approach. Eur J Nutr 2010; 50:41-51. [PMID: 20429009 DOI: 10.1007/s00394-010-0113-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 04/15/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE Substituting added sugar in carbonated soft drinks with intense sweeteners may have potential beneficial, but also adverse health effects. This study assessed the benefits and risks associated with substituting added sugar in carbonated soft drinks with intense sweeteners in young adults in the Netherlands. METHODS A tiered approach was used analogous to the risk assessment paradigm, consisting of benefit and hazard identification, exposure assessment and finally benefit and risk characterization and comparison. Two extreme scenarios were compared in which all carbonated soft drinks were sweetened with either intense sweeteners or added sugar. National food consumption survey data were used, and intake of added sugar and intense sweeteners was calculated using the food composition table or analytical data for sweetener content. RESULTS Reduction in dental caries and body weight were identified as benefits of substituting sugar. The mean difference in total energy intake between the scenarios was 542 kJ per day in men and 357 kJ per day in women, under the assumption that no compensation takes place. In the 100% sweetener scenario, the average BMI decreased 1.7 kg/m(2) in men and 1.3 kg/m(2) in women when compared to the 100% sugar scenario. Risks are negligible, as the intake of intense sweeteners remains below the ADI in the substitution scenario. CONCLUSIONS Substitution of added sugar by intense sweeteners in carbonated soft drinks has beneficial effects on BMI and the reduction in dental caries, and does not seem to have adverse health effects in young adults, given the available knowledge and assumptions made.
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Affiliation(s)
- Marieke A Hendriksen
- National Institute for Public Health and Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, the Netherlands.
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Bosetti C, Gallus S, Talamini R, Montella M, Franceschi S, Negri E, La Vecchia C. Artificial Sweeteners and the Risk of Gastric, Pancreatic, and Endometrial Cancers in Italy. Cancer Epidemiol Biomarkers Prev 2009; 18:2235-8. [DOI: 10.1158/1055-9965.epi-09-0365] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Magnuson BA, Burdock GA, Doull J, Kroes RM, Marsh GM, Pariza MW, Spencer PS, Waddell WJ, Walker R, Williams GM. Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Crit Rev Toxicol 2008; 37:629-727. [PMID: 17828671 DOI: 10.1080/10408440701516184] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aspartame is a methyl ester of a dipeptide used as a synthetic nonnutritive sweetener in over 90 countries worldwide in over 6000 products. The purpose of this investigation was to review the scientific literature on the absorption and metabolism, the current consumption levels worldwide, the toxicology, and recent epidemiological studies on aspartame. Current use levels of aspartame, even by high users in special subgroups, remains well below the U.S. Food and Drug Administration and European Food Safety Authority established acceptable daily intake levels of 50 and 40 mg/kg bw/day, respectively. Consumption of large doses of aspartame in a single bolus dose will have an effect on some biochemical parameters, including plasma amino acid levels and brain neurotransmitter levels. The rise in plasma levels of phenylalanine and aspartic acid following administration of aspartame at doses less than or equal to 50 mg/kg bw do not exceed those observed postprandially. Acute, subacute and chronic toxicity studies with aspartame, and its decomposition products, conducted in mice, rats, hamsters and dogs have consistently found no adverse effect of aspartame with doses up to at least 4000 mg/kg bw/day. Critical review of all carcinogenicity studies conducted on aspartame found no credible evidence that aspartame is carcinogenic. The data from the extensive investigations into the possibility of neurotoxic effects of aspartame, in general, do not support the hypothesis that aspartame in the human diet will affect nervous system function, learning or behavior. Epidemiological studies on aspartame include several case-control studies and one well-conducted prospective epidemiological study with a large cohort, in which the consumption of aspartame was measured. The studies provide no evidence to support an association between aspartame and cancer in any tissue. The weight of existing evidence is that aspartame is safe at current levels of consumption as a nonnutritive sweetener.
