35 minute read
The truth of aspartame's impact on body and health
The truth of aspartame's impact on body and health
Ariel Belic
Barrenjoey High School
Abstract
This research paper analyses data derived from three distinct research studies conducted over varying time periods. The central objective of this investigation is to present a comprehensive comparative assessment aimed at finding the potential implications of routine aspartame consumption on human health, encompassing both fluctuations in body mass and heightened cancer risk. To accomplish this, a methodology was employed, the selection of three distinct clinical trials were chosen to systematically investigate the effects of aspartame on human subjects. These trials were designed with both control and experimental groups. The data extraction process was extensive, encompassing crucial parameters such as study design specifics, participant demographics, and intervention details. Through rigorous analysis, causal relationships were unveiled by identifying patterns among variables, effectively presented through tables and graphs. The discussion comprehensively evaluated trial similarities, disparities, and implications, culminating in a thorough examination of key findings, strengths, limitations, and potential directions for future research endeavours. Within these studies, leptin, an appetite-regulating hormone, was a central focus. Interestingly, both the aspartame and non-aspartame groups displayed increased leptin stability, though unexpected variations are observed within the latter group. This prompts contemplation of factors such as small sample sizes and potentially healthier dietary habits from baseline. Study 2 and 3 were both measured comparatively with each other in tables. In Study 2, a divergent trend of weight gain happened in the aspartame group, while the non- aspartame group experienced weight loss. Study 3 as a decade long study, revealing that aspartame may contribute to long-term weight loss objectives. Study 1 explored the relationship between aspartame consumption and cancer risk, employing a volunteer-based cohort. Correlation analysis suggests a subtle elevation in cancer occurrences among consumers of aspartame compared to non-consumers. However, scrutiny elucidates that socio-economic and lifestyle factors exert a more substantial influence on this correlation than aspartame itself. Despite this, the study's multidisciplinary approach offers a comprehensive overview of aspartame's effects, albeit with some potential reduction in validity owing to variations in measurements. While rodent studies hint at potential tumour development with aspartame, the human perspective assumes precedence due to metabolic disparities. Notably, the challenges in locating pertinent human studies necessitated the inclusion of a diverse array of measurements. It is imperative to recognize that limitations exist, encompassing the utilization of moderate aspartame doses falling beneath recommended daily thresholds. Recent evaluations by authoritative bodies such as IARC (International Agency for Research on Cancer) and JECFA (Joint Expert Committee on Food Additives) which encompass the studies under scrutiny, further supporting the evidence supporting the safety of aspartame consumption within WHO's stipulated limits of 40mg/kg body weight. In summary, this research signifies that aspartame may have a negligible impact on certain factors, though its influence remains marginal. Notably, the findings suggest that aspartame consumption could potentially aid in deliberate long-term weight loss objectives. Overall, this study indicates that regular aspartame consumption is unlikely to have adverse health effects, including body mass fluctuations and heightened cancer risk. However, to glean comprehensive insights into the longterm consequences of aspartame consumption, controlled clinical studies on human subjects must be undertaken.
Keywords: aspartame, leptin, body composition
Introduction
Aspartame is an artificial sweetener used in food and beverage products including yogurt, gum, protein bars and no sugar drinks. The substance was approved by the FDA in 1983, and quickly became a popular substance. Aspartame is two hundred times sweeter than sucrose, acting as a replacement for sugar and potentially reducing caloric intake. With growing rates of obesity, artificial sweeteners have become a popular weight management tool and thus a hot topic in the media. With this media attention comes an abundant amount of misinformation on the substance and its effects on the body. Current studies, research and clinical trials have not provided definite and conclusive evidence to the safety of aspartame and its effects on the human body.
Introduction
Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study
Researchers sought to investigate the relationship between cancer risk and the consumption of specific artificial sweeteners, including aspartame. The study was conducted by a team of specialists in the scientific and food safety field and sponsored by reputable academic institutions in France, renowned for their excellence in research and education. The study examined a large-scale population-based cohort of 102,865 French individuals over 18 years old, the majority of whom were women. Dietary data, including information on the consumption of artificial sweeteners, were collected through webbased questionnaires and 24-hour dietary records. The large sample size enhanced statistical power and generalizability. The study's strengths included robust dietary analysis using multiple models and periodic dietary assessments, enhancing the accuracy and reliability of the findings. However, a limitation was that the cohort was volunteer based, leading to an uneven gender distribution and potential selection bias. Additionally, the study could not explore associations with other cancer sites due to limited case numbers. Aspartame showed an association with an elevated risk of breast and obesity-related cancers. These findings have significant implications for food regulation agencies worldwide and may influence how individuals at risk of cancer consider consuming artificial sweeteners. To further improve the study's reliability, future research could aim for a more diverse participant pool, considering participants from varied socioeconomic backgrounds and a balanced gender representation. Nonetheless, the study highlights the importance of public awareness regarding potential risks associated with artificial sweeteners, particularly aspartame.
