Can you have aspartame in your tea, diet cola? Top diabetologists decode WHO report

Does this mean that I can get cancer from taking aspartame?

What is aspartame? (Designed by Mithun Chakraborty)

No. At least, not in the quantities that are usually consumed. Adding a couple of pellets of aspartame to your tea or coffee or drinking a diet soda every once in a while are unlikely to cause cancer. Says Dr V Mohan, chairman of Dr Mohan Diabetes Speciality Centre in Chennai, “My suggestion to people, who are taking aspartame, is to continue to use it but not in too large a quantity. Contrary to expectations that there would be strong evidence for aspartame being pro-carcinogenic, the WHO report concluded that in the permissible quantities aspartame may be continued. The report suggested that only if consumed in overdoses — much above the permissible dose of aspartame — could there be a possible carcinogenic effect. And, even this was based on a low level of evidence.”

Maintaining his recommendation that diabetics continue to use the commonly available aspartame in moderation, Dr Ambrish Mithal, Chairman and Head of Endocrinology and Diabetes at Max Healthcare, says, “The report is very detailed, taking into account all available evidence. But the conclusion is that anything in moderation is not harmful. It is easy for scientific papers to say don’t use artificial sweeteners, but when you are interacting with patients in the real world, that is not possible. We cannot even recommend moving away from aspartame to something else as it is one of the most commonly available sweeteners. Besides, what would you switch to? Sucralose seems to be okay, but again there is some evidence to suggest that it alters the gut microbiota. There is no evidence of adverse events with stevia. However, that could just be because the product is relatively newer and more studies are needed,” he says.

Still, the WHO report, feels Dr Anoop Misra, Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, is significant. “The WHO report says that there is limited evidence that aspartame could be carcinogenic. But this announcement is very important. That is because people should be aware of what they are consuming — they shouldn’t keep on eating or drinking products with such artificial sweeteners thinking that it is completely safe. It can be consumed in limited quantities but people shouldn’t go overboard with it. People should also be aware that sometimes the packaged products contain more than one sweetener, then the impacts of the other should also be considered. For example, sucralose has been shown to produce chemicals that can damage DNA and cause leaky gut in laboratory studies or how erythritol has been linked to increased risk of cardio-vascular diseases.It is also known that intensely sweet, zero-calorie products may also lead to obesity, diabetes, and heart disease in the long run because it makes people crave for other calories,” he says.

The “possibly carcinogenic” tag for the sweetener comes from an analysis by the WHO’s International Agency for Research on Cancer (IARC). This analysis focusses on hazard identification — a process to determine whether a substance has properties or potential for causing cancers. It does not, however, take into account the level of exposure to the substance needed to actually get cancer from it. The second committee – WHO and the Food and Agriculture Organization (FAO) Joint Expert Committee on Food Additives (JECFA) — analysed whether the sweetener could cause cancer or other adverse health impacts if consumed at current ADI levels. This committee concluded that there wasn’t sufficient evidence to suggest that these levels be reduced.

Moreover, aspartame can be completely broken down by the intestine into metabolites that are identical to ones absorbed by the body after consumption of common foods. The experts agreed that none of the aspartame, when ingested, circulates in the body.

Should I choose a normal soda or a diet soda?

Diet soda is one of the products that prominently uses aspartame to sweeten it. While doctors are always worried about the hidden sweeteners in packaged foods and beverages, Dr Mithal says choosing artificial sweeteners may be better than choosing full sugar. “If a healthy adult is consuming one soda say once in a week, then they may have the regular version. However, for a person who sits on their office desk and consumes say seven to eight sodas a day, having the diet version would definitely be better. This is because the data on the harmful effects of consuming excessive sugar is very convincing,” he adds.

Studies done by Dr Mohan also suggest that there is no harm in consuming artificial sweeteners in limited quantities. “We have completed three studies recently looking at sucralose and we find that there is no harmful effect of taking sucralose in these limited doses. And, hence, judicious use of non-nutritive sweeteners (NNS) may be continued. In fact, we found beneficial effects in both people with diabetes and those without diabetes with respect to reduction in body weight and waist circumference when NNS replaced sugar in the coffee and tea.” Dr Francesco Branca, Director of the Department of Nutrition and Food Safety at WHO, says that aspartame-based chewing gums have been found to be better for the teeth.

What is the safe level of aspartame consumption?

The recent analysis by the international committee stuck to the previously established ADI level of 0 – 40 mg per kg of body weight. This limit is actually much higher than what people usually consume in a day. An average person weighing 70 kg based on this ADI can consume up to 2,800 mg of aspartame. To put it into perspective, the limit would mean consuming around 155 pellets of the sweetener or drinking 9 to 14 cans of diet soda in a day!

If it seems like too much, it is. While this is the maximum safe limit determined for the use of aspartame, it assumes that you are eating the sweetener by itself. This is usually not the case. While the sweetener itself is likely to add fewer calories as compared to say consuming as much sugar, it is added to foods that are likely to be calorie-dense. Consuming a calorie-loaded diet can lead to lifestyle diseases such as obesity, hypertension and diabetes.

What does WHO say about consumption of sugars and artificial sweeteners, including aspartame?

With obesity and associated non-communicable diseases on the rise, the WHO recommends cutting down on consumption of free sugars — sugar added to foods by manufacturers, in the kitchen, or on the table. The inter-government body strongly recommends reducing the consumption of free sugars to 10 per cent of the total energy intake, which translates to roughly about 12 teaspoons a day. A further reduction to five per cent of total energy intake or six teaspoons of sugar a day will provide additional health benefits, it says. The challenge with keeping a count of this sugar is that a lot of it comes from added sugars in packaged foods.

A couple of months ago, the WHO came out with the recommendation that artificial sweeteners such as aspartame not be used for achieving weight control or reducing the risk of non-communicable diseases. Its report said that artificial sweeteners in the long run did not help keeping the weight in check and possibly increased the risk of Type 2 diabetes, cardiovascular diseases and premature death.