Aspartame and its effects on health
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7469.755 (Published 30 September 2004) Cite this as: BMJ 2004;329:755
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In their editorial, "Aspartame and its effects on health" (1),
Professor Lean and Catherine Hankey described my web page
as "sensationalist journalism." That web page contains
nearly 400 pages of referenced discussion related to the
toxicity of aspartame and its metabolites. In addition,
there are several hundred pages of reports from individuals
detailing their experience of aspartame toxicity. I would
invite healthcare professionals to peruse a portion the
scientific sections that address both independent and
aspartame industry-funded research in detail:
http://www.holisticmed.com/aspartame/abuse/
http://www.holisticmed.com/aspartame/scf2002.html
http://www.holisticmed.com/aspartame/aspfaq.html
In addition, there are numerous reasoned articles
written by independent researchers and phsycians
that have been reproduced on the web:
http://www.dorway.com/doctors.html
Citations in the editorial that related to
aspartame and health effects included a web page
published by an aspartame industry-funded public
relations organization (2) and a published review
written by NutraSweet company employees and others
who have received funding from the manufacturer (3).
In is not surprising, therefore, that the authors
erroneously stated that "aspartame comprises just
two amino acids" and implied that the evidence does
not support the link between aspartame and health
effects. On the other hand, evidence from independent
research and published case reports (as detailed on
the above-mentioned web pages) demonstrates that
aspartame can cause a wide range of adverse health
effects.
Addressing the response by Dr. Finer, Medical Advisor
to Ajinomoto (aspartame manufacturer), he states that:
1) Individuals must consume 200 to 500 mg/kg of methanol in order to
cause toxicity. Kavet (4) estimated that as little as a single dose of 300
mg/kg of methanol can be lethal. Dr. Finer's comments related only to
single, lethal doses of methanol and not to chronic methanol and
formaldehyde toxicity.
2) Various manufacturer-sponsored studies of aspartame ingestion
showed no rise in plasma methanol levels. The methanol technique used in
the studies was a technique developed in 1969 (5) and incapable of
reading rises in plasma methanol less than 350 to 600%. Tephly (6) and
other aspartame manufacturer sponsored researchers involved in plasma
methanol measurements have refused to use sensitive testing methods
despite their availability for many years (7-9).
3) Dr. Briffa cited a study by Trocho et al. (10), that showed an
accumulation of significant levels formaldehyde adducts in various organs
and tissues (brain, liver, etc.) after ingestion of relatively small
amounts of aspartame. However, Dr. Briffa did not cite the letter by,
Tephly (11), a researcher involved in many of the aspartame manufacturer-
funded studies related to methanol and formate. However, the issues raised
by Tephly (such as items #1 and #2 above) have been refuted in numerous
forums and by using the data in the Trocho et al. study itself:
"The 'alternative' point expressed by Tephly, suggesting that
aspartame methanol-label goes all the way into formic acid and the C1
pathway was thoroughly refuted by us, using experimental data. There was
no labelled methionine nor thymine in protein and DNA respectively in the
rat protein we recovered from rats treated with aspartame. This means--
unequivocally-- that the label present in DNA and protein adducts was NOT
incorporated into amino acids or nucleic acid bases. The only explanation
for our data was that the label was in the form of formaldehyde adducts."
(12)
Dr. Finer did not discuss in detail other issues related to
aspartame and formaldehyde typically mentioned by the manufacturer:
methanol in fruits, formaldehyde in foods, long-term studies on
non-human primates and production of formaldehyde and methanol
in the body. The above-mentioned web pages addresses all of these
issues as well as various industry-sponsored double-blind studies
often cited by the manufacturer.
Dr. Finer is correct about me being an "excited" responder to
the editorial. I am excited that busy healthcare professionals are
finding the time to look at the independent research and, based
on case reports received, are beginning to warn their patients
off of aspartame. I am also excited that the World Health
Organization's recent approval of the sweetener stevia (13)
allows diabetics and others in Europe a healthier, time-tested
alternative.
