The WHO is about to declare aspartame can cause cancer. Here’s why you should listen. 世界卫生组织即将宣布阿斯巴甜会导致癌症。
Get ready for an earful about the health risks of Diet Coke, Trident gum, Equal, and other sugar-free items.
There’s some astonishing news in the world of food safety: Aspartame, a common artificial sweetener used in a wide range of foods and beverages, is about to be declared a carcinogen by a leading global health agency.
In mid-July, the International Agency for Research on Cancer (IARC) — a branch of the World Health Organization (WHO) — plans to release the results of a fresh review of safety data on the product. According to Reuters, the agency will declare that aspartame is “possibly carcinogenic to humans.” A separate WHO committee that develops recommendations on how much of a product is safe (the Joint WHO and Food and Agriculture Organization’s Expert Committee on Food Additives) plans to simultaneously release guidelines aimed at answering consumers’ questions about how much aspartame they can safely consume.
The news has lots of consumers spitting out their diet sodas — and it also has a lot of people confused about what to do with what feels like yet another wave of confusing and conflicting guidance about a food product.
As we try to figure out what to add to and ban from our shopping carts, it’s worth understanding aspartame’s path from the lab to our refrigerators.
It’s also worth examining what might set an IARC statement about a product’s safety apart from the assessments made by other agencies consumers trust with these decisions.
A history of scary, conflicting, and hard-to-trust guidance on aspartame
It can be hard for attentive consumers to know who to trust to weigh in on aspartame’s safety.
That’s because since its earliest days, the product’s manufacturers — and the industry that now reaps enormous profits from its sale — have sought to influence its approval for consumer use.
When American pharmaceutical company G.D. Searle first tried to get aspartame approved by the US US Food and Drug Administration (FDA) in 1973, it was denied: Independent scientists alleged the product could cause a range of neurologic disorders, and some alleged the company hadn’t been entirely above-board in its safety testing.
1973年，当美国制药公司 G.D。 Searle 首次试图获得美国食品和药物管理局(FDA)的批准时，阿斯巴甜被否决了: 独立科学家声称该产品可能导致一系列神经系统紊乱，一些人声称该公司在安全测试中并没有完全光明正大。
In January 1981, Ronald Reagan became the US president. His transition team included then-CEO of G.D. Searle, one Donald Rumsfeld. Although an independent FDA board warned that May that the drug might induce brain tumors, the agency’s newly installed director overruled them, and the FDA approved the product for consumer use that July.
1981年1月，罗纳德•里根(Ronald Reagan)成为美国总统。他的过渡团队包括当时 GD 的首席执行官瑟尔，一个唐纳德 · 拉姆斯菲尔德。虽然独立的 FDA 委员会警告说，五月的药物可能诱发脑肿瘤，该机构的新任主任否决了他们，并批准该产品的消费者使用该七月。
In the 1990s, scientists began to raise concerns about aspartame’s safety. A neurologist published a study suggesting the product might play a role in causing brain cancer in humans, and the FDA’s own toxicologist raised concerns about the product’s cancer-causing potential.
To better characterize the drug’s risk, the Ramazzini Institute, an Italian nonprofit research laboratory, began studying its effects on rats in 1997.
This is a common first step in determining the safety of synthetic products produced for human consumption. But this study was particularly high-quality in that it included thousands of rats and gave them a range of aspartame doses.
The purpose was to determine whether more aspartame led to more outcomes, a finding that would be strongly suggestive that aspartame was a cause of those outcomes and not just a coincidental exposure.
What the Italian scientists found did not look good: The rats that consumed aspartame had higher levels of malignant tumors in multiple organs, including kidneys, breasts, and the nervous system. These findings were noted even at low doses of aspartame — exposures similar to what the US and European authorities consider the acceptable daily intake of the product.
The study generated reams of controversy that have played out in the scientific literature ever since, with multiple groups of scientists across the globe independently re-evaluating the tissue samples from the Italian studies and coming up with their own conclusions about what they showed.
Interestingly, many of the scientists who disputed the Ramazzini Institute’s findings were funded by industry interests that profit from aspartame’s consumption: the American Beverage Association; Ajinomoto, an aspartame supplier; and the Calorie Control Council, to name just a few.
有趣的是，许多对拉马齐尼研究所的发现提出异议的科学家都是由从阿斯巴甜消费中获利的行业利益集团资助的: 美国饮料协会、阿斯巴甜供应商味之素(Ajinomoto)以及卡路里控制委员会(Calorie Control Council)等等。
The upshot here is not that you need to launch all of your diet soda directly into the sun — at least, not yet. The guidance to come may yet indicate that there’s some amount of the product that’s safe to consume.
Plus, to live on this planet is to routinely balance our desire for delight with the annoying reality that many fun things have some kind of health risk attached.
But consumers are entitled to have all the safety information companies do when making decisions about which health risks are worth taking. And the industry that produces and profits from aspartame has made complete information hard for consumers to get.
We deserve more transparency — and there’s a good chance the IARC’s guidance will at least achieve that.