Aspartame Consumption for 12 Weeks Does Not Affect Glycemia, Appetite, or Body Weight of Healthy, Lean Adults in a Randomized Controlled Trial
This study aimed to address the controversy surrounding the claim that aspartame and other artificial sweeteners may have negative effects on energy balance and glycemia. The research focused on investigating the effects of aspartame on postprandial glycemia, appetite, body weight, and body composition in healthy adults with a normal BMI. The study was sponsored by reputable institutions, the Department of Nutrition Science at Purdue University and the Division of Endocrinology at Indiana University School of Medicine, both known for conducting high-quality research in their respective fields. The involvement of these institutions enhances the credibility of the study and ensures the availability of necessary resources and expertise. The research involved 100 participants who were randomly assigned to one of three groups: no aspartame, 350 mg aspartame/d, and 1050 mg aspartame/d. The study used a randomized controlled trial design, considered the gold standard in medical research, to ensure that observed differences were attributed to aspartame consumption. Various tests and measures, such as glucose tolerance, insulin levels, and body composition, were employed to gather comprehensive data. The study's strengths included its randomized design, objective metabolic health markers and investigation of dose-dependent effects. However, limitations included the relatively small sample size and the study's short duration, which may impact generalizability and long-term effects. Additionally, the study focused solely on aspartame without considering other potential influencing factors. The results of the study indicated no significant difference in glycaemic response after 12 weeks of daily aspartame ingestion compared to the nonaspartame control. Furthermore, aspartame consumption did not affect appetite in normal- weight individuals over the study period. These findings contribute to the existing evidence suggesting that aspartame consumption, even at high doses, does not significantly impact the body's metabolic processes. In conclusion, the research adds valuable insights to the ongoing debate on the safety and effects of aspartame consumption. With its large sample size, randomized controlled design, and comprehensive biomarker assessments, the study strengthens the evidence supporting the lack of negative effects of aspartame consumption in healthy individuals.
The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight
The study, conducted from 1988, aimed to assess whether incorporating aspartame into a weight- control program would enhance weight loss and long-term weight management. The findings hold significance as they provide evidence supporting the use of aspartame as a sugar substitute alongside a weight-control program, potentially serving as a valuable tool in managing obesity among women. Additionally, the study's examination of exercise habits and self-reported eating control as influencing factors in weight loss and regain contributes to a better understanding of the complexities of weight management. The research included 163 obese women who were randomly divided into groups, with some consuming aspartame during a 19-week weight reduction program, a 1-year maintenance phase, and a 2-year follow-up period. The American Society for Nutrition (ASN) sponsored this study, a reputable professional society dedicated to advancing nutrition research and education. The study's methodology involved a 17-month weight- control program, comprising dietary counselling, physical activity, and behaviour modification. Throughout the program, weight loss and regain were monitored, and participants' exercise habits and eating control were assessed through questionnaires. Statistical analyses were performed to compare outcomes between the groups. The study's strengths include its extended 2-year follow-up period, enabling evaluation of the weight-control program's effectiveness over the long term. To ensure reliable results, the study employed screening tools to exclude participants with disordered eating or mental health issues that might influence the findings. Nonetheless, the study has limitations, such as its exclusive focus on obese women, restricting generalizability to other samples. The reliance on self-reported data poses the risk of bias and potential inaccuracies in reporting food intake and exercise habits. Importantly, the aspartame group exhibited long- term weight maintenance, regaining only 2.6 kg in the year after a 10-kg weight loss, compared to the noaspartame group, which regained 5.4 kg. This suggests that aspartame's inclusion in a weight- control program may facilitate sustained weight management and holds promise as a tool for addressing obesity. The findings prompt further research in this area, indicating that high-intensity sweeteners, such as aspartame, may have a role in weight management interventions.
