The Non-Sugar Sweetener Debate is NOT Sweet

By Christina Dorett, Seventh Generation Interfaith Coalition for Responsible Investment

Sucrose is a natural sugar, a vital source of energy for our bodies, and Sucralose is a Non-Sugar Sweetener (NSS) or sugar substitute. Would you know the difference? It is not a coincidence that the names are deceptively similar.

Aspartame is another widely used NSS but what are the potential risk factors of continued ingestion of NSS?  The International Agency for Research on Cancer recently classified Aspartame - prominently used as an NSS in Coke’s and PepsiCo’s low- and no-sugar beverages - as “possibly carcinogenic to humans”.^[1]   Meanwhile, the companies state that testing by globally recognized food safety authorities deems the products safe.

While data may in part drive our food choices, deciphering what data is both reliable and valid, and what is intended to obscure the ugly truth, leaves consumers squirreling through a maze of research studies on the risks of NSS.

That’s why ICCR members have filed shareholder resolutions this season at Coca-Cola and PepsiCo, asking the companies to issue third-party assessments on their efforts to assess and mitigate potential health harms associated with non-sugar sweeteners.

What Do the Doctors Say?

On January 22nd, 2024, JAMA Pediatrics reported on the need for more transparency around the potential harm of NSS, in particular the use of Aspartame to reduce the calorie count:

“The lack of publicly accessible information disclosing amounts of NSS in products is particularly timely considering that, in July 2023, the International Agency for Research on Cancer (IARC) classified aspartame as a “possible carcinogen,” whereas the Joint Food and Agriculture Organization/WHO Expert Committee on Food Additives (JECFA) found the evidence linking aspartame consumption and cancer unconvincing and did not alter intake recommendations. However, both bodies emphasized the need for better studies on the health effects of aspartame, which necessitates reliable exposure estimates.”^[2]

A study published in the Journal of Toxicology and Environmental Health in May 2023, found evidence that refutes the Food and Drug Administration’s (FDA) assertion that NSS are safe:

“Ingestion of sucralose by humans and/or animals within approved Acceptable Daily Intake (ADI) levels was found to disrupt the microbiome in the gastrointestinal tract….  Sucralose also impacts the intestinal tissue. Sucralose ingestion induced histopathological changes including lymphocytic infiltrates into the intestinal epithelium, glandular disorganization, and epithelial scarring…Consumption of sucralose was noted to alter glucose and/or insulin concentrations in the plasma of some human subjects when delivered in liquids or capsules.”^[3]

More research is needed to validate the degree of risk NSS pose. If regulatory bodies fulfill their roles by funding research and publishing findings to educate consumers, we would all have the opportunity to be better informed and therefore make healthier decisions regarding food options for our children and ourselves.

Acceptable Daily Intake (ADI)

Part of the US FDA’s procedure for approving any food additive is to establish the Acceptable Daily Intake (ADI). The ADI is the amount of the substance that a person could consume safely, every day throughout life, based on animal and human studies.

A 12-ounce can of diet soda contains around 200 milligrams of aspartame. The ADI for soda prescribes that 3,409 milligrams of aspartame a day is safe, for a person weighing 68 kg or 150 lbs. This means that a 150 lb consumer could safely consume 17 cans of diet soda per day!

Aspartame

Aspartame was first approved by the FDA for use in 1974. Its brand names are Equal, Nutrasweet, and Sugar Twin^[4]. In July 2023, the World Health Organization (WHO) recommended “against the use of NSS to control body weight or reduce the risk of noncommunicable diseases”.^[5]

Based on a 2022 meta-analysis, this report demonstrated the “use of NSS does not confer any long-term benefit in reducing body fat in adults or children” and suggests that there “may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults”.^[6]

Lack of Regulatory Oversight

The FDA has decreed that JECFA is better suited to assess any risks associated with the consumption of aspartame because it considers all relevant toxicological endpoints, including carcinogenicity.^[7] The implication that the WHO is not able to issue public health recommendations based on an assessment of all available data (including public and non-public proprietary data), or that the IARC should wait to publish findings until after coordinating with the JECFA, is tantamount to the FDA surrendering to the Food and Beverage giants and their trade associations. The FDA’s and JEFCA’s primary role is to protect consumers, who have no lobbyist to advocate for their right to know the risks of NSS.