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Lim U, Hartge P, Morton LM, Schatzkin A. Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies. Cancer Epidemiol Biomarkers Prev 2007. [DOI: 10.1158/1055-9965.epi-07-0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Unhee Lim
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland
| | - Patricia Hartge
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland
| | - Lindsay M. Morton
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland
| | - Arthur Schatzkin
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland
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Gallus S, Scotti L, Negri E, Talamini R, Franceschi S, Montella M, Giacosa A, Dal Maso L, La Vecchia C. Artificial sweeteners and cancer risk in a network of case–control studies. Ann Oncol 2007; 18:40-44. [PMID: 17043096 DOI: 10.1093/annonc/mdl346] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The role of sweeteners on cancer risk has been widely debated over the last few decades. To provide additional information on saccharin and other sweeteners (mainly aspartame), we considered data from a large network of case-control studies. METHODS An integrated network of case-control studies has been conducted between 1991 and 2004 in Italy. Cases were 598 patients with incident, histologically confirmed cancers of the oral cavity and pharynx, 304 of the oesophagus, 1225 of the colon, 728 of the rectum, 460 of the larynx, 2569 of the breast, 1031 of the ovary, 1294 of the prostate and 767 of the kidney (renal cell carcinoma). Controls were 7028 patients (3301 men and 3727 women) admitted to the same hospitals as cases for acute, non-neoplastic disorders. Odds ratios (ORs), and the corresponding 95% confidence intervals (CIs), were derived by unconditional logistic regression models. RESULTS The ORs for consumption of saccharin were 0.83 (95% CI 0.30-2.29) for cancers of the oral cavity and pharynx, 1.58 (95% CI 0.59-4.25) for oesophageal, 0.95 (95% CI 0.67-1.35) for colon, 0.93 (95% CI 0.60-1.45) for rectal, 1.55 (95% CI 0.76-3.16) for laryngeal, 1.01 (95% CI 0.77-1.33) for breast, 0.46 (95% CI 0.29-0.74) for ovarian, 0.91 (95% CI 0.59-1.40) for prostate and 0.79 (95% CI 0.49-1.28) for kidney cancer. The ORs for consumption of other sweeteners, mainly aspartame, were 0.77 (95% CI 0.39-1.53) for cancers of the oral cavity and pharynx, 0.77 (95% CI 0.34-1.75) for oesophageal, 0.90 (95% CI 0.70-1.16) for colon, 0.71 (95% CI 0.50-1.02) for rectal, 1.62 (95% CI 0.84-3.14) for laryngeal, 0.80 (95% CI 0.65-0.97) for breast, 0.75 (95% CI 0.56-1.00) for ovarian, 1.23 (95% CI 0.86-1.76) for prostate and 1.03 (95% CI 0.73-1.46) for kidney cancer. A significant inverse trend in risk for increasing categories of total sweeteners was found for breast and ovarian cancer, and a direct one for laryngeal cancer. CONCLUSION The present work indicates a lack of association between saccharin, aspartame and other sweeteners and the risk of several common neoplasms.
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Affiliation(s)
- S Gallus
- Istituto di Ricerche Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milan.
| | - L Scotti
- Istituto di Ricerche Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milan
| | - E Negri
- Istituto di Ricerche Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milan
| | - R Talamini
- Servizio di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Via Pedemontana Occ.le, 33081 Aviano (Pordenone), Italy
| | - S Franceschi
- International Agency for Research on Cancer, 150 Cours Albert Thomas, F-69372 cedex 08, Lyon, France
| | - M Montella
- Unità di Epidemiologia, Istituto Tumori 'Fondazione Pascale', Via Mariano Semmola, 80100 Naples
| | - A Giacosa
- Policlinico di Monza, Via Amati 11, 20052 Monza (MI)
| | - L Dal Maso
- Servizio di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Via Pedemontana Occ.le, 33081 Aviano (Pordenone), Italy
| | - C La Vecchia
- Istituto di Ricerche Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milan; Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Via Venezian 1, 20133 Milan, Italy
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Canimoğlu S, Rencüzoğullari E. The cytogenetic effects of food sweetener maltitol in human peripheral lymphocytes. Drug Chem Toxicol 2006; 29:269-78. [PMID: 16777705 DOI: 10.1080/01480540600651600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The effects of the low-calorie artifical sweetener maltitol (E965), a sugar alcohol (Polyol), on sister chromatid exchange (SCE), chromosome aberration (CA), and micronucleus formation (MN) were investigated in human peripheral lymphocytes. Maltitol did not induce SCE at all concentrations (1.25, 2.5, and 5 mg/mL) and treatment periods (24 and 48 h). Maltitol induced CA, although not statistically significantly. Maltitol induced the frequency of MN at 24 and 48 h in a non-dose-dependent manner. In addition, maltitol did not decrease the replication index (RI) and the mitotic index (MI) at all concentrations and treatment periods. Maltitol did not alter the pH and osmolality of the medium. In conclusion, it can be concluded that maltitol has a weak genotoxic potential and it appears non-cytotoxic to human peripheral lymphocytes in vitro.