Is the Use of Artificial Sweeteners Beneficial for Patients with Diabetes Mellitus? The Advantages and Disadvantages of Artificial Sweeteners
This Study delves into a diverse array of artificial sweeteners available and examines their metabolic effects, specifically exploring their potential benefits in the treatment of diabetes. Published in 2022, the article stands as a contemporary and trustworthy source of information. Funding for the study was provided by the Japan Society for the Promotion of Sciences, a highly esteemed and reputable organization. Given that Asia, including Japan, exhibits substantial consumption of artificial sweeteners and aspartame, it is plausible that the motivation behind this research was to uncover the true nature of a product widely consumed by the Japanese population and to promote the nation's health. While the article encompasses various aspects concerning the impact of artificial sweeteners on metabolism, weight management, carcinogenic risks, and diabetes, it predominantly focuses on artificial sweeteners other than aspartame. Consequently, this partial divergence from the topic of aspartame somewhat limits the article's relevance. Nonetheless, the overall reliability of the study remains intact, albeit with a scarcity of conclusive evidence pertaining to aspartame.
Summary of findings of the evaluation of aspartame at the International Agency for Research on Cancer (IARC) Monographs Programme’s 134th Meeting, and the Joint FAO/WHO Expert Committee on Food Additives (JECFA) 96th meeting
The Ninety-sixth meeting of the Joint FAO/WHO Executive Committee on Food Additives, held in Geneva from 27 June to 6 July 2023, focused on the safety evaluation of certain food additives and flavourings. The meeting convened a panel of experts in food toxicology to assess the risks associated with the consumption of aspartame and to establish safety recommendations. The Committee delved into specific studies, including the NutriNet-Santé cohort study, to evaluate the potential genotoxicity and carcinogenicity of oral exposure to aspartame. After thorough analysis, the experts unanimously concluded that there was no cause for concern regarding the genotoxicity and carcinogenicity of aspartame in animals following oral exposure. Based on the evidence presented, they found no reason to modify the current recommendation of a maximum acceptable daily intake of 40 mg/kg per day for aspartame. The endorsement of aspartame as a safe food additive in the specified dosages provides reassurance to both consumers and the food industry. The outcome of this meeting serves to counteract misconceptions and concerns that have occasionally surrounded the use of aspartame in the past. As research and regulatory authorities collaborate to ensure the safety of food additives, consumers can have confidence in the products they consume, and the food industry can continue to innovate while prioritizing public health and safety.
Aspartame Consumption, Mitochondrial Disorder- Induced Impaired Ovarian Function, and Infertility Risk
This article is a detailed research study published in 2022 by International Journal of Molecular Sciences which identifies and discusses gaps within the research of aspartame. This article is highly relevant to this research project as it goes into detail in analysing data and trials assessing multiple studies on the effects of aspartame on fertility, humans and animals. It comes to conclusive evidence for the chemical having effects on pregnancy and foetal growth, which is important to recognise as it makes us reconsider how safe this chemical really is. The writers of this study are all highly reliable as they are highly educated in nutritional sciences as well as female reproduction. Thus, this journal is valuable to this research project, giving current, reliable, detailed and conclusive information about the effects of aspartame on the human body.
Can Artificial Sweeteners Increase the Risk of Cancer Incidence and Mortality: Evidence from Prospective Studies
This journal studied the effects of artificial sweeteners on morality and carcinogenic risk. It compared and graphed many relevant studies testing the effects of artificial sweeteners on morality and cancer risk. The conductors of this study were all Chinese and had an extensive education in medical and nutritional sciences. As well as being published in 2022, this study was highly reliable. It concluded that while association with artificial sweeteners may increase morality, a relationship between cancer and the substances could not be found. The study only gathered research about all artificial sweeteners making it able to attain evidence from it, but its methodology was inspiring to this research project. Thus, the study was useful, but only in its methodology and general conclusion.
Aspartame: Physiology and Biochemistry
This book reviews the biochemical processes involved with consuming aspartame as well as its use of being a sweetening agent. It was written by many credible writers and was authorized by Filer Steg ink. Unfortunately, the book was published in 1984 making it out of date and new information and findings may have come out about aspartame since then. The book provides many studies and trials done on animals but little to none on human interactions with the chemical. I could only access page 408 and could not read the section about human effects of the substance. While this book contains lots of information about the effects of the substance, the information is not modern and thus not a reliable source.
