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What is aspartame?

Aspartame (English: Aspartame, abbreviated APM) is also called aspartame or sugar substitute (E number: E951). Aspartame is a low-calorie sweetener that has been used for decades as a way to lower your intake of added sugar while still getting the satisfaction from enjoying something sweet. Aspartame is approximately 200 times sweeter than sugar, so only a small amount of sweetener is needed to match the sweetness provided by sugar. In tabletop packaged and prepared foods and beverages, aspartame is often mixed with other sweeteners or food ingredients to minimize bitterness and enhance the overall taste.

Aspartame is composed of two amino acids - aspartic acid and phenylalanine. When ingested, aspartame is broken down into these amino acids, which are used in protein synthesis and metabolism. In addition to aspartate and phenylalanine, aspartame digestion produces small amounts of methanol, a compound naturally found in foods such as fruits, vegetables, and their juices. Drinking a beverage containing aspartame produces approximately five to six times less methanol than drinking the same volume of tomato juice.

Aspartame can be used as an ingredient in beverages (such as diet sodas, low-sugar or low-sugar juices, and flavored waters), dairy products (such as light yogurt and low-fat flavored milk), nutrition bars, and desserts (such as sweetened drinks). Free pudding and gelatin, light ice cream and popsicles), gum, sauces, syrups and condiments. Aspartame is also found in a variety of low-calorie tabletop sweeteners. The most common brand of aspartame tabletop sweetener in the United States is Equal®. Brands outside the United States include Canderel® (found in Europe) and Pal Sweet® (found in Asia). Additionally, some prescription and over-the-counter medicines and chewable vitamins may contain aspartame to increase their palatability. Aspartame is less suitable for use in foods that require prolonged baking, as prolonged exposure to high temperatures can cause it to lose its sweetness.

Is it safe to consume aspartame?

Yes. Aspartame is one of the most well-studied ingredients in the human food supply, with more than 200 studies supporting its safety. The U.S. Food and Drug Administration (FDA) approved its use in dry foods in 1981, in carbonated beverages in 1983, and as a general-purpose sweetener in 1996. Leading global health authorities such as the European Food Safety Authority (EFSA) and the United Kingdom's FAO/WHO Expert Committee on Food Additives (JECFA) have conducted scientific risk assessments and safety evaluations of food additives and concluded that Spartame is safe for its intended use. Based on these conclusions and other independent reviews, government regulatory agencies around the world, including Japan's Ministry of Health, Labor and Welfare; Australia New Zealand Food Standards; Health Canada; and the U.S. FDA, have allowed the use of aspartame.

The FDA sets the acceptable daily intake (ADI) for aspartame at 50 milligrams per kilogram of body weight per day (mg/kg). The ADI set by EFSA is slightly lower at 40 mg/kg per day. The amount of ADI is 100 times less than the amount of aspartame that achieved the No Observed Adverse Effect Level (NOAEL) in toxicology studies. The ADI is a conservative number that most people will not reach. According to the ADI established by the FDA, a person weighing 150 pounds (68 kg) would exceed the ADI (3,400 mg of aspartame) if the average person consumed more than 19 cans of diet soda or more than 85 packages of aspartame per day. The course of their lives. Among those who reported consuming aspartame, the estimated average intake was 4.9 mg/kg per day, less than 10% of the FDA's recommended daily intake. For people in the 95th percentile of aspartame intake, intake was estimated at 13.3 mg/kg per day, still well below the FDA's ADI. Globally, aspartame intake remains well below the FDA and EFSA ADI. A 2018 study noted that only in rare cases, even among the highest intake groups, did individuals exceed 20% of the ADI.

Although aspartame is safe up to the ADI, people with phenylketonuria (PKU) should limit their aspartame intake. PKU is a rare genetic disorder that causes patients to be unable to properly metabolize phenylalanine, one of the amino acids found in aspartame and many common foods, including milk, cheese, nuts and meat. People with PKU need to avoid or limit their intake of phenylalanine from all sources. The FDA requires all packaged foods and beverages containing the ingredient aspartame to carry a statement on the label informing consumers of the presence of phenylalanine.

What is ADI?