Why the IARC’s guidance is especially authoritative
为什么 IARC 的指南特别权威
If aspartame’s safety has been under discussion for such a long time, why is IARC only making a statement about it now? Although that’s not entirely clear, experts say that the way IARC conducts its evaluations gives its assessments a particularly high level of integrity.
如果阿斯巴甜的安全性已经讨论了这么长时间，为什么 IARC 现在才发表声明？尽管这还不完全清楚，但专家们说，IARC 进行评估的方式使其评估具有特别高的完整性。
That means it’s worth paying attention to the agency’s take on product safety.
In June, a group of authors from the Ramazzini Institute published a new paper describing a reanalysis of their original results using some new WHO tumor classifications. The study results “confirm and reinforce” their previous findings, write the authors.
It’s still not clear whether this study, or some other new science, is the reason for the IARC’s announcement.
目前还不清楚这项研究，或者其他一些新的科学，是 IARC 宣布的原因。
But whatever the reason for IARC’s timing, its assessment is not subject to the kinds of industry conflicts of interest that pose challenges to the FDA, or the analogous European Food Safety Authority (EFSA), said Erik Millstone, a longtime scholar of food safety policy and professor emeritus of science policy at the University of Sussex in England.
但是，不管国际癌症研究机构选择这个时机的原因是什么，它的评估并不受那些对 FDA 或类似的欧洲食品安全局(EFSA)构成挑战的行业利益冲突的影响，埃里克 · 米尔斯通(Erik milstone)说。米尔斯通长期研究食品安全政策和英国名誉教授的科学政策萨塞克斯大学。
When these other agencies approved aspartame, they did it “on the basis of corporate data, most of which wasn’t in the public domain,” said Millstone. In a letter to the EFSA, he quoted from the agency’s own statements indicating it considered unpublished data in its assessment.
米尔斯顿说，当这些其他机构批准阿斯巴甜时，他们是“根据公司数据批准的，其中大部分数据不属于公共领域”。在写给 EFSA 的一封信中，他引用了该机构自己的声明，表示在其评估中考虑了未发表的数据。
On the other hand, he said, the IARC is more selective in its use of unpublished, confidential commercial data, and it takes greater care to exclude people with conflicts of interest from contributing to its evaluations.
A few years ago, Millstone and a co-author looked closely at how the European Food Safety Authority had weighed the 154 studies on aspartame safety when it looked to assess the product in 2013. About half of the studies favored aspartame’s safety and about half indicated it might do harm.
几年前，米尔斯顿和一位合著者仔细研究了欧洲食品安全局(European Food Safety Authority)在2013年评估阿斯巴甜产品时对154项阿斯巴甜安全性研究的权衡情况。大约一半的研究支持阿斯巴甜的安全性，大约一半的研究表明它可能有害。
The agency had judged all of the harm-suggesting studies — but only a quarter of the safety-affirming studies — to be “unreliable,” wrote the authors. And the agency had applied looser quality standards to the studies suggesting safety than it had to the studies suggesting harm.
Agency reviewers pushed back against Millstone’s assessment. And in any case, aspartame has remained on the European market.
Millstone is not alone in thinking that IARC has higher standards for assessing product safety than other consumer product agencies. A senior scientist at the Center for Science in the Public Interest independently evaluated the European Food Safety Agency’s aspartame approval process and judged the agency’s conclusions were “not sound and not supported by the science; they contradict established criteria and principles by IARC.”
米尔斯通并不是唯一一个认为 IARC 在评估产品安全性方面比其他消费品机构有更高标准的人。公共利益科学中心的一位资深科学家独立评估了欧洲食品安全局(European Food Safety Agency)对阿斯巴甜的审批过程，认为该机构的结论“不合理，也没有科学依据; 它们与 IARC 确立的标准和原则相抵触”
“In the early 1970s, US standards were noticeably higher than European standards,” said Millstone. “But over time, the FDA has been increasingly subordinated to commercial interests.”
The FDA has rules about who can serve on its advisory committees that are aimed at preventing conflicts of interest. However, a recent investigation by ProPublica found that consultants employed by McKinsey worked for the FDA on drug safety monitoring projects while simultaneously working for pharmaceutical companies directly affected by those projects. A recently passed congressional bill aims to reduce such conflicts.
FDA 对于谁可以担任旨在防止利益冲突的咨询委员会成员有规定。然而，ProPublica 最近的一项调查发现，麦肯锡聘请的顾问为 FDA 的药物安全监测项目工作，同时为直接受到这些项目影响的制药公司工作。最近通过的一项国会议案旨在减少此类冲突。
Industry influence in consumer safety agencies means some government agencies have bent over backward to discount unwelcome results, said Millstone. But there’s something else going on that’s even harder to combat, he said: “Institutional inertia.”
“These supposedly authoritative institutions are loath to admit that they have ever made a mistake in the past,” he said, “especially if the evidence showing that they’re making a mistake had been available earlier — and they’d ignored it.”
Consumers may also be tempted to reject information that provokes feelings of fear or regret — to clap hands over ears in a living embodiment of the “hear no evil” emoji — and that’s natural.
But if you’re a person who wants to make decisions based on high-quality information, the IARC’s statement will be one to watch.
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