Consumption of high intensity sweeteners worldwide
This article discussed the global consumption and sweetness of artificial sweeteners. The company that published and created the article is a renounced Chinese company which supplies fundamental food products and ingredients. This article provides relevant information to the study as it provides valuable modern statistics on which country is consuming the most aspartame. This knowledge can help us review if sources and studies on aspartame are politically or economically motivated. While the company doesn't provide a date or author for the article it is inclined to provide correct information as they are well recognized and use this information for their own benefit in selling their products.
Compound Summary for CID 134601. PubChem.
This website gives comprehensive information on aspartame as a chemical. All information published comes from the National Centre for Biotechnology Information and was last updated in 2023. It provides raw data on aspartame and its function as a molecule. It also provides useful, cited information such as: use as an ingredient, drug and medication information, pharmacology and biochemistry, studies and biological test result and its safety. NCBI remains a reliable source, continuously updating aspartame knowledge with the latest research, bridging the gap between theory and practice. NCBI compiles pertinent studies, revealing balanced insights into potential benefits and health concerns, guiding well- informed decision-making about aspartame consumption.
Scientific research question
Does regular consumption of aspartame have detrimental health impacts including body mass fluctuations and increased cancer risk?
Scientific hypothesis
Ho: Regular consumption of aspartame has no detrimental health impacts including body mass fluctuations and increased cancer risk.
HA: Regular consumption of aspartame has detrimental health impacts including body mass fluctuations and increased cancer risk.
Methodology
Three clinical trials were selected for quantitative and qualitative analysis to determine the effects of aspartame on the human body. The trials had a control group that did not consume aspartame and an experimental group that did consume aspartame daily to weekly and were published and reviewed by peers. Relevant data on the study design, population characteristics, intervention details, and outcomes were extracted from each trial. The analysis identified trends and patterns between the variables being tested, establishing a causal relationship rather than just a correlation. The results were presented using tables and graphs, and each trial's findings were examined in detail. The similarities and differences in the results of the trials were discussed, along with the possible reasons for these variations. The implications of the findings for clinical practice and future research were also analysed. Finally, a conclusion was drawn based on the results and discussion, emphasizing the key findings and their implications, as well as the study's strengths and limitations. Recommendations for future research were also provided.
Results
Discussion
The studies were split up into the following labels with “Artificial sweeteners and cancer risk: Results from the NutriNetSanté population-based cohort study” being referred to as ‘Study 1’, “Aspartame Consumption for 12 Weeks Does Not Affect Glycemia, Appetite, or Body Weight of Healthy, Lean Adults in a Randomized Controlled Trial” being referred to as ‘Study 2’ and “The effect of aspartame as part of a multidisciplinary weight- control program on short- and long-term control of body weight” referred to as ‘Study 3’.
Table 1A and 1B compares the leptin levels and hunger levels of two different studies. Leptin is a hormone produced by the adipose tissue that regulates appetite, body weight, and other physiological processes. Higher leptin levels indicate reduced hunger and increased energy expenditure. The results of the two studies showed that both the aspartame group and non-aspartame group had an increase in leptin levels and a decrease in hunger levels after 12 weeks. However, the non-aspartame groups showed a greater difference in both leptin and hunger levels, which is unexpected since they were the control group and theoretically should have stayed at similar levels. This may be due to the small sample size of thirty-three people, which makes it easier for outliers to occur. Alternatively, the non-aspartame group may have been influenced to eat more regulated and healthier meals, resulting in more stable and regulated leptin levels. It is also possible that aspartame has a direct effect on stabilizing leptin levels in the human body. Additionally, there was more variation in the hunger level results of the nonaspartame group, further suggesting that the study influenced the groups to eat differently. The evidence suggest that aspartame may aid in regulating and stabilising leptin levels and hunger as there was less of a difference in variation of leptin and hunger after time when compared to the non-aspartame group.