1. Michael Lean, Catherine Hankey. Aspartame and its effects on
health BMJ 2004;329:755-756 (2nd October 2004).
2. Aspartame Information Center. http://www.aspartame.org/
Web site owned by the Calorie Control Council.
"It represents 60 manufacturers and suppliers of low-calorie,
low-fat and light foods and beverages, including the manufacturers
and suppliers of more than a dozen different dietary sweeteners,
fat replacers and other low-calorie ingredients."
http://www.caloriecontrol.org/aboutCCC.html (accessed 19 Oct 2004).
3. Butchko HH, Stargel WW. Aspartame: scientific evaluation
in the postmarketing period. Reg Toxic Pharma 2001;34: 221-233.
4. Kavet R, et al. The Toxicity of Inhaled Methanol Vapors.
Critical Reviews in Toxicology 1990 21;1:21-50.
5. Baker, R.N., A.L. Alenty, J.F. Zack. Simultaneous
determination of lower alcohols, acetone and acetaldehyde in
blood by gas chromatography. Journal of Chromatographic Science,
1969; 7:312-314.
6. Stegink, Lewis D., Tephly, Thomas R., et al. Repeated
ingestion of aspartame-sweetended beverages: further
observations in individuals heterozygous for phenylketonuria.
Metabolism, 1990; 39(10):1076-1081.
7. d'Alessandro, Alessandra, et al. Formate in serum and
urine after controlled methanol exposure at the threshold limit
value. Environmental Health Perspectives, 1994; 102(2): 178-181.
8. Davoli, E., et al. Trace analysis of methanol in rat
serum by headspace high resolution gas chromatography/selected
ion monitoring," Journal of Chromatographic Science, 1986;
24:113-116.
9. Cook, M.R., F.J. Bergman, et al. Effects of methanol
vapor on human neurobehavioral measures. Research Report No. 42
(Peer Reviewed), Health Effects Institute, 141 Portland Street,
Suite 7300, Cambridge, MA 02139, +1-617-621-0266, August 1991.
10. Trocho C, et al. Formaldehyde derived from dietary aspartame
binds to tissue components in vivo. Life Sciences 1998 63;5:337.
11. Tephly TR. Comments on the purported generation of formaldehyde
and adduct formation from the sweetener aspartame. Life Sci., 1999,
65(13), 157-160.
12. Alemany 2002. Letter from Dr. Mari Alemany to Rich Murray,
September 8, 2002. http://groups.yahoo.com/group/aspartameNM/message/864 .
13. Joint FAO/WHO Expert Committee on Food Additives, 63rd Meeting,
Geneva, 8-17 June 2004:
http://www.who.int/ipcs/publications/jecfa/en/Summary63final.pdf
Competing interests:
None declared
Competing interests: No competing interests
It is not only genetics which determines susceptibility to have
migraine attacks triggered by common foods and chemicals like aspartame.
Women are more reactive in the premenstrual phase of the menstrual
cycle. While the pre-trial incidence of migraine was 9%, first year
exposures to some trial combinations of exogenous progesterones and
oestrogens induced migraine in 40 to 60% of women.1
Also common nutritional deficiencies of zinc and /or magnesium
increase the susceptibility in many of us. Among couples complaining of
unexplained infertility or recurrent miscarriages, individuals who also
suffered from headaches or migraine attacks had lower levels of these
essential minerals than headache-free couples.2
Neil Ward and colleagues found that intake of the food additive
tartrazine reduced serum and salivary zinc concentrations and increased
urinary zinc content with a corresponding deterioration in
behaviour/emotional responses of hyperactive children compared with
controls.3
A similar sudden loss of in zinc, especially in individuals who are
already zinc deficient, may help to explain the different individual
responses to aspartame.
1.Grant ECG. Relation between headaches from oral contraceptives and
development of endometrial arterioles. BMJ 1968;3:402-5.
2.Grant ECG. The pill, hormone replacement therapy, vascular and mood
over-reactivity , and mineral imbalance .J Nutr Environ Med 1998;8:105-
116.