Ignoring the demand for more research, the American Beverage Association and soda giants like Coke and Pepsi hold tight to the JECFA claim that Aspartame is safe and the ADI recommendations remain unchanged. And they get away with it, since regulatory controls on the use of NSS are absent.

In November 2023, the Environmental Working Group (EWG) reported on this “regulatory vacuum” and how the use of NSS has accelerated at exponential rates^[8]:

“Despite growing health concerns and little government oversight, the use of [non-sugar] sweeteners in processed foods and drinks has exploded over the past decade, an EWG analysis shows. Using data from Food Scores, [EWG’s] searchable database of more than 80,000 foods, EWG found that between 2013 and 2022, the use of sweeteners has gone up: 

• by more than 600 percent in baby food.
• by more than 400 percent in snacks, cookies and candy, with sweeteners appearing on product labels nearly 25,000 times in 2022.
• by more than 400 percent in beverages.
• by more than 400 percent in frozen foods.

Perhaps most striking, the use of sweeteners has increased over 700 percent since 2013 in diet and nutrition foods, which are often marketed as ‘healthy’, as people search for alternatives to sugar.”

On January 28th,2024, The Guardian published an article: “Should I worry about drinking diet soda?”^[9]:

“... at least one observational study that looked at people’s habits over an eight‑year period found that drinking more than 21 artificially sweetened drinks a week almost doubled their risk of becoming overweight or obese. So what else could be going on? One answer may be that diet soda drinkers are more likely to be doing something that increases their obesity risk, such as regularly eating processed food or overeating because they believe they are “saving” on the calories they drink.”

The label “Diet Soda” is an example of how names are deceiving. While diet sodas are low in calories, and give the illusion that they are “healthier” than regular sodas, this marketing ploy is an example of how “diet soda” obscures the ugly truth of NSS:

• possibly carcinogenic to humans 
• increased risk of type 2 diabetes
• increased risk of cardiovascular diseases
• doubled risk of becoming overweight or obese
• disrupts the microbiome in the gastrointestinal tract
• impacts the intestinal tissue
• lymphocytic infiltration into the intestinal epithelium (inner lining)
• glandular disorganization
• epithelial scarring
• altered glucose and/or insulin concentrations in the human plasma
• does not confer any long-term benefit in reducing body fat in adults or children

The continued and accelerated rate of the use of NSS and the aggressive advertising of diet sodas^[10] begs the question: Who is supposed to protect consumers, families and children from the misinformation, confusing data and aggressive advertising to promote diet sodas? The need for more regulatory control and research is clear, but keeping the waters muddied means “fatter” corporate bottom lines.

^[1] https://www.iarc.who.int/news-events/aspartame-hazard-and-risk-assessment-results-released/

^[2] https://jamanetwork.com/journals/jamapediatrics/fullarticle/2814105?guestAccessKey=742960cc-dcbf-4dc8-aba8-632f728e5cf9&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=012224

^[3] https://www.tandfonline.com/doi/full/10.1080/10937404.2023.2213903

^[4] ual%2C%20Nutrasweet%2C%20Sugar%20Twin.

^[5] https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline

^[6] ibid https://www.fda.gov/consumers/consumer-updates/how-sweet-it-all-about-sweeteners#:~:text=Sweeteners%20Approved%20as%20Food%20Additives,Eq

^[7] https://www.fda.gov/media/166332/download

^[8] https://www.ewg.org/news-insights/news/2023/11/use-sweeteners-exploding-despite-regulatory-vacuum?auHash=NbeIqcDWytbX_vYHjXizCeJygwOusJWPdl6ZgAIhkBw

^[9] https://www.theguardian.com/lifeandstyle/series/should-i-worry-)

^[10] https://uconnruddcenter.org/wp-content/uploads/sites/2909/2022/11/Rudd-Targeted-Marketing-Report-2022.pdf