Study 3 measured active weight loss and weight maintenance, while Study 2 was not on any active weight loss regime. This lets us analyse the effects on weight both intentional and unintentional which will provide data for people who may be looking to loose or gain weight. Study 2 showed a weight gain in the aspartame group of 0.2kg while the non-aspartame showed a weight loss of 0.5. The non aspartame group in study 2 had a weight change which is unexpected since they were the control group and should have stayed at a similar weight. This may be due to the small sample size of thirty-three people, which makes it easier for outliers to occur. Alternatively, the non-aspartame group may have been influenced to eat more regulated and healthier meals, resulting in healthier and lower calorie food intake. Study 2 shows the aspartame group had a weight gain, and the non-aspartame group had a weight loss; this doesn't necessarily mean that aspartame causes weight gain. Compared to Study 3, the results show that the aspartame group had a significant total weight loss in the long term compared to the non-aspartame group. This means that aspartame may cause short term weight gain but aid in long term weight loss. In relation to the aspartame groups table 1A and 1B and two show increased leptin stability, hunger stability and stability long term eight loss, giving evidence in aspartames aid in metabolic regulation and weight loss. Information was extracted from Study 1 and utilized to construct a graph depicting the proportions of the sample population who developed cancer. This graph contrasts the rates of cancer occurrence among individuals who consumed high levels of aspartame with those who were non-consumers. The R value (correlation coefficient) was r = 0.998502, With consumers as x and nonconsumers as y. This shows that there was a slight difference between people who got cancer in both groups. Since the r value is very close to 1, this means that there is a strong correlation and not a significant difference in the factors tested. This graph show that the chance of developing cancer is higher in consumers than nonconsumers. While this information is valuable and true to the data the original study debates it's on validity in this as it as a volunteer-based cohort. The original study goes in depth into why the volunteerbased cohort study style skewed the results and why the slightly higher cancer risk is due to correlation and trends in the socioeconomic and lifestyle of the participants.
Both a benefit and limitation of this study was that the study measured varied factors involving aspartame consumption. By using a multidisciplinary approach, the effects of aspartame found are broader and more generalized. By using studies that complement each other a bigger picture can be created that mirrors the real world, where there are many factors that relate to the topic of aspartame. This paper aims to discuss and present evidence on the three main controversies of aspartame's effects. Another benefit of these studies is that they were human studies. Studies on rats are common and valid in the scientific field but not appropriate for this field of research. In most studies involving aspartame done on rats it has resulted in the rats’ developing tumours. This is not relevant to the effects of aspartame on humans as they metabolize the substance differently and the effects are vastly different. There are limited public studies on humans involving aspartame so finding the studies and resources for this report was challenging. This contributed to the multidisciplinary approach of this paper as papers measuring all the same factors could not be found. A limitation to having different measurements and factors evaluated is that the validity is decreased as there is less repetition. This report’s reliability was decreased as each study chosen had a moderate and weak dose of aspartame that was given to the aspartame group. The recommended aspartame limit for a human is 40 mg/kg. Diet coke
contains 188 mg of aspartame. Each study had a dose of approximately 1000 mg per day dosage of aspartame. The average adult weighs approximately 70 kg. This means that the recommended aspartame daily limit for the average adult is approximately 2800 mg. With most of the studies having participants consume under half of the daily limit does not show the full effect of aspartame if it is taken in the highest dosage. Results of consumers who took the daily limit or above could potentially vary and reveal side effects that would not occur below this threshold. This report could be more accurate if the studies chosen had the dosage of aspartame higher to the recommended limit. The IARC and JECFA have recently conducted evaluations of scientific data, encompassing peer-reviewed papers and governmental reports. The studies featured in this report were also incorporated into the assessment. Considering the World Health Organization's recent reaffirmation of the safe daily intake of aspartame at 40mg/kg of body weight, the increasing wealth of information regarding aspartame consumption further supports its absence of evidence in harm following consumption.
Conclusion
In this research report the data suggests that regular consumption of aspartame has no detrimental health impacts including body mass fluctuations and increased cancer risk. The research suggests that aspartame slights impact some of these factors, but only to a negligible extent. The research shows that aspartame intake may aid in purposeful long term weight loss. The current findings provide valuable insights into the potential benign nature of regular aspartame consumption However, to gain a comprehensive understanding of its long-term effects, future research should prioritize conducting rigorous controlled clinical studies involving a diverse range of human participants. This will require substantial funding support from both public and private sectors, enabling larger scale more extended investigations that can offer more conclusive evidence. Such research could significantly contribute to refining our understanding of aspartame's health implications and guide informed dietary recommendation.