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Affiliation(s)
- Semir Canimoğlu
- Cukurova University, Natural and Applied Sciences Institute, Department of Biology, Adanna, Turkey
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Lim U, Subar AF, Mouw T, Hartge P, Morton LM, Stolzenberg-Solomon R, Campbell D, Hollenbeck AR, Schatzkin A. Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies. Cancer Epidemiol Biomarkers Prev 2006; 15:1654-9. [PMID: 16985027 DOI: 10.1158/1055-9965.epi-06-0203] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In a few animal experiments, aspartame has been linked to hematopoietic and brain cancers. Most animal studies have found no increase in the risk of these or other cancers. Data on humans are sparse for either cancer. Concern lingers regarding this widely used artificial sweetener. OBJECTIVE We investigated prospectively whether aspartame consumption is associated with the risk of hematopoietic cancers or gliomas (malignant brain cancer). METHODS We examined 285,079 men and 188,905 women ages 50 to 71 years in the NIH-AARP Diet and Health Study cohort. Daily aspartame intake was derived from responses to a baseline self-administered food frequency questionnaire that queried consumption of four aspartame-containing beverages (soda, fruit drinks, sweetened iced tea, and aspartame added to hot coffee and tea) during the past year. Histologically confirmed incident cancers were identified from eight state cancer registries. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression that adjusted for age, sex, ethnicity, body mass index, and history of diabetes. RESULTS During over 5 years of follow-up (1995-2000), 1,888 hematopoietic cancers and 315 malignant gliomas were ascertained. Higher levels of aspartame intake were not associated with the risk of overall hematopoietic cancer (RR for >/=600 mg/d, 0.98; 95% CI, 0.76-1.27), glioma (RR for >/=400 mg/d, 0.73; 95% CI, 0.46-1.15; P for inverse linear trend = 0.05), or their subtypes in men and women. CONCLUSIONS Our findings do not support the hypothesis that aspartame increases hematopoietic or brain cancer risk.
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Affiliation(s)
- Unhee Lim
- Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, EPN 4005, Rockville, MD 20852-7344, USA
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Bunin GR, Kushi LH, Gallagher PR, Rorke-Adams LB, McBride ML, Cnaan A. Maternal Diet During Pregnancy and its Association with Medulloblastoma in Children: A Children’s Oncology Group Study (United States). Cancer Causes Control 2005; 16:877-91. [PMID: 16132798 DOI: 10.1007/s10552-005-3144-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 03/03/2005] [Indexed: 10/25/2022]
Abstract
Fruit, vegetables, vitamin C, and folate during pregnancy have been suggested as protective factors for medulloblastoma/primitive neuroectodermal tumor (PNET), a common brain tumor in children. The authors sought to replicate these findings and investigate other aspects of diet. Mothers of 315 cases under age six at diagnosis and 315 controls were interviewed about their pregnancy diet. The authors observed modest, inverse associations for fruits/juices (odds ratio (OR) for highest compared to lowest category = 0.6, 95% confidence interval (CI): 0.3, 1.1) and vitamin C (OR = 0.6, 95% CI: 0.4, 1.1). In contrast to the previous study, folate and vegetables showed no association. As hypothesized, cured meats were not associated with medulloblastoma/PNET, in contrast to other childhood brain tumors. An inverse association with non-fresh peaches and similar fruits (OR = 0.5, 95% CI: 0.3, 0.8) and a positive association with non-chocolate candy (OR = 1.7, 95% CI: 1.0, 3.0) replicated previous findings. French fries (OR = 2.4, 95% CI: 1.2, 4.9) and chili peppers (OR = 1.8, 95% CI: 1.0, 3.0) were associated with medulloblastoma/PNET. The results suggest that some aspects of diet are worthy of further research.
