MON-324 Systematic Literature Review of Non-caloric Sweeteners: Cancer Risk and Daily Intake Guidelines

Abstract Disclosure: A. Ojha: None. Background: Non-caloric sweeteners (NCS), such as aspartame, erythritol, and monk fruit, are widely used to reduce sugar intake and manage conditions like obesity and diabetes. Despite their popularity, concerns about their potential carcinogenicity persist, especially after the 2023 IARC classification of aspartame as “possibly carcinogenic to humans.” Regulatory agencies, including the FDA and EFSA, have set acceptable daily intake (ADI) thresholds, but mixed results from various studies—ranging from preclinical to epidemiological—have raised questions about their long-term safety, particularly for individuals with metabolic disorders. Objective: This systematic review critically evaluates the cancer risk associated with non-caloric sweeteners, focusing on aspartame, and assesses whether their consumption within ADI limits ensures safety. The review also compares the safety profiles of aspartame with those of other common NCS (erythritol and monk fruit) and evaluates the potential long-term health implications. 3. Methods: A systematic literature review was conducted by querying PubMed, Google Scholar, and publications from WHO, IARC, FDA, and EFSA. Studies published between 2000 and 2023 were included if they examined the carcinogenicity, oxidative stress, DNA damage, or other health effects of NCS. Studies adhering to established ADI limits were prioritized. A critical analysis of study design, quality, and methodology was performed, including a comparison of findings from aspartame and other NCS. 4. Results: Preclinical studies indicate potential oxidative stress and DNA damage at doses much higher than those typically consumed by humans. Epidemiological studies, such as the NutriNet-Santé cohort, show mixed results, with some suggesting associations between high NCS intake and cancer risk, particularly for liver and breast cancer, while others show no significant association. Reviews by regulatory bodies, including EFSA and FDA, reaffirm that NCS, such as aspartame, are considered safe when consumed within ADI limits. The intake levels required to exceed ADI thresholds are impractical, suggesting that typical consumption does not pose a significant cancer risk. However, the conflicting findings highlight the need for further studies, particularly long-term trials, to clarify these effects. 5. Conclusion: Current evidence does not support a definitive link between NCS consumption and cancer risk when consumed within ADI limits. However, the variability in study findings, especially in the context of long-term human data, underscores the need for additional research to confirm these results. Future studies should focus on the effects of NCS in populations with metabolic disorders, and regulatory agencies should continue to monitor emerging evidence to ensure the safe use of NCS. Presentation: Monday, July 14, 2025