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Humphries, P., & et al. (2007, August 8). Direct and indirect cellular effects of aspartame on the brain. European Journal of Clinical Nutrition, 2008(62), 451 - 462. https://doi.org/10.1038/sj.ejcn.1602866
Joint News Release. (2023, Jul 14). Aspartame hazard and risk assessment results released. World Health Organization. Retrieved 7 20, 2023, from https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-riskassessment-results-released
Lizuka, K., & Department of Clinical Nutrition, Fujita Health University. (2022, October 22). Is the Use of Artificial Sweeteners Beneficial for Patients with Diabetes Mellitus? The Advantages and Disadvantages of Artificial Sweeteners. Nutrients, 2022(14), 470 - 1192. https://doi.org/10.3390/nu14214446
Mattes, R., et al, & Ajinomoto USA, INC. (2018, January 18). The Effects of Aspartame on Appetite, Body Composition and Oral Glucose Tolerance [Clinical Trial]. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT029 99321?term=aspartame&draw=3&rank=1
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Stegink, F. (1984). Aspartame: Physiology and Biochemistry. CRC Press. https://books.google.com.au/books?hl=en& lr=&id=NAoHEAAAQBAJ&oi=fnd&pg=PP1& dq=aspartame&ots=ZQQyMp52jj&sig=ewX z6SshO43E6lgz1q_QFRBtkuw#v=onepage &q=aspartame&f=false
Varkey, E. (2019, June 30). Which are the most popular products in our shopping cart that contain the artificial sweetener Aspartame? Bridging Science And Life. Retrieved February 16, 2023, from https://bridgingscienceandlife.com/foodproducts-aspartame/
World Health Organization. (2023, July 14). Summary of findings of the evaluation of aspartame at the International Agency for Research on Cancer (IARC) Monographs Programme’s 134th Meeting, and the Joint FAO/WHO Expert Committee on Food Additives (JECFA) 96th meeting [Meeting report]. Retrieved 7 21, 2023, from https://www.who.int/publications/m/item/s ummary-of-findings-of-the-evaluation-ofaspartame-at-the-international-agency-for-research-oncancer-(iarc)-monographs-programme-s134th-meeting and-the-joint-fao-whoexpert-committee-on-food-additives(jecfa)-96th
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Appendices
Appendix 1: An in-depth literature review of each of the studies chosen:
Artificial sweeteners and cancer risk: Results from the NutriNet-Santé populationbased cohort study
The topic of research is determining whether consuming artificial sweeteners increase or decrease the chances of developing chronic diseases such as cancer. The study is significant as previous studies investigating the carcinogenicity of aspartame have only had small experimental studies. The purpose of this research is to conduct a study with strong epidemiological evidence to support the validity of the findings. Artificial sweeteners are used as a substitute for added sugars in many food and drink products due to the harmful effects of added sugars on chronic diseases. However, the safety of these sweeteners is disputed, especially regarding their potential to cause cancer. This is likely since studying the long-term effects of aspartame on human health is challenging, as many other factors can also influence the development of cancer. Furthermore, the studies that have been conducted often produce conflicting findings, which makes it difficult to draw firm conclusions about the relationship between aspartame and cancer risk. The study was conducted by multiple specialists in the scientific and food safety field. The organizations which sponsored the study were reputable institutions involved in research and education in various fields related to health and nutrition. Sorbonne Paris Nord University, INSERM, INRAE, CNAM, and the University of Paris are all well-known academic institutions in France with a longstanding history of excellence in research and education. Their involvement in sponsoring the study indicates that the study was likely to be well-organized, wellfunded, and well-attended, which can contribute to its success. The objective of this study was to investigate the associations between intakes of artificial sweeteners and cancer risk in a large-scale population based cohort on detailed dietary data including names/brands of industrial products. The study was a web-based cohort of 102,865 French people over the age of 18, (78.5% women, 21.5% men). Over the internet, questionnaires were given to the participants. These questionnaires detailed information which was collected at baseline and every year thereafter through a 5-questionnaire kit, regarding health status, anthropometric data, physical activity, lifestyle and sociodemographic characteristics and diet. Daily intakes of energy, alcohol, and macro- and micronutrients were assessed via the NutriEnt-Santé food composition table (providing nutritional composition for about 3,500 items). Participants were divided into 3 groups: non-consumers, lower consumers, and higher consumers. The study was conducted between 2009 and 2021. Strengths of this study were that participant diets were robustly analysed through multiple models and dietary assessment. Dietary intakes were collected every 6 months by 3 non-consecutive webbased 24-hour dietary records, randomly assigned over 15 days (2 weekdays and 1 weekend day). This randomized survey structure was a reliable research method in many as it allowed the study to collect unbiased data, increasing the generalizability of their findings. Another strength of the methodology was having such a large research cohort. This allowed; Increased statistical power and improved generalizability, enhanced precision, better identification of rare events and an increased ability to detect subgroup differences. With all these reliability factors taken into precaution, the accuracy of the study is increased. A limitation to this study was that it was a volunteerbased cohort, resulting in more women participating in the study then men. volunteer-based cohorts tend to have participants who are older, female, highly educated, health-conscious, and have lower artificial sweetener intake levels. The study also was limited as it could not investigate the associations for other cancer sites due to the limited number of cases. The study does not establish causal links, and residual confounding bias cannot be eliminated, but the researchers attempted to minimize it through various adjustment factors. The study ultimately found that higher consumers of artificial sweeteners, particularly aspartame and acesulfame-K, had an increased risk of overall cancer. Aspartame was specifically associated with an increased risk of breast and obesity-related cancers. The hazard ratio for higher consumers of total artificial sweeteners was 1.13, with a p-trend of 0.002. The results showed that patients who consumed aspartame had a 13.5% higher chance of getting cancer. These findings offer new insights into the ongoing review of food additive sweeteners by the European Food Safety Authority and other health organizations worldwide and could impact how people with risk of cancer consume artificial sweeteners, including aspartame. To make this study more dependable and valuable, a more diverse group of participants could have been chosen, such as having more men in the study and participants from a diverse range of socio economics. These findings highlight the importance of educating the public on the potential risks associated with artificial sweeteners, especially aspartame, and emphasize the importance of food regulation agencies to evaluate and reconsider the use of aspartame and other artificial sweeteners in food and drink products, in order to minimize health risks for consumers.