The Acceptable Daily Intake (ADI) is the average daily intake over a lifetime that is expected to be safe for human consumption based on numerous studies. It is derived by determining the No Observed Adverse Effect Level (NOAEL), which is the highest intake level at which no adverse effects are found in lifetime studies in animal models, divided by 100. Setting the ADI 100 times lower than the upper limit found in studies to have no adverse effects helps ensure safe levels for human intake.

Can children eat aspartame?

Yes. Aspartame metabolism is the same in healthy children and healthy adults. EFSA, FDA and JECFA concluded that aspartame is safe for consumption by adults and children within the ADI range. Just like adults, the only exception is children with PKU who need to avoid or limit their intake of phenylalanine.

Aspartame added to foods and drinks increases sweetness without increasing calorie intake, increasing sugar intake, or increasing the risk of tooth decay. In recent decades, with a focus on reducing the consumption of added sugars, the proportion of daily consumption of low-calorie sweeteners has increased among children and adults since 2000. Just like the intake of adults, the absolute amounts of low-calorie sweeteners consumed by children are considered well within acceptable levels.

The American Heart Association (AHA) recommends that children avoid regular drinks containing low-calorie sweeteners and instead recommends drinking water and other unsweetened beverages, such as plain milk. A notable exception in the 2018 AHA scientific advisory was for children with diabetes, whose blood sugar management may benefit from drinking low-calorie sugary drinks instead of sugary drinks. Citing a lack of data, the American Academy of Pediatrics' 2019 policy statement does not provide recommendations for children under two years of age to consume foods or beverages containing low-calorie sweeteners.

Can pregnant and breastfeeding women consume aspartame?

Yes. According to the FDA and EFSA, low-calorie sweeteners (including aspartame) are safe for women who are pregnant or breastfeeding when consumed within the ADI. Research shows that aspartame has no adverse effects on pregnant women, nursing mothers, or their fetuses. After ingestion, aspartame is rapidly metabolized to the amino acids phenylalanine and aspartate and small amounts of methanol, so aspartame is not present in breast milk. All women who are pregnant or breastfeeding need the necessary nutrients and calories to ensure optimal growth and development of their baby, while being careful not to exceed their needs.

Can diabetics eat aspartame?

Yes. Foods and drinks containing aspartame are often recommended to people with diabetes as an alternative to sugary foods and drinks and to help them satisfy their dietary cravings. Sweetness. Extensive research shows that aspartame does not increase blood sugar levels or otherwise affect blood sugar management in humans. In a 2018 randomized controlled trial, aspartame ingestion had no effect on blood glucose or insulin levels during a 12-week intervention compared with placebo. A recent consensus statement from experts in the fields of nutrition, medicine, physical activity, and public health cited low-calorie sweeteners in concluding that their use in diabetes management may contribute to better glycemic control. The flavoring agent has a neutral effect on glycated hemoglobin, insulin, fasting and postprandial blood glucose.

Global health professional organizations have published their own conclusions on the safety and effects of low-calorie sweeteners in people with diabetes. The 2022 American Diabetes Association Diabetes Medical Care Standards state, “For some people with diabetes who are accustomed to sugar-containing products, nonnutritive sweeteners (containing few or no calories when consumed in moderate amounts) may be nutritional sweeteners ( Acceptable alternatives to calorie-containing sweeteners (such as sugar, honey, and agave syrup). Although the use of nonnutritive sweeteners does not appear to have a significant impact on blood sugar management, they can reduce overall caloric and carbohydrate Intake." Diabetes UK and Diabetes Canada support the safety and potential uses of low-calorie sweeteners such as aspartame for people with diabetes.

Despite these conclusions, several studies regularly raise questions about aspartame and blood sugar management. Some observational studies have shown an association between low-calorie sweetener intake and type 2 diabetes risk, but have not been able to directly link the cause to type 2 diabetes risk. Like studies of weight and obesity, they run the risk of confounding and reversing cause-and-effect relationships. For example, many studies did not adjust for obesity, a direct contributor to prediabetes and type 2 diabetes. This is a serious omission given that overweight and obese people tend to consume more low-calorie sweetened beverages than lean people.

Can aspartame help with weight loss or weight maintenance?