3. Ward NI, Soulsbury KA, Zettel VH, et al. The influence of the
chemical additive tartrazine on the zinc-status of hyperactive children –
a double-blind placebo-controlled study. J Nutr Med 1990;1:51-57.
Competing interests:
None declared
Competing interests: No competing interests
It seems to me that there is a wider problem revealed by this debate,
namely the extent to which safety testing relies on population-level
studies which have not, thus far, paid much attention to the distribution
of harmful effects and the possibility that some genotypes are more
sensitive than others. Anecdotally, aspartame seems to be capable of
triggering me into migraine-like reactions, like those that I experience
from exposure to monosodium glutamate, cheap red wine and other known
triggers. People like me seem to be a relatively small proportion of the
population but can certainly experience serious adverse effects from
substances that are considered to be safe in population studies and are
widely employed by the food industry. Our sensitivity almost certainly
has a genetic basis, although I am not aware of any work that identifies
specific alleles or even proposes a plausible mechanism that might
precipitate such reactions. I suspect that a new generation of food safety
studies needs to be considered to take account of genetic variation and
that we should be moving towards a situation where it is easier for those
of us at-risk to identify ourselves and to determine from product and menu
labelling that we should not consumer certain products, both natural and
synthetically enhanced, that contain known triggers of adverse reactions
when encountering our metabolism. This does not necessarily imply that
products like aspartame are not safe for mass consumption - but I would
personally prefer to avoid a couple of hours intense pain and vomiting if
I inadvertently consume more than a fairly small amount.
Competing interests:
None declared
Competing interests: No competing interests
In 1974, Drs Fischer, Hommel, Fiedler, and Bibergeil published an
article titled "Reflex mechanism on insulin secretion." It's been
followed by research data showing the details of insulin secretion
time course.
The insulin level rises already in the first minute after the start
of a
carbohydrate-rich meal, whereas the glucose level begins to
increase only in the third minute. This early rise in insulin level is
observed also when either carbohydrate-free food or even artificial
food without any caloric value is offered. The phenomenon is now
well-researched under the name "cephalic phase of insulin
release" though it is amazing how little it influenced the art and
science of dietetics and the current discussion.
It usually comes without questioning that it's carbohydrate-
containing food absorbed into the circulation that stimulate the
pancreatic beta-cells to secrete insulin. However, careful analysis
of the time course of insulin secretion during carbohydrate
ingestion has shown that insulin secretion can start even before
glucose is actually absorbed. This so-called early insulin response
is elicited by stimulation not only of taste buds but also through
sight and smell of the food or even by meal anticipation.
Why any sweet taste, coming with any artificial sweetener, raises
glucose concentration in the blood *before* the food has a chance
to be digested? Because your body knows that eventually, it will
have all the carbs you've swallowed and it doesn't wait until it that
happens and borrows real carbohydrates from its carbohydrate
depots. When the sweet-tasted food is real, the carbohydrates
eventually do get into the blood. And if they're not?
Being fooled, your body reacts rather vindictively: it forces you to
*
want* more sweets plus next time, you consume more calories
with any food, including the innocent protein food -- to convert it
into glucose in process of gluconeogenesis. So, you'd be better off
without artificial sweeteners, Aspartame or not.
Sources
Endocrinol Exp 1974 Jun;8(2):137-46
Am J Physiol 1975 Oct;229(4):1019-22
Physiol Behav 1990 Jun;47(6):1295-7
Am J Physiol Endocrinol Metab 278(4):E603-E610
dietandbody.com/article1082.html
Competing interests:
None declared
Competing interests: No competing interests
I read with interest Dr Finer’s riposte (1) to the rapid responses
relating to Lean and Hankey’s editorial (2). It is clearly an attempt to
discredit detractors and allay fears about aspartame. In his response, Dr
Finer strives to cast doubt on the validity of the criticisms of
aspartame, and states that "it is worth dissecting some of [sic]
statements to illustrate the often simplistic and selective approach to
evidence that detractors use". It seems only reasonable that Dr Finer’s
response should be subjected to the same scrutiny.
