• WHO body says aspartame sweetener possibly cancer-causing
• US FDA claims its scientists don’t have safety concerns if sweetener used under approved conditions

KARACHI: While international bodies consider a certain amount of daily use of artificial sweetener aspartame as safe, health experts called for discouraging use of all kinds of sugar substitutes in a country like Pakistan where regulatory bodies are persistently failing to deliver, it emerged on Monday.

They were speaking to Dawn against the backdrop of a recently released assessment of aspartame sweetener by the International Agency for Research on Cancer (IARC) of the World Health Organisation (WHO).

Aspartame has been used in multiple food and beverage products since the 1980s, including diet drinks, chewing gum, ice cream and other dairy products such as yoghurt; breakfast cereals, toothpaste, and medications such as cough drops and chewable vitamins.

The IARC has classified aspartame as “possibly carcinogenic to humans”; although another UN committee reaffirmed the acceptable daily intake of 40mg/kg body weight.

The joint assessment from IARC, and the Joint Expert Committee on Food Additives (JECFA), which is part of WHO and the Food and Agriculture Organisation (FAO), represents the first public intervention by the UN health agency on the widely used sweetener.

Commenting on the subject, Dr Javed Akbar Sial of the Cardiac Association of Pakistan said, “Aspartame’s classification by ICRC indicates that scientists have limited evidence that the artificial sweetener can cause cancer. But, that doesn’t mean that the substance is completely safe for human use.”

The field of science, he pointed out, continued to evolve every day as new data was available. “Even after so much advancement, there are a lot of grey areas. One can’t say that things which are considered safe today might be declared harmful in coming years as new evidence emerges.”

Sugary drinks, he said, increased risk for heart disease. “If carbohydrates are not burned out, they are turned into fats, posing risk to heart health.”

IARC has classified aspartame as possibly carcinogenic to humans (Group 2B) on the basis of limited evidence for cancer in humans (specifically, for hepatocellular carcinoma, which is a type of liver cancer). There was also limited evidence for cancer in experimental animals and limited evidence related to the possible mechanisms for causing cancer.

Experts believe that the findings of limited evidence of carcinogenicity in humans and animals, and of limited mechanistic evidence on how carcinogenicity may occur, underscore the need for more research to refine our understanding on whether consumption of aspartame poses a carcinogenic hazard.

The WHO assessment, however, was rejected by the United States Food and Drug Administration (FDA).

In a statement, it said: “Aspartame is one of the most studied food additives in the human food supply. FDA scientists do not have safety concerns when aspartame is used under the approved conditions.”

It added that Health Canada and the European Food Safety Authority had both evaluated the sweetener and considered it safe at current permitted levels.

Dr Abdul Ghafoor Shoro, a senior general physician heading Pakistan Medical Association-Centre, believed that WHO analysis carried more importance and should be taken seriously as the international body had worldwide presence and evaluated the data collected from a range of sources, including peer-reviewed papers, governmental reports and studies conducted for regulatory purposes.

“It’s not hard to understand why the FDA has rejected WHO’s assessment since a powerful beverage industry operates in the US. It’s an open secret that artificial sweeteners damage the liver, stomach and intestines, apart from causing other health complications,” he said.

Dr Shoro emphasised the need for local data and said Pakistan had a “unique” situation and needed to generate its own research for policy decisions. “There are no regulatory checks. Hence, what could be a safe level in the US couldn’t be expected to be implemented in our country lacking official monitoring on food quality.”

Prof Asher Fawwad, who represents the Diabetic Association of Pakistan, said a more clear status of aspartame would have emerged if the international body had carried out a planned study instead of analysing data from different sources.

“There is no doubt that there has been a steep rise in cases of diabetes and obesity contributing to heart ailments in recent years. One of the factors is extensive use of sweetened beverages, apart from other factors,” he said, while underscoring the need for focusing on preventive strategies.

Published in Dawn, July 18th, 2023