Aspartame Consumption for 12 Weeks Does Not Affect Glycemia, Appetite, or Body Weight of Healthy, Lean Adults in a Randomized Controlled Trial
The prevalence of overweight and obesity in children and adults is high and is associated with impaired glucose tolerance and diabetes. To combat obesity and high sugar intake artificial sweeteners, such as aspartame, are added to foods and beverages and their consumption by children and adults is high and increasing. Recent meta-analyses suggest that the use of artificial sweeteners is associated with lower BMI and have a moderate or no effect on postprandial glycemia. Several professional societies have noted that artificial sweeteners may undermine attempts to manage body weight and glycemia, and the issue remains contentious. The study addresses the controversy surrounding the claim that aspartame and other artificial sweeteners are problematic for energy balance and glycemia. Aspartame has been implicated in this claim. However, the proposed mechanisms for this claim are of uncertain validity, including that it: elicits greater sweetness intensity than sucrose, stimulate insulin release, have a hedonic training effect, enhance appetitive sensations, and alter glucose absorption. This study was conducted to assess the effects of aspartame on postprandial glycemia, appetite, body weight, and body composition in healthy adults with a normal BMI. The sponsors for this study included, The Department of Nutrition Science at Purdue University and the Division of Endocrinology at Indiana University School of Medicine are both reputable institutions with a history of conducting high-quality research. These institutions have experienced researchers and experts in the field of nutrition and endocrinology, respectively. They are reliable sponsors for a study because they are likely to provide the necessary resources and expertise to conduct a rigorous and well-designed study. Additionally, both institutions have a reputation for scientific integrity, which further enhances their credibility as study sponsors. In this study conducted between 10 August 2016 and 7 February 2017, 100 individuals were randomly assigned to treatments out of 214 respondents who completed a battery of questionnaires and measurements of baseline health and demographic information before signing a consent form approved by the Purdue University Institutional Review Board. The study participants were randomly assigned to one of three groups, with 33 participants in the group ingesting no aspartame, 33 in the group ingesting 350 mg aspartame/d, and 34 in the group ingesting 1050 mg aspartame/d. Of the 100 participants, 93 completed the trial. Multiple tests were carried out on participants during the 12week study including: weight and body composition measurements, blood test, analyte assays, insulin and glucose assays and urine samples. The results measure the results from baseline and after the 12 weeks of consumption. There are several strengths to this study's methodology. First, it uses a randomized controlled trial design, which is considered the gold standard in medical research. Randomization helps to ensure that any observed differences between the groups are due to the intervention (in this case, aspartame consumption) rather than other factors. Second, the study measured glucose tolerance and insulin levels, which are important markers of metabolic health. These measures are objective and can provide valuable insight into how aspartame affects the body. Third, the study used a range of aspartame doses, allowing for the investigation of potential dose-dependent effects. This can help to better understand the relationship between aspartame consumption and metabolic health outcomes. Finally, the study reports on attrition rates and notes that withdrawals were not due to study-related complications. This indicates that the study was well-tolerated by participants and adds to the overall validity of the results. The limitations of the study include the small sample size of only 93 participants, which may limit the generalizability of the findings to larger populations. The study also had a short duration of only 3 months, which may not be long enough to detect any long-term effects of aspartame consumption on glucose tolerance, insulin levels, appetite, body weight, or body composition. The study only measured the effects of aspartame and did not consider other factors that may have influenced the results, such as dietary habits, physical activity levels, or medication use. The selfreported data on dietary intake and physical activity, may be subject to errors or biases. The studies showed that there was no significant difference in glycaemic response after 12 weeks of daily beverage ingestion of aspartame doses of 350-mg/d and 1050-mg/d compared to the noaspartame control. The study also found that aspartame did not influence appetite in normal-weight individuals over a period of 12 weeks. The findings add to the body of evidence that suggests aspartame consumption, even at high doses, does not have significant effects on the biomolecular processes within the body. The study’s large sample size randomized controlled design, and use of biomarker excretion to assess compliance with the intervention add to the study's strength. The research problem addressed in the paper is significant because it adds to the growing body of evidence that supports the safety and lack of negative effects of aspartame consumption in healthy individuals, using a large sample size and a randomized controlled design.
