Aspartame remains one of the most scrutinized synthetic food additives worldwide. This narrative review provides an integrative analysis of its systemic health impacts, focusing on the 2023 International Agency for Research on Cancer (IARC) classification of aspartame as a Group 2B possible carcinogen and its implications for public health policy. By synthesizing epidemiological evidence from the NutriNet-Santé cohort, contemporary meta-analyses (2021–2026), and mechanistic studies on oxidative stress and gut dysbiosis, this paper evaluates the "aspartame paradox" - the tension between its intended role in caloric reduction and its potential as a metabolic and oncological disruptor. Furthermore, the review examines socio-regulatory challenges in risk communication, analyzing how divergent global guidelines influence consumer behavior and health equity. Ultimately, this review underscores the need for a unified regulatory framework to better inform public health initiatives.
Gromadzki et al. (Thu,) studied this question.