H.J. Roberts published a book in 1990, called
ASPARTAME (NUTRASWEET): IS IT SAFE?
The unscientific nature of the allegations made in this book
prompted Dr Arturo Rolla of Harvard Medical School to write to
the New England Journal of Medicine drawing attention to the
irresponsibility of Hyram Roberts' publications.
The author, an internist from West Palm Beach, Florida, became
suspicious that many of his patients' symptoms were caused by
aspartame. He prepared a questionnaire for his patients that
was later given to persons across the country who thought they
were having reactions to this sugar substitute.
Headache, dizziness, fatigue, memory loss, mood swings,
changes in vision, nausea, diarrhoea, unexplained pains,
sleep and personality disorders, and the like are non-specific
and very common complaints among persons consulting a physician.
When frequent symptoms are matched with the use of a widely consumed
product, it is very likely that a chance association will appear.
For comparison, the same questionnaire should have been given to a
control group not taking aspartame and to another group taking
aspartame but without apparent complaints. Only unbiased
comparisons of these groups would shed some light on the
question of safety.
The author then asked patients who were already convinced that
aspartame was the cause of their symptoms to stop using it.
The results are predictably biased, because of the counterplacebo
effect, but he presents them as scientific evidence. He writes
that he is aware of "suggestibility" and "self-serving sensationalism".
Nevertheless, he published this book for the general public, full of
personal anecdotes of "severe" and "dramatic" reactions, along with
the frequent diagnosis of "reactive hypoglycaemia," causing "full
blown convulsions," "precipitating migraine headaches,"
Dr Roberts did not apply a rigid scientific method to test
his hypothesis, but presents it as a fact to the general
public without previous scrutiny by his peers. He quotes
the Wall Street Journal and other newspapers as often as
the scientific press. By the time he raises the question
of a connection between aspartame and Alzheimer's disease,
his credibility will be questioned even by lay readers.
Roberts presents and then criticizes the way the Food and
Drug Administration approved aspartame as a food additive,
not as a drug. Some of his points are valid. The system,
like democracy, is not perfect, but it is the best we have.
The author positions himself as a lone crusader fighting
industry, government, and the medical establishment
("organizations and individuals having vested interests").
This type of book raises many questions for the medical
community. Is it right for a physician with a hypothesis
to write a book this nature without first seeking scientific
proof and presenting the data to a medical journal or
society? I appreciate the concern and effort of the
author, but my reaction to his book is as negative
as it is strong. There is no place for a publication
such as this one. It only adds to public misinformation,
confusion and mistrust. There are many other medical and
scientific avenues available. I hope the author will
continue his effort using more rigid scientific methods,
in order to be able to present it to his peers. He has a
right to write, but he also has a responsibility as a
physician. Freedom of the press relies as much on the
honesty and responsibility of the writer as on the
government that supports it.
ARTURO R ROLLA, M.D.
Harvard Medical School
Boston, MA 02115
New England Journal of Medicine 323:1495-1496
22 November 1990