Dr Finer dismisses much of the evidence which shows aspartame has the
potential for harm by saying that the "issue is the quality of that
research of which a good test is whether it has been accepted for
publication in peer reviewed journals". Earlier in his response, however,
he cites a study that is not published in a peer-reviewed journal (3).
Also, I feel compelled to remind Dr Finer that of the 92 independently
funded aspartame safety studies referred to in the on-line review
referred to in my earlier response (4) (92 per cent of which suggested
that aspartame has the potential to cause harm), ALL were published in
peer-reviewed journals (5).
The quality of some of the science that Dr Finer uses to make his
case is also leaves a lot to be desired. For instance, he cites one study
(6) which involved giving aspartame to just 6 (six) healthy young adults
for just 1 (one) day (when it is the chronic, long-term exposure to the
constituents of aspartame and its metabolites that is consistently raised
as the real concern). Another study that Dr Finer cites (7) is also
critically flawed. This study assessed the effects of aspartame on
healthy subjects who may not be representative of individuals sensitive to
aspartame or its metabolites. Although 24 weeks in duration, this study
does not preclude health hazards that may come from consuming aspartame in
the long term. It should be noted that some individuals may be able to
ingest aspartame without clinically-obvious adverse effects for many
months or years (8). Also, in the Leon study (7), aspartame was given in
slow-dissolving capsules i.e. in a way that is not ‘bioequivalent’ to
aspartame ingested via food products, particularly beverages. This study
still actually turned up a greater than 50 per cent increase in adverse
reactions in the aspartame group. However, because the researchers split
the reactions into 14 small sub-categories, the chances of seeing
statistically significant differences in any one sub-category were very
low.
It seems utterly ironic to me that Dr Finer should emphasise the
importance of quality research, only for him to use such poor science in
an attempt to vindicate aspartame. And it appears somewhat hypocritical
that Dr Finer should accuse others of using a "simplistic and selective"
approach to the evidence they use.
Dr Finer seems dismissive of the potential for bias related to
industry funding in the area. Is he really blissfully unaware of the very
real issues that may pervert scientific objectivity, including publication
bias? Maybe he is ignorant of the published research which shows that
pharmaceutical industry funding can have a significant impact on the
apparent outcome of research (9). It may enlighten Dr Finer to know that
the authors of this study concluded that "systematic bias favours products
which are made by the company funding the research". It seems that in the
area of industry-related research, there’s an element of ‘he who pays the
piper, calls the tune’. And let us not imagine for one moment that the
food industry is not capable of underhand and cynical practices. Only
this week, BBC’s Panorama programme did a good job of exposing the food
industry’s attempts to influence the "official" findings of diet-related
reports and food policy, as well as its ability to coerce and corrupt at
the highest level (10).
It is perhaps worthy of note that the lead author of the editorial,
Professor Michael Lean, is not only Professor of human nutrition at the
Unversity of Glasgow, but also the Chairman of the Advisory Committee on
Research (ACR) that advises the Food Standards Agency (FSA) - the
organisation that plays a leading role in dictating food policy in the UK.
Personally, I am concerned that several members of the ACR have personal
interests in food companies or trade organisations that promote specific
foodstuffs (11). I am also perplexed at how Professor Lean (and his co-
author) managed to write an editorial that seemed to take aspartame's
safety so unquestioningly, in the face of considerable scientific evidence
to the contrary.
In his response, Finer cites another study that appears to exonerate
aspartame (12). He seems at great pains to point out that this study was
partly funded by the aspartame industry, and questions whether this study
should be regarded as industry funded or not. Does he really need someone
to answer this question for him? Finer’s own observations here are
utterly consistent with the findings of the on-line review that shows that
industry-funded (either whole or in part) research ALWAYS finds in favour
of aspartame (5).