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Affiliation(s)
- Greta R Bunin
- Oncology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Abstract
Artificial sweeteners are added to a wide variety of food, drinks, drugs and hygiene products. Since their introduction, the mass media have reported about potential cancer risks, which has contributed to undermine the public's sense of security. It can be assumed that every citizen of Western countries uses artificial sweeteners, knowingly or not. A cancer-inducing activity of one of these substances would mean a health risk to an entire population. We performed several PubMed searches of the National Library of Medicine for articles in English about artificial sweeteners. These articles included 'first generation' sweeteners such as saccharin, cyclamate and aspartame, as well as 'new generation' sweeteners such as acesulfame-K, sucralose, alitame and neotame. Epidemiological studies in humans did not find the bladder cancer-inducing effects of saccharin and cyclamate that had been reported from animal studies in rats. Despite some rather unscientific assumptions, there is no evidence that aspartame is carcinogenic. Case-control studies showed an elevated relative risk of 1.3 for heavy artificial sweetener use (no specific substances specified) of >1.7 g/day. For new generation sweeteners, it is too early to establish any epidemiological evidence about possible carcinogenic risks. As many artificial sweeteners are combined in today's products, the carcinogenic risk of a single substance is difficult to assess. However, according to the current literature, the possible risk of artificial sweeteners to induce cancer seems to be negligible.
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Affiliation(s)
- M R Weihrauch
- Department of Internal Medicine I of the University of Cologne, Cologne, Germany.
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Butchko HH, Stargel WW, Comer CP, Mayhew DA, Benninger C, Blackburn GL, de Sonneville LMJ, Geha RS, Hertelendy Z, Koestner A, Leon AS, Liepa GU, McMartin KE, Mendenhall CL, Munro IC, Novotny EJ, Renwick AG, Schiffman SS, Schomer DL, Shaywitz BA, Spiers PA, Tephly TR, Thomas JA, Trefz FK. Aspartame: review of safety. Regul Toxicol Pharmacol 2002; 35:S1-93. [PMID: 12180494 DOI: 10.1006/rtph.2002.1542] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Over 20 years have elapsed since aspartame was approved by regulatory agencies as a sweetener and flavor enhancer. The safety of aspartame and its metabolic constituents was established through extensive toxicology studies in laboratory animals, using much greater doses than people could possibly consume. Its safety was further confirmed through studies in several human subpopulations, including healthy infants, children, adolescents, and adults; obese individuals; diabetics; lactating women; and individuals heterozygous (PKUH) for the genetic disease phenylketonuria (PKU) who have a decreased ability to metabolize the essential amino acid, phenylalanine. Several scientific issues continued to be raised after approval, largely as a concern for theoretical toxicity from its metabolic components--the amino acids, aspartate and phenylalanine, and methanol--even though dietary exposure to these components is much greater than from aspartame. Nonetheless, additional research, including evaluations of possible associations between aspartame and headaches, seizures, behavior, cognition, and mood as well as allergic-type reactions and use by potentially sensitive subpopulations, has continued after approval. These findings are reviewed here. The safety testing of aspartame has gone well beyond that required to evaluate the safety of a food additive. When all the research on aspartame, including evaluations in both the premarketing and postmarketing periods, is examined as a whole, it is clear that aspartame is safe, and there are no unresolved questions regarding its safety under conditions of intended use.
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Affiliation(s)
- Harriett H Butchko
- Medical and Scientific Affairs, The NutraSweet Company, Mt Prospect, Illinois 60056, USA.
