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WELCOME Philip Handler President National Academy of Sciences I am pleased to welcome you to the latest in the series of forums sponsored by the Academy and offered as opportunities to air controver- sial issues that contain substantial elements of technical content. Previous forums have dealt with such matters as energy, the use of human subjects in research, and the safety of drugs and food additives. This Forum is of a slightly different character than its predeces- sors. Some time ago the Academy was asked by the Food and Drug Administration to examine the status of the safety of saccharin; it was considered that there was some possibility that saccharin might be found to be carcinogenic to some degree. Were that to be found to be the case, rather than simply submitting a report, the idea of a forum seemed attractive since there would then be a true public issue, neces- sitating evaluation of risks and benefits. The scenario we had in mind a year ago, when it was thought that it would be well to convene this meeting, ran something like this: Imagine that the laboratory data on saccharin, when extrapolated to man in some simplistic fashion, would indicate some specific degree of risk, e.g., one chance in l0 million, one chance in a million, whatever you will. Assume also that there is a persuasive rationale for having available for public consumption a nonnutritive sweetener. This rationale rests on the large body of actuarial statistics, which, in a general way, states that those who are overweight die sooner than those who are not, bearing out an old aphorism I learned as a graduate stu- dent: "The thin rats bury the fat rats." If, indeed, nonnutritive artificial sweeteners could contribute to the lengthening of the life- span of the average citizen, regardless of exactly how long that might be, then there would be posed an issue of policy: What degree of risk is acceptable in order to achieve the benefit of the statistical
lengthening of the mean lifespan, particularly of males, since they are the ones who seem to be more at risk? It is not clear to me today that that scenario can be as clearly drawn as we had presupposed. But that is the problem before you: Whether or not there is risk, and whether or not there is benefit asso- ciated with the unrestricted use of nonnutritive sweeteners. If it is possible to quantitate those, we would be pleased to be so informed. The Academy has had something of a continuing history of involvement with these issues, previously having been asked to examine the safety of saccharin and of cyclamates. As you know, the most recent report on saccharin, which we did not wish to delay until this meeting could be convened, indicated that experimentally one still does not know cate- gorically the safety of saccharin. However, the data available seemed to indicate that the risk, if it does exist at all, is so small as not to warrant action on the part of the FDA at this time. The FDA in turn has recently asked the National Cancer Institute to take another look at cyclamates. A Wall Street Journal story about that request cites a quotation by someone in the FDA to the effect that it is generally believed that cyclamates are not sufficiently carcino- genic as to warrant their removal from society. That seems a strange way to make a request from a neutral body. It is not that I hold any prejudice in that regard, because I have long felt that the experimen- tal basis for the previous FDA action derived from a set of experiments that had been badly designed in the first instance, were inconclusive with respect to the actual findings, and did not seem, to me personal- ly, to warrant any action at the time. In any case, in a great display of confidence in the Academy (sic!) this time the request has gone to the National Cancer Institute. It so happens, by the way, that this request is double-edged, because it was really the findings of a group at the National Cancer Institute that were endorsed by a committee of the Academy in transmitting a message to the FDA with respect to what we thought about cyclamates at the time. These, then, are the several issues before you, the risks and the benefits of the known artificial sweeteners. To those have been added one other at my request. In a general way the previous history of this subject had really related simply to reducing caloric intake, indepen- dent of the nature of those calories; the issue was obesity rather than the source of the dietary calories. As long as we are having this dis- cussion, I asked that we also consider the role of sucrose itself as a special source of calories, that we ask whether or not the problems with which one might here be concerned are those of calories at large, or whether they are sucrose calories specifically. These are the general questions. The scenario we had once imagined cannot be laid out in a sufficient clarity for you to debate whether a specific risk level with respect to saccharin, for example, is war- ranted by a specific benefit, such as an extra two weeks of life for all American males. As far as I know, neither the risk nor the benefit can be presented with certainty. In the next two days, you will, therefore, explore what they might be -- what risks are involved and
what benefits. Following this Forum, we hope to make available a sum- mary for the public record generally, and for the Food and Drug Admin- istration specifically. The subjects before us have aroused rather a remarkable amount of public interest from time to time, and a great deal of emotion among some. It would surely enliven this Forum if some of that emotion were to be revealed during the course of these two days. With that, I will turn the meeting over to your chairman for today, Michael Kasha, a dis- tinguished biophysicist and a superb scientist.