Still further cause for concern comes from Dr Finer’s comments (or
rather, lack of them) regarding aspartame’s role in weight loss. He
congratulates Lean and Hankey on addressing "the evidence that suggests
aspartame may usefully protect consumers from some of the environmental
pressures that have been firmly implicated in the current epidemic of
obesity and diabetes". Dr Finer fails to acknowledge, however, that Lean
and Hankey’s appraisal in this respect was theoretical. I wonder what Dr
Finer thinks of the glaring lack of evidence that aspartame ingestion is
effective for weight loss. Perhaps he could explain his appetite for
aspartame, bearing in mind the fact that not one single double-blind
placebo-controlled study that attests to aspartame’s efficacy and a weight
loss aid has been published? I note that Professor Lean is quoted on the
FSA website as saying: "Very important policy decisions are being made by
the FSA and it is in the public interest that that these are based on top
quality research." Maybe he too would like to comment on the dearth of
"top quality research" that exists in support of aspartame’s supposed
health benefits?
The bias that pervades this area seems neatly mirrored in the
electronic responses to Lean and Hankey’s editorial. It is perhaps worth
noting that, to date, all but one of the rapid responses that pertain to
aspartame have been critical of the review and/or aspartame. Some may
take a rather cynical view of the fact that the only individual who has
leapt to aspartame’s defence is in the pay of its manufacturer
(Ajinomoto).
Dr Finer claims not to be surprised that there have been responses
from "excited nutritionists, wellness experts and journalists". Dr
Finer’s use of the adjective "excited" seems inappropriate to me. Perhaps
this was an attempt by him to portray genuinely concerned individuals as
somewhat hysterical? Also, perhaps Dr Finer could explain why he chose to
refer to the responses from "nutritionists, wellness experts or
journalists" when, in fact, the majority of responses, to date, have come
from doctors. I wonder whether Dr Finer calculated that this omission
might somehow make it easier for him to dismiss the "detractors".
Dr Finer does make one valid point, though: that some individuals
critical of aspartame have their own agendas. I’ll tell him what mine is:
that people should have access to balanced information about aspartame,
including the knowledge that:
a. aspartame has not been proven to help weight loss.
b. a considerable body of evidence exists which shows that this
synthetic chemical has potential for adverse effects on human health.
c. there is a glaring disparity between the findings of industry-
funded and non-industry funded research.
Dr Finer’s soothing reassurances do not change these basic facts.
While he may believe that there is ‘safety in science’, a closer, more
impartial look at the research into aspartame reveals that, in reality,
there is no place to hide.
References:
1. Finer, N. Aspartame - safety in science. Rapid response published
12th October 2004.
2. Lean MJ, Hankey C. Aspartame and its effects on health. BMJ 2004
328:755-756
3. Stegink LD, Filer LJ. Effects of aspartame ingestion on plasma
aspartate, phenylalanine and
methanol concentrations in potentially sensitive populations. In: The
clinical evaluation of a food additive. Assessment of Aspartame. Tschanz
C, Butchko HH, Stargel WW, Kotsonis FN, Edts, 1996(a), pp 87-113, CRC
Press, Boca Raton, New York, London, Tokyo.
4. Briffa J. It’s not just misleading websites that the public should
be protected from. BMJ Rapid response published 3rd October 2004.
5. http://www.dorway.com/peerrev.html
6. Stegink LD, et al. Effect of repeated ingestion of aspartame-
sweetened beverage on plasma amino acid, blood methanol and blood formate
concentrations in normal adults. Metabolism 1989, 38:357-363.
7. Roberts. Reactions Attributed to Aspartame-Containing Products:
551 Cases Journal of Applied Nutrition 1988 40; 85-94
8. Leon AS, et al. Safety of Long-term Large Doses of Aspartame. Arch
Intern Med. 1989;1 49:2318-2324
9. Lexchin J, et al. Pharmaceutical industry sponsorship and research
outcome and quality: systematic review. BMJ 2003 326(7400):1167-1170.
10. Panorama: The Trouble With Sugar BBC1 aired 10th October 2004
11. http://www.food.gov.uk/multimedia/pdfs/acr051_6.pdf
12. Spiers PA, et al. Aspartame: neuropsychologic and
neurophysiologic evaluation of acute and chronic effects. Am J Clin Nutr.