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Pereira RA, Koifman S. Associação entre fatores da dieta e tumores de cérebro em adultos: uma revisão da literatura. CAD SAUDE PUBLICA 2001. [DOI: 10.1590/s0102-311x2001000600003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Desenvolveu-se uma revisão da literatura científica publicada entre 1986 e 1999, sobre a associação entre fatores da dieta e os tumores de cérebro em adultos, com o objetivo de descrever as associações observadas e discutir os aspectos metodológicos que possam influenciar os resultados observados. De um modo geral, os estudos revisados parecem apontar na direção de uma associação moderada entre os fatores da dieta e os tumores de cérebro; há evidências de que o consumo de compostos N-nitroso possa favorecer o desenvolvimento desses tumores, e de que o consumo de vegetais e frutas pode ter papel na sua inibição. A participação dos respondentes substitutos nos estudos analisados, pode ter introduzido viés de memória nas informações levantadas e contribuído para a inconsistência dos achados. As investigações epidemiológicas sobre a associação da dieta com estes tumores devem considerar a análise de outros fatores alimentares, além dos compostos N-nitroso. É necessário precisar os períodos de exposição que devem ser investigados e contar com criteriosa metodologia, de modo a prevenir a ocorrência de tendenciosidades relacionadas com a seleção dos controles e minimizar os efeitos do viés de memória.
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Hardell L, Mild KH, Påhlson A, Hallquist A. Ionizing radiation, cellular telephones and the risk for brain tumours. Eur J Cancer Prev 2001; 10:523-9. [PMID: 11916351 DOI: 10.1097/00008469-200112000-00007] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A case-control study on brain tumours included 233 patients aged 20-80 years and alive at the study time. They had histopathologically verified brain tumour and lived in the Uppsala-Orebro region (1994-1996) or the Stockholm region (1995-1996). Two matched controls to each case were selected from the Swedish Population Register. Two hundred and nine cases (90%) and 425 controls (91%) answered the questionnaire. Results are presented for the whole study group, as given here, and for malignant and benign tumours separately. For workers in the chemical industry the odds ratio (OR) was 4.10, 95% confidence interval (95% CI) 1.25-13.4 and laboratory workers OR 3.21, 95% CI 1.16-8.85. Radiotherapy of the head and neck region gave OR 3.61, 95% CI 0.65-19.9. Medical diagnostic X-ray of the same area yielded OR 1.64, 95% CI 1.04-2.58. Work as a physician gave OR 6.00, 95% CI 0.62-57.7. All three cases had worked with fluoroscopy. Ipsilateral (same side) use of a cellular telephone increased the risk of tumours in the temporal, temporoparietal and occipital areas, with OR 2.42, 95% CI 0.97-6.05 (i.e. the anatomical areas with highest exposure to microwaves from a mobile phone).
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Affiliation(s)
- L Hardell
- Department of Oncology, Orebro Medical Centre, Sweden.
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Butchko HH, Stargel WW. Aspartame: scientific evaluation in the postmarketing period. Regul Toxicol Pharmacol 2001; 34:221-33. [PMID: 11754527 DOI: 10.1006/rtph.2001.1500] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Prior to marketing, the safety of the high-intensity sweetener aspartame for its intended uses as a sweetener and flavor enhancer was demonstrated by the results of over 100 scientific studies in animals and humans. In the postmarketing period, the safety of aspartame was further evaluated through extensive monitoring of intake, postmarketing surveillance of anecdotal reports of alleged health effects, and additional research to evaluate these anecdotal reports and other scientific issues. The results of the extensive intake evaluation in the United States, which was done over an 8-year period, and the results of studies done in other countries demonstrated intakes which were well below the acceptable daily intakes set by the FDA and regulatory bodies in other countries, as well as the Joint FAO/WHO Expert Committee on Food Additives. Evaluation of the anecdotal reports of adverse health effects, the first such system for a food additive, revealed that the reported effects were generally mild and also common in the general population and that there was no consistent or unique pattern of symptoms that could be causally linked to consumption of aspartame. Finally, the results of the extensive scientific research done to evaluate these allegations did not show a causal relationship between aspartame and adverse effects. Thus, the weight of scientific evidence confirms that, even in amounts many times what people typically consume, aspartame is safe for its intended uses as a sweetener and flavor enhancer.
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Affiliation(s)
- H H Butchko
- Medical and Scientific Affairs, The NutraSweet Company, Mt. Prospect, IL 60056, USA
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