In recent years, with the rise of sugar reduction, artificial sweeteners have become a favorite of many people because of their low sugar content and low calories. However, a large-scale peer-reviewed study in France found that artificial sweeteners may not be healthy carbohydrate substitutes. People who consume large amounts of artificial sweeteners, especially aspartame and acetylsulfanilamide commonly used in soft drinks, are especially at risk for breast cancer and obesity related cancers. The study was published in the recent journal PLoS Medicine. To assess the potential carcinogenicity of artificial sweeteners, the researchers analyzed data from 102865 French adults who participated in a large nutritional health study in France. The average age of these participants was 42.2 ± 14.5 years, of which 78.5% were women. The researchers collected information about participants' gender, age, education level, information on history, diet, lifestyle and health data, weight gain, diabetes, family history of cancer, and collected data on intake of artificial sweeteners from 24 hour diet records to assess participants' baseline intake of energy, alcohol, sodium, saturated fatty acids, fiber, sugar, whole grain foods and dairy products. Subsequently, the researchers followed up every 6 months and collected cancer diagnosis information of participants during this period. The study found that 36.9% of participants consumed artificial sweeteners, mainly aspartame, accounting for 58% of their intake, followed by Acesulfame (29%) and sucralose (10%). The three sweeteners were consumed by 28%, 34% and 14% of participants, respectively. The study also found that the artificial sweeteners consumed by participants mainly came from sugar free or sugar substitute soft drinks, table foods (such as sugar biscuits, cakes, pastries, breakfast cereals, sauces, salty foods and super processed fish products), as well as yogurt or cheese. They account for 53%, 29% and 8% of the intake of artificial sweeteners, respectively. During the follow-up period, 3358 new cancer cases were diagnosed, including 982 cases of breast cancer, 403 cases of prostate cancer and 2023 cases of obesity related cancers (such as colorectal cancer, gastric cancer, liver cancer, oral cancer, pharyngeal cancer, laryngeal cancer, esophageal cancer, ovarian cancer and endometrial cancer). The mean age at diagnosis was 59.5 ± 12.2 years. Overall, artificial sweetener intake was positively associated with overall cancer risk. The study found that participants who took a large amount of aspartame and aspartame had higher risk of cancer and higher risk of breast cancer and obesity related cancers. The researchers said that despite the limitations of the study, it still did not support the use of artificial sweeteners as a safe substitute for sugar in food or beverages. (outlook new era)