1998 68(3):531-537
Competing interests:
None declared
Competing interests: No competing interests
Lean and Hankey’s editorial on aspartame succinctly outlined the
substantial evidence that supports the safety of aspartame. They also
address the evidence that suggests aspartame may usefully protect
consumers from some of the environmental pressures that have been firmly
implicated in the current epidemic of obesity and diabetes. Lean and
Hankey also drew attention to the extraordinary opinions paraded on web-
sites that border from the merely uninformed and un-evidenced, to the
frankly bizarre.
It is not surprising therefore that this editorial has excited
responses from excited nutritionists, wellness experts and journalists.
It is not possible to refute each of the issues raised in the space of a
rapid response letter, but it is worth dissecting some of statements to
illustrate the often simplistic and selective approach to evidence that
detractors use.
Joseph Mercola uses emotive and ill-defined terms such as ‘natural
substances’ to imply that natural is good and unnatural is bad.
Digitalis, bacterial contamination and aflatoxins are all natural but I
would rather my food was free of them. He talks about ‘flooding the
brain’ with amino acids, something for which there is simply no evidence.
His statement pre-supposes that aspartame causes excessive rises in plasma
phenylalanine that then crosses the blood brain barrier to enter the
brain. Plasma phenylalanine levels rise to between 80 and 120 mmol/L after
a protein meal such as a glass of the ‘natural substance’ milk. This is
about the same as after a dose of 34 mg/kg bw aspartame (equivalent to
about 28 cans of aspartame-sweetened drink consumed all in one go) (1).
Current data (2) show that average daily intake of aspartame in adults is
between 0.05 and 0.4 mg/kg bw/day and maximum values between 1 and 2.75
mg/kg bw/day. In French young diabetics mean consumption of aspartame was
estimated at 1.9 mg/kg bw/d (less than 5% of the ADI) and maximum intake
was 15.6 mg/kg bw/d (40% of the ADI). It is thus unclear on what data Dr
Mercola has based his statement.
Dr Briffa and others raise the issue of the small amounts of methanol
produced by aspartame metabolism. It is the metabolite formate, not
methanol itself that can cause toxicity in man. In order for the body to
accumulate a significant amount of formate, a human must consume 200 to
500 mg of methanol per kg of body weight (3), an amount that corresponds
to drinking 600 to 1700 cans of diet soft drink at once. Researchers have
studied whether methanol levels in the blood rise significantly when
humans consume aspartame. In one study, subjects were given 34 mg-
aspartame/kg body weight. Blood levels did not rise detectably (4)
Another experiment showed that blood methanol levels did not rise even
when subjects consumed 200 mg-aspartame/kg body weight (5). In long term
studies, researchers found that when humans consume aspartame, the
resulting formate production is balanced by excretion, so that blood
levels of formate do not change [Leon and others, 1989].
Briffa goes on to quote a study by Trocho et al (7) as evidence for
formaldehyde accumulation in animals with ‘low level of ingestion of
aspartame’, but not that from Tephly (8) who questions these conclusions
in a letter published to the journal editor and outlines previous research
on methanol toxicity in monkeys not discussed by Trocho et al. relevant to
the question of methanol toxicity. Tephly cites previous studies in
monkeys that show high levels and rapid rise of blood formate following
administration of methanol or formaldehyde. This study and a human case
study of formaldehyde intoxication provide evidence for a half-life of 1.5
minutes for formaldehyde and its rapid conversion to formate. He also
questions the use of rodents to study methanol toxicity as primates
metabolize methanol and formate by different enzymatic pathways. More
importantly he also describes the normal disposition of formaldehyde to
formate and it's inclusion into the one-carbon folate pool eventually
leading to S-adenosylmethionine (SAM), often referred to as the universal
methyl donor. Tephly reports that the appearance of around 1% of the
radio-labelled carbon in protein, DNA or RNA could be explained by the
very rapid flux of the carbon through SAM or other folate dependant
reactions into these molecules and tissues. He stresses that this flux
of carbon derived from methanol from any source (fruit juice, pectin or
aspartame) is a result of normal biochemistry and is not a toxic event.
