Common artificial sweetener may cause DNA damage, cancer

Many people turn to artificial sugar substitutes to reduce their calorie intake, but a growing body of evidence shows the potential health hazards associated with these substances.

Now, a new study found that a chemical, sucralose-6-acetate, found in sucralose (sold under the trade name Splenda) causes DNA damage.

Researchers from North Carolina State University and the University of North Carolina at Chapel Hill determined the chemical is "genotoxic," which means it harms genetic information within cells. They also exposed human gut tissues to sucralose to examine the effects on gut health and the potential for carcinogenicity.

The results were recently published in the Journal of Toxicology and Environmental Health.

Susan Schiffman, PhD, corresponding author of the study and an adjunct professor in the joint department of biomedical engineering at North Carolina State University and the University of North Carolina at Chapel Hill, told Medical News Today:

"The most compelling finding was that a contaminant and metabolite of sucralose could damage DNA in human blood cells and express genes in human gut epithelium that can induce inflammation and even cancer."

For the study, researchers exposed human blood cells to sucralose-6-acetate in several in vitro experiments. The results showed signs of genotoxicity.

The researchers also found that sucralose caused leaky gut or damage to the gut lining. In addition, they observed the genetic activity of the gut cells and discovered that sucralose caused an increase in gene activity linked to oxidative stress, inflammation, and carcinogenicity.

The results support the growing evidence of the harmful effects of artificial sweeteners, such as an increased risk of heart disease and cancer.

"For many years, artificial sweeteners have already been suspected of having carcinogenic effects," Dr. Danielle Leonardo, a board certified specialist in internal medicine and medical oncology in Calabarzon, Philippines, not involved in the research, told MNT.

"This [study] is another push toward confirming this hypothesis. I believe that we have already established the foundational research for the theory and the preliminary data is already present," Dr. Leonardo added.

While the results are cause for concern, it's unclear how sucralose could affect health on a broader scale. As such, further research on the effects of sucrose-6-acetate is still needed, particularly in human trials.

"We are limited by the fact that these are only in vitro (test tube) and animal studies and so we are still a long way before we discover its applicability in human patients," Dr. Leonardo explained.

Dr. John Damianos, a hospital resident at Yale School of Medicine, not involved in the research, told MNT that "the paper studied sucralose-6-acetate in isolation."

"While this compound is an intermediate of sucralose (comprising up to 0.67% of sucralose) and metabolite, it does not make up the majority of ingested sucralose, and it is uncertain how much is produced in the human intestine," he noted.

Dr. Damianos added that "the findings raise potentially concerning findings that deserve further study, but do not practically reflect what occasional or even frequent ingestion of sucralose-sweetened food and beverages have on health."

According to Dr. Schiffman, the next steps for research will be looking at the biological impact of sucralose when paired with acesulfame-K, another artificial sweetener that often accompanies sucralose in food products.

Future sucralose research could also include population-based studies, which may deepen scientists’ understanding of the connection between sucralose-6-acetate and cancer.

"Population-based studies on the cancer risk of sucralose-6-acetate may be considered in the future. But it will be difficult to establish a direct cause-and-effect relationship between sucralose-6-acetate and cancer because of the multifactorial dimension of cancer. Still, this data already suggests that the public be more careful in taking these artificial sweeteners and shift to other ‘safer’ alternatives."

– Dr. Danielle Leonardo, a board certified specialist in internal medicine and medical oncology

If you’re wondering whether it's better to consume smaller amounts of refined sugar rather than excessive amounts of artificial sugar, it may ultimately come down to how much you consume.

The Dietary Guidelines for Americans recommends people over 2 years old limit their sugar intake to no more than 10% of their daily calories — or no more than 10 teaspoons of sugar per day. Children under 2 shouldn't have any added sugars at all.

Still, health experts have cautioned that 10 teaspoons of sugar per day may still be too much. The American Heart Association (AHA), for instance, recommends no more than 6 teaspoons of sugar per day for women and 9 teaspoons a day per men.

"We know that excess refined sugar is associated with a myriad of adverse health outcomes," Dr. Damianos said. "There is also accumulating data that certain artificial sweeteners may also be harmful."

For overall health, experts recommend adherence to a healthful eating pattern that emphasizes whole foods and limits processed foods and foods high in sugar.

Dr. Damianos said a balanced diet is "consistently associated with better health outcomes."

Experts recommend avoiding added sugars as much as possible, which may include natural sugars such as honey or agave.

When choosing sugar substitutes, you could opt for stevia or monk fruit over artificial sweeteners — but it's a good idea to talk with your doctor first, particularly if you have a health condition like diabetes.

"Naturally-occurring sugar substitutes that are not created in the laboratories are considered healthier alternatives," Dr. Leonardo said.

Considering the risks of refined sugar, Dr. Damianos said he encourages his patients to consider healthier low- or no sugar alternatives.

"Instead of soda or diet soda, switch to seltzer water," Dr. Damianos recommended.

"Instead of highly processed foods and drinks to satisfy that sweet tooth, grab fruits with their natural sugars paired with an abundance of health-promoting fiber and phytonutrients," he added.

"Date sugar and Yacon syrup are unique sugar alternatives that have a lower glycemic index than sugar, may provide health benefits, and make for great baking. Coconut sugar, molasses, honey, maple syrup, and agave are commonly used but still can raise blood sugar, and so should be used sparingly. I also encourage patients to consider the totality of the diet, with particular attention to increasing dietary fiber and healthy fats, which blunt the insulin spike."

– Dr. John Damianos, Yale School of Medicine