The International Agency for Research on Cancer @IARCWHO has concluded that the artificial sweetener #aspartame is “possibly carcinogenic to humans” but that the evidence for this is limited in humans, specifically regarding hepatocellular carcinomahttps://t.co/eqoR1LWcUB

— The BMJ (@bmj_latest) July 14, 2023

Exclusive: Aspartame, one of the world's most common artificial sweeteners, is set to be declared a possible carcinogen next month by a leading global health body, pitting it against the food industry and regulators https://t.co/7Jv2XiJmAU pic.twitter.com/8bKuC53BMx

— Reuters (@Reuters) June 29, 2023

I think every journalist writing about this subject should be required to explain:

According to the WHO aspartame is as carcinogenic as aloe vera and pickled veg.

And less carcinogenic than eating red meat, drinking hot drinks, or being a hairdresser.

I wonder how many have? https://t.co/PCzTzNXBnp

— James A Wong (@Botanygeek) June 29, 2023

The discussion about these IARC decisions is a bit ridiculous, so I thought I'd outline why I am still perfectly happy personally to drink aspartame (and do it regularly) 1/n https://t.co/CWJgh1Z6Lk

— Health Nerd (@GidMK) June 29, 2023

3/n This is divided into four categories:

3: No evidence it causes cancer
2b: Possibly (some evidence, usually slim) it causes cancer
2a: Probably (some evidence, a bit more robust) it causes cancer
1: Causes cancer (strong evidence)

— Health Nerd (@GidMK) June 29, 2023

5/n Firstly, it's important to put this decision in context. Other things that are currently on the 2b list from the IARC:

– Coconut oil soaps
– Nickel
– Sassafras oil
– Aloe vera
– Bracken fern
– Pickled vegetables
– Talcum powder

Etc

— Health Nerd (@GidMK) June 29, 2023

7/n The epidemiological evidence is also quite good for aspartame, and in general does not show an elevated risk. For example, a large cohort from 2014 found no increased risk for NHL types and higher aspartame intake https://t.co/IOEi3HkfbW

— Health Nerd (@GidMK) June 29, 2023

10/n Now, these studies are limited. It's very hard to precisely estimate the intake of aspartame specifically in any one group of people. Mostly, we use estimates based on stated consumption of various artificially-sweetened foods

— Health Nerd (@GidMK) June 29, 2023

12/n There are also some studies of this nature where weak associations have been found: https://t.co/azUDgS5GiY

So the evidence isn't entirely null, although much of it certainly is

— Health Nerd (@GidMK) June 29, 2023

14/n I haven't reviewed every study on this topic in depth, but at least for the epidemiological evidence it's mostly of a similar quality – large-scale cohorts with longitudinal follow-up, and few if any associations found

— Health Nerd (@GidMK) June 29, 2023

16/n Personally, having read a fair bit of evidence on the topic, I don't find the association between aspartame (or other artificial sweeteners) and cancer at all convincing 🤷‍♂️

— Health Nerd (@GidMK) June 29, 2023

18/n If we take these results entirely at face value, it would mean that going from ingesting no aspartame at all to having a 'high' intake of aspartame (about a Diet Coke every 3 days) for a decade, your risk of cancer would go from 31/1000 to 33/1000

— Health Nerd (@GidMK) June 29, 2023

19/n I wrote this all up in a bit more detail here: https://t.co/8TZ2Kugr1z

— Health Nerd (@GidMK) June 30, 2023