On the issue of research sponsorship and whether this biases the
research. It seems entirely appropriate that companies should respond to
concerns over their products’ safety by commissioning research. The only
issue is the quality of that research of which a good test is whether it
has been accepted for publication in peer reviewed journals. It is a
dangerous game to assume that non-industry researchers or commentators do
not have conflicts; they may be renewing grants, writing books or
newspaper articles or trying to attract patients to their practice for
personal income. Amongst the 74 studies Dr Briffa quotes as non-industry
supported by are several papers from the MIT group. It is curious that
their recent publication (9) that concluded ‘Large daily doses of
aspartame had no effect on neuropsychologic, neurophysiologic, or
behavioral functioning in healthy young adults’ is omitted. This study was
jointly funded by both NutraSweet and The Center for Brain Science. Would
this, coming from a laboratory and clinical research centre at the heart
of raising dangers about aspartame be regarded as industry sponsored or
non-industry sponsored?
Those wishing authoritative recent reviews would do well to read the
‘Opinion of the Scientific Committee on Food: Update on the Safety of
Aspartame’ (10) and the 2002 issue of Regulatory Toxicology and
Pharmacology (11).
(1) Stegink LD et al. Effect of aspartame and aspartate loading upon
plasma and erythrocyte free amino acid levels in normal adult volunteers.
J Nutr. 1977, 107: 1837-1845.
(2) French Food Safety Agency Report 2002.
http://www.aspartame.org/pdf/AFSSA-Eng.pdf.
(3) Food and Drug Administration, Federal Register, 984.
(4) Stegink LD et al. Effect of repeated ingestion of aspartame-sweetened
beverage on plasma amino acid, blood methanol and blood formate
concentrations in normal adults. Metabolism 1989, 38:357-363.
(5) Stegink LD, Filer LJ. Effects of aspartame ingestion on plasma
aspartate, phenylalanine and methanol concentrations in potentially
sensitive populations. In: The clinical evaluation of a food additive.
Assessment of Aspartame. Tschanz C, Butchko HH, Stargel WW, Kotsonis FN,
Edts, 1996(a), pp 87-113, CRC Press, Boca Raton, New York, London, Tokyo.
(6) Leon AS et al. Safety of Long-term Large Doses of Aspartame. Arch
Intern Med. 1989;1 49:2318-2324
(7)Trocho et al. Formaldehyde derived from dietary aspartame binds to
tissue components in vitro. Life Sci. 1998, 63 (5), 337-349.
(8)Tephly TR. Comments on the purported generation of formaldehyde and
adduct formation from the sweetener aspartame. Life Sci., 1999, 65(13),
157-160
(9) Spiers PA, Sabounjian L, Reiner A, Myers DK, Wurtman J, Schomer DL.
Aspartame: neuropsychologic and neurophysiologic evaluation of acute and
chronic effects. Am J Clin Nutr. 1998 Sep;68(3):531-7
(10) Opinion of the Scientific Committee on Food: Update on the Safety of
Aspartame’. SCF/CS/ADD/EDUL/222 Final. Brusssels Dec 2002.
http://www.food.gov.uk/multimedia/pdfs/aspartameopinion.pdf
(11) Butchko HH et al. Aspartame: Review of safety. Regul Toxicol
Pharmacol. 2002;35:S1-S93.
Competing interests:
Medical Adviser to Ajinomoto
Competing interests: No competing interests
Dear Sir,
I agree with Professor Lean and Dr. Hankey that the proliferation of
sensationalist websites attributing any and every symptom a person might
have to the consumption of aspartame is not helpful. Such sites cloud the
issue for people like myself who would like to see a rational approach and
solution to the aspartame problem.
