Due to the growing awareness of obesity, diabetes, and other lifestyle diseases, artificial sweeteners have gained popularity recently as they add sweetness to the food without the calories of sugar. They are also known as non-nutritive sweeteners (NNS) or low-calorie sweeteners (LCS).  Aspartame, sucralose, saccharin and acesulfame-K are some of the most commonly used artificial sweeteners. But are these artificial sweeteners safe to be taken in the long term? Let us have a look based on scientific studies and data from food regulatory authorities.

Benefits of Regular Use of Artificial Sweeteners:

  • Weight Reduction: They provide sweetness to food without many calories so they are beneficial for weight reduction and are considered as a good substitute for sugar. 
  • Help in Blood Sugar Control: Sucralose and aspartame do not spike blood glucose or insulin levels and so are considered safe for people with diabetes
  • Dental Health: Unlike sugar, they do not ferment in the mouth and do not cause dental caries.

Possible Long Term Side Effects of Artificial Sweeteners:

  • Disturb Metabolic Health: Long term use may impair insulin sensitivity and thus disturbing the glucose metabolism. This may increase the risk of obesity, type 2 diabetes and metabolic syndrome.
  • Potential Carcinogenicity: The IARC (under WHO) classified aspartame as “possibly carcinogenic” (Group 2B) in 2023, though the FDA and EFSA maintain its safety at current ADI (40–50 mg/kg/day) levels.
  • Disturb the Gut Microbiome Balance:  A landmark Nature study done in 2014 says that saccharin can cause glucose intolerance in some individuals by altering the gut microbes. This may increase the risk of developing type 2 diabetes.Increase 
  • Risk to Develop Heart Diseases: Epidemiological studies have reported increased risk of heart issues in high consumers. Studies done on animals showed changes in ECG. 
  • Cause Inflammation: Aspartame and saccharin may increase pro-inflammatory markers though more research is needed on this subject.

What Do the Regulatory Authorities Say?

  • The US FDA has approved six artificial sweeteners as ''Generally Recognized as Safe '' (GRAS) which are aspartame, acesulfame potassium, saccharin, sucralose, neotame, and advantame. And each one has an established ''Acceptable Daily Intake'' (ADI) limit. In India, 
  • The FSSAI permits saccharin, aspartame, acesulfame K, sucralose, and neotame use within the acceptable limits. Due to a lack of India-specific long-term safety data, FSSAI is currently retaining the  existing limits set by the US FDA.
  • The WHO recommends against long-term use for weight control, due to the lack of evidence of benefit and potential for adverse outcomes like T2DM and CVD. 

Conclusion:

The effect of long term use of artificial sweeteners still remains debatable due to the lack of long term evidence based studies and data. Regulatory bodies (FDA, FSSAI, EFSA) continue to permit their use within established ADIs, while WHO advises caution for long-term reliance. Occasional use does not seem to cause any significant health concerns.

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