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Artificial sweeteners are touted as an alternative to sugar — but research casts doubt on their safety – CBC.ca

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The safety of artificial sweeteners has been debated for decades, but new research is renewing concerns about their potential health impacts.

Researchers behind a large-scale nutrition study out of France say they’ve found associations between consumption of artificial sweeteners, like aspartame and sucralose, and cardiovascular disease and cancer.

The NutriNet-Santé study, which included more than 100,000 participants, is among the largest of its kind, and the first to quantify the amount of sweeteners consumed, they say.

“It’s an important step — a new brick to the wall — regarding the weight of evidence that we would train together regarding artificial sweeteners and health,” said Mathilde Touvier, head of the Nutritional Epidemiology Research Team at the French National Institute for Health and Medical Research and one of the study’s authors.

Non-nutritive sweeteners, as they’re known in nutritional science, are intensely sweet — some hundreds of times sweeter than sugar — and favoured by many for offering the taste of sugar without the calories. And as the long-term effects of too much sugar become better known, artificial sweeteners are also seen as an alternative.

LISTEN: Dietitian Leslie Beck on reducing artificial sweetener intake: 

The Dose16:06Is it time to cut out artificial sweeteners?

While diet soda might be the most obvious source, artificial sweeteners are found in all kinds of common foods, including yogurts, baked goods and even ketchup.

Previous studies have found sugar substitutes can alter gut microbiomes and elevate blood sugar. Other studies have even suggested that they can lead to weight gain, though that has been disputed.

“There really is growing evidence to challenge the assumption that artificial sweeteners are metabolically inert substances. And I do think these findings should give us pause,” said Leslie Beck, a dietitian and health columnist, in an interview with The Dose’s Dr. Brian Goldman.

International health agencies examining sweeteners

The most recent NutriNet-Santé study on cardiovascular health was published last month in the British Medical Journal. 

It sorted participants into three groups — lower, higher and non-consumers of artificial sweeteners. Those in the higher cohort consumed around 77 milligrams of artificial sweeteners per day, equal to roughly two packets of sweetener or less than 200 millilitres of diet soda.

Compared to non-consumers, higher consumers tended to be younger, have a higher body mass index, were more likely to smoke and less likely to exercise. 

What the study found is that aspartame intake was associated with higher rates of cerebrovascular events such as stroke, and acesulfame potassium and sucralose were associated with higher rates of coronary heart disease, in high consuming participants compared to non-consumers.

The NutriNet-Santé study is the first to quantify artificial sweetener consumption from all sources — not just artificially sweetened beverages, researcher says. (SpeedKingz/Shutterstock)

A separate study also using data from the NutriNet-Santé group, published last March in the journal PLOS Medicine, found an association between artificial sweeteners — aspartame and acesulfame potassium in particular — and cancer risk.

Touvier notes that the World Health Organization (WHO) is currently investigating the safety of artificial sweeteners. 

In a meta-analysis of nearly 300 studies published in April, the WHO found there may be short-term benefits for weight loss when sugar-based drinks are replaced with artificially sweetened beverages — but not when compared to water. It also found that studies suggest “the possibility of long-term harm in the form of increased risk of obesity, Type 2 diabetes, cardiovascular diseases and mortality,” but cautioned that additional research is needed.

“We hope that this new work will bring important evidence and help [the WHO] to revise, potentially, their opinion and regulation on artificial sweeteners,” said Touvier.

In Canada, sugar substitutes are regulated and approved following a safety assessment by Health Canada.

Lower consumption of sweet foods

David Ma, a professor and nutrition researcher at the University of Guelph, says while the most recent NutriNet-Santé study’s findings uncovered increased cardiovascular health risk in a relatively small number of people, they suggest there’s a “signal” for potential long-term health effects. 

However, that doesn’t indicate immediate danger for most consumers.

“I would say that, you know, the sky is not going to fall down because we have artificial sweeteners in our diet,” said Ma, who is also the director of the Guelph Family Health Study. 

“But certainly we need to have an eye out for everything in our diet, including artificial sweeteners in terms of the short-term and the longer-term effects.”

Like everything in nutrition, the researchers say moderation is key. And Touvier says based on her study’s findings, occasional consumption of artificial sweeteners is fairly low risk.

Canada’s food guide states that sugar substitutes are not needed for healthy eating. In fact, using them can lead to less healthy food choices and increase preference for sweet foods.

Whether it’s sweetness from artificial sweeteners or sugar, Beck said cutting back is key. She recommends:

  • Gradually reducing your sweetener use — by using a quarter packet less each week, for example.
  • Switching to flavoured, carbonated waters for those who crave pop.
  • Considering plain yogurt sweetened naturally with fresh fruit instead of sweetened yogurts.

“It is entirely possible to adjust your taste buds and come to prefer a less sweet taste,” said the dietitian.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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