As one of the individuals who has a “frightening personal account” of
“multiple health disasters” which disappeared when I removed aspartame
from my diet (and which reappeared when inadvertently re-challenged), I
can assure all readers that I do not have an “opinion” “fuelled … by
anecdote”, nor by any website, but that I have experienced-based
knowledge. Duty or not, the government bodies are not monitoring health-
effects of aspartame: the necessary system for the reporting of such
problems does not exist; the medical profession has not been alerted to
the side-effects experienced from the many different forms of aspartame
and so cannot contribute useful clinical information.
After my own bad experiences of aspartame, I started to invite people
around me to talk about any awareness they had of ill-effects from the
sweetener. I very easily contacted over thirty individuals (in Scotland)
who told the same story of severe illness, of negligible help from medical
professionals, and of finally discovering for themselves what was the
cause. Consider the implications of this. If a private individual can
trace thirty people just by asking around, the total number of aspartame
‘survivors’ out there must be very large. Since, for every individual who
has managed to work out their aspartame problem for themselves, there must
be many more who have not, and the number of these sufferers must
therefore be staggering.
Professor Lean concludes “the public probably needs protection
against misleading websites”. I wholeheartedly agree, but, appearing
beside the article in the British Medical Journal website is a link to a
site claiming “reliable and official information about aspartame”. This
website belongs to the makers, and global distributors, of aspartame.
Like all commercial enterprises, it uses careful wording to appear to
answer questions on safety and to give reassurances without actually
acknowledging the problems which raised the safety questions in the first
place. The site is clearly neither ‘reliable’ nor ‘official’, it is a
commercial PR exercise, and is using advertisement in a respected medical
journal to camouflage its true nature..
The public definitely needs protection against ALL misleading
websites.
Yours faithfully,
Joanna Clarke
BSc. AIBMS MIBiol
Glasgow
Competing interests:
None declared
Competing interests: No competing interests
In 1995, the US FDA was forced to reveal under the Freedom of
Information Act, 92 symptoms caused by aspartame.
Memory loss, seizures, death, bone and joint pain, change in vision,
chane in heart rate.
To see a list go to www.dorway.com, www.presidiotex.com/aspartame or
www.aspartamekills.com
Competing interests:
None declared
Competing interests: No competing interests
I became severely ill with chronic fatigue and severe depression in
1996. In 2001 I read an article on aspartame and I stopped using it. I
have gradually become much improved, and I am now able to function without
constantly contemplating suicide.
There is more than enough evidence that aspartame is unsafe, but
industry is too powerful and has too much money to allow the evidence to
become known.
There have been studies in the US that have shown that artificial
sweeteners actually contribute to weight gain now to weight loss. These
studies seem to have been suppressed also. Amazing what money can do.
Before you publically support toxic agents you should do a more
complete reveiw of the literature.
I am very dissapointed in the British Medical Journal. Of course that
may be the British way of life.
I can be reached at lastcaldoc@aol.com.
Thank you
Competing interests:
None declared
Competing interests: No competing interests
Lay-Observer's Response
As a lay-person I found this article, and especially its response, both interesting and informative. I have some anecdotal evidence from my own life that indicates that soft-drinks may indeed be harmful, and also, that saturated animal fat, in the absence of carbohydrate, is probably beneficial to one's health.
The free speech, however, of the Internet may be problematic to some while others will find it fascinating and informative. Obviously the Internet has become a Cyclopean and illustrious world library which has the capacity to educate both professional and lay person alike. As a rapid global communicator it has manifestly become the greatest political tool devised. It is not, however, a respecter of rank. It may appear a threat to some, but, when it does, they may wish to question their motives.
I am glad to have witnessed this argument and to have observed the frankness of its contributers and that of the authors of the responses.
If I may take the liberty here in quoting this rather interesting but cynical-like truism:
"Some people must think I am a mushroom.
They keep me in the dark, and feed me with bull"
Surely the liberty of the Internet will aid in resolving this minor but not inconsequential human quandary? The Internet appears to possess the capacity to expose publicly, scoundrels, and the frailties in argument, which has to be to the benefit of the individual. One learns so much from it. I now feel better informed!
Competing interests:
None declared
Competing interests: No competing interests