Aspartame and its effects on health
The sweetener has been demonised unfairly in sections of the press and several websites
European population of 375 million consumes about 2000 tonnes annually of
aspartame (NutraSweet, Canderel) an artificial sweetener, which contains two
amino acids-aspartic acid and phenylalanine.(1) It is 180-200
times sweeter than sucrose, and almost half a million extra tonnes of sugar
would therefore be needed to generate the same sweetness. Was the world
screaming for all this sweetness, and what has it done to us? Anyone searching
the web on aspartame, launched in 1981 by Monsanto, the manufacturer of
NutraSweet, will find a vast catalogue of frightening personal accounts
attributing multiple health disasters to exposure to aspartame.(1)
Although no orchestrated public outcry about aspartame has taken place, much
sensationalist journalism has been published mostly on websites . In contrast,
aspartame marketing implies that it embodies a healthy way of life and avoids
obesity. Are these claims of hazards and benefits supported by evidence?
does not support links between aspartame and cancer, hair loss, depression,
dementia, behavioural disturbances, or any of the other conditions appearing in
websites. Agencies such as the Food Standards Agency, European Food Standards
Authority, and the Food and Drug Administration have a duty to monitor relations
between foodstuffs and health and to commission research when reasonable doubt
emerges. Aspartame's safety was convincing to the European Scientific Committee
on Food in 1988,(2) but proving negatives is difficult, and it is even
harder to persuade vocal sectors of the public whose opinions are fuelled more
by anecdote than by evidence. The Food Standards Agency takes public concerns
very seriously and thus pressed the European Scientific Committee on Food to
conduct a further review, encompassing over 500 reports, in 2002. It concluded
from biochemical, clinical, and behavioural research that the acceptable daily
intake of 40 mg/kg/day of aspartame remained entirely safe-except for people
aspartame embody a healthy way of life and avoid obesity? In most Western
countries sugar provides around 10% of total calories (about 200 kcal (837 kJ),
or 50 g daily). If this were entirely replaced by a non-nutritive, non-caloric
sweetener such as aspartame then obesity could indeed be vanquished-assuming
these calories are not replaced due to stimulation of appetite. We eat about 5 g
aspartame annually, equivalent to another kg of sucrose, whose 4000 kcal (16 740
kJ) could generate 0.5 kg gain in weight. But evidence that aspartame prevents
weight gain or obesity is generally inconclusive, (4, 5) although
in children, the consumption of sugar sweetened soft drinks relates notably to
increasing obesity, whereas increasing "diet" drinks or fruit juice is
inversely related to weight gain.(6)
recommendations for the management of diabetes conclude that up to 10% of total
energy can safely come from sugars but that artificial sweeteners may help avoid
weight gain.(7, 8) When sugar is consumed as a sweetener it is
chemically identical with the sugar found in fruits, which we are promoting
keenly, and its metabolic effects are no different if consumed in reasonable
amounts even by people with diabetes.(8) Most evidence points to fat
as the main dietary culprit in obesity, and one counterargument to the use of
artificial sweetener instead of sugar includes evidence that high sugar diets
tend to be lower in fat.(9) Displacing saturated fat would offer
particular advantages by reducing risk of heart disease.(10)
Carried to extremes, large amounts of sucrose will increase triglycerides, a key
component of the metabolic syndrome, and turn the tables back towards promoting
heart disease. Its fructose component is responsible for this hazard.(11)
sweeteners are promoted to prevent dental caries, as sugars form the main
substrate for mouth bacteria. However, avoiding sugar does not reduce dental
caries dramatically in regions with high levels of caries.(3) The
dominant factors are fluoride deficiency and prolonged exposure to sugar between
meals. If children consume sweetened drinks between meals or suck on sweet
foods, resulting in prolonged periods of exposure to sugar, then replacing the
sugar with artificial sweeteners in such products has some rationale. Children
exposed to heavily sweetened foods develop a "sweet palate," but those
who take the plunge and take unsweetened drinks may prefer them, which seems a
has aspartame been demonised by the world's press and countless websites?
Monsanto was in the public eye, accused of enthusiastic dissemination of
genetically modified plants and foods. People resent interference with foods,
and synthetic food components are regarded with suspicion. However, aspartame
comprises just two amino acids (aspartic acid and phenylalanine). Could this
present a risk? Phenylalanine is a natural amino acid, and is toxic only in
patients who have phenylketonuria.
labelling of sweetener is contentious. Six artificial sweeteners are permitted
in Europe, each with an acceptable daily intake. Consumers cannot be expected to
calculate cumulative daily intakes of each. Instead, manufacturers are
encouraged to use cocktails of sweeteners so it becomes difficult for anyone to
reach the acceptable daily intake of any sweetener individually-adults need at
least 10 cans of a drink fully sweetened with aspartame alone to reach the
acceptable daily intake of 40 mg/kg/day. When using combinations of sweeteners,
even high level consumers rarely exceed 10 mg/day. Intakes over 1g/day were
needed to alter brain neurotransmitters and provoke seizures in monkeys, and
randomised controlled trials of high doses in humans have not shown any
behavioural or other effects.(13, 14) The cynical conclusion is
that there is probably too much sweetness and never enough light, and the public
probably needs protection against misleading websites.
Michael E J Lean, Professor
Division of Developmental Medicine, University of Glasgow,
Royal Infirmary, Queen Elizabeth Building, Glasgow G31 2ER
Catherine R Hankey, Lecturer, University Department of Human Nutrition
Division of Developmental Medicine, University of Glasgow, Royal Infirmary, Queen
Elizabeth Building, Glasgow G31 2ER
2 October 2004
Competing interests: None declared.
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Commission. Health and Consumer Protection Directorate-General, Scientific
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|13.||Wolraich ML, Lindgren SD, Stumbo PJ, Stegink LD, Appelbaum MI, Kiritsy MC. Effects of
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