The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight
The study took place from 1988 and aimed to determine if adding aspartame to a weight-control program would improve weight loss and long-term weight control. These findings of this study are important as they provide evidence that the use of aspartame as a sugar substitute in combination with a weight-control program may be a useful tool in the management of obesity in women. The study's focus on exercise habits and self-reported eating control as additional factors impacting weight loss and weight regain also adds to the understanding of the complex nature of weight management.163 obese women were randomly assigned to either consume or abstain from aspartame during a 19week weight reduction program, a 1-year maintenance program, and a 2-year followup period. The sponsor for this study was The American Society for Nutrition (ASN). It is a professional society that focuses on the advancement of nutrition research and education. It is a reliable sponsor for a study investigating the effect of a weightcontrol program that includes aspartame, as it aligns with their mission to promote the understanding of the role of nutrition in optimizing health for all. ASN has a reputation for promoting rigorous and evidence-based research, which would lend credibility to the study findings. The methodology of the study involved recruiting obese women to participate in a 17-month weight-control program. Participants were screened based on eligibility criteria, including medical and dieting-weight history, clinical and laboratory evaluation, and completion of questionnaires. They were then randomly assigned to consume or abstain from aspartame-sweetened foods and beverages during the weight-control program, which included an active weight loss phase, a maintenance program, and a follow-up period. Weight loss and weight regain were measured throughout the program. The study also assessed the participants' exercise habits and selfreported eating control. Statistical analyses were performed to compare the outcomes between the aspartame and noaspartame groups. Ethical approval was obtained, and participants provided informed written consent. The study had multiple strengths including having a long follow-up period of 2 years, allowing for evaluation of the effectiveness of the weight-control program over the long term. Another strength was having a multidisciplinary approach, including dietary counselling, physical activity, and behaviour modification, which is considered an effective approach to weight loss. The study also utilized various tools such as the EAT-40 and Beck’s depression inventory to screen out participants with disordered eating or mental health issues that could impact the results. The study also contained limitations such as: only including obese women, limiting the generalizability of the findings to other populations such as men and people with an average weight. The study also relied on self-reported data, which may be subject to bias and may not accurately reflect actual food intake or exercise habits. The study found that using aspartame-containing foods and beverages in a multidisciplinary weight-loss program was as effective as the same program without aspartame in promoting weight loss. However, the more significant finding was that participants in the aspartame group experienced longterm maintenance of a reduced body weight, with only a 2.6-kg weight regain in the year after a 10-kg weight loss, compared to a 5.4-kg weight regain in the no-aspartame group. The findings of this study suggest that the use of aspartame as part of a weight-control program can facilitate long-term weight maintenance and may be a useful tool in the management of obesity. This has implications for future research in the field, as it suggests that the use of high-intensity sweeteners like aspartame may have a role to play in weight management interventions.
Appendix 2: Original data set from studies analysed
Appendix 3: hunger related leptin levels, Mathematical methods in determining values for Table 2:
Total weight loss in Study 3 was calculated by subtracting the weight loss from initial weight. (Aspartame group: 101.1 - 5.5 = 95.6), (non-aspartame group: 99.6 - 0.3 = 99.3)
Study 2; total weight change over 12 weeks: Total weight change was calculated by subtracting the total weight change from initial weight; (aspartame group: 63.8 - 63.6 = 0.2), (non-aspartame group: 63.0 - 63.5= - 0.5)
Appendix 4: Risk assessment