Replacing full-sugar foods and beverages with foods and beverages sweetened with aspartame can play a role in weight loss or weight management. The National Weight Control Registry is the largest longitudinal study of people who have successfully maintained weight loss—people who have lost at least 30 pounds and maintained that weight loss for more than a year. In a survey of members of the National Weight Control Registry, more than 50 percent of respondents said they regularly consumed low-calorie foods. - Calorie drinks, which 78% said helped control calorie intake.

Some observational studies have reported an association between low-calorie sweeteners and increased weight and waist circumference in adults. A 2017 meta-analysis of systematic reviews of observational studies found that consumption of low-calorie sweeteners was also associated with increased body mass index, obesity, and higher rates of multiple diet-related diseases in adults. Many other recent systematic reviews and meta-analyses have concluded that findings from observational studies show no association between low-calorie sweetener intake and body weight, and a smaller association with higher body mass index (BMI). positive correlation. In children and adolescents, observational studies suggest an association between drinking low-calorie sweetened beverages and weight gain, whereas evidence from randomized trials does not.

It is important to note the limitations of observational studies, which examine associations between exposures (such as aspartame intake) and outcomes (such as weight or health status) and cannot provide evidence of cause and effect. Observational studies also run the risk of demonstrating reverse causation, where the direction of causation is opposite to what one would expect. A common example is a person changing their diet after being diagnosed with a health condition: the disease caused their dietary choices; the dietary choices did not cause the disease. Additionally, observational studies are not randomized, so they cannot control for all other exposures or factors that may cause or influence the results.

For example, one hypothesis is that people may compensate for "no-calorie" choices by eating or drinking more calories in other food choices or at future meals. Although this may occur in some cases, scientific research shows little evidence that people consistently and consciously consume excess calories from consuming low-calorie sweeteners or foods and beverages containing sweeteners. Imagine that a person might order a dessert at a restaurant because he had a diet soda with his meal: the extra calories in the dessert would be greater than the calories saved by ordering a diet drink. These extra calories may cause weight gain or prevent further weight loss. This behavior is known as the "permission effect" or "self-licensing," in which individuals justify their indulgent behavior by finding reasons to make behavior inconsistent with their goals more acceptable.

There are also suggestions that people who are already overweight or obese can start choosing low-calorie sweetened foods and drinks as one way to lose weight. This makes it difficult to hypothesize that use of low-calorie sweeteners may be the cause of weight gain, since reverse causation may be a factor.

Data from randomized controlled trials, considered the gold standard for assessing causal effects, show that replacing regular caloric sweeteners with low-calorie sweeteners can lead to modest weight loss. In a 2016 randomized clinical trial, more than 300 participants were assigned to drink either water or low-calorie sweetened beverages over a year as part of a program that included 12 40-week weight maintenance interventions. Participants in the low-calorie sweet drink group lost an average of 6.21 kilograms, while those in the water group lost an average of 2.45 kilograms. However, other studies have concluded that consumption of low-calorie sweeteners does not lead to significant weight loss or weight gain: A 2017 systematic review and meta-analysis of randomized controlled trials found that low- and no-calorie sweeteners had an impact on body weight. Index (BMI) and other body composition measures had no effect.

The 2020 Dietary Guidelines Advisory Committee (DGAC) scientific report conducted a systematic review of 37 studies (six of which were randomized controlled trials) published between January 2000 and June 2019, covering low- and no-diet diets. Effects of caloric sugary drinks on obesity. The DGAC report concluded that low- and no-calorie sweeteners should be considered as an option for weight management.

It’s important to note that weight loss and weight maintenance require multiple, simultaneous approaches. Making a single change, such as replacing full-calorie, sugary products with low-calorie sweeteners, is just one component. Lifestyle and behavioral habits, such as eating a healthy diet, exercising regularly, getting enough sleep, and maintaining a social support network, are all important factors in achieving weight loss and weight maintenance goals.

Will aspartame make me hungrier?

Very tasty foods activate reward and pleasure areas of the brain. This positive correlation can enhance appetite, and if left unchecked, the resulting increased food intake may lead to overweight and obesity. Sugary foods show similar effects on reward pathways as their counterparts made with low-calorie sweeteners, but do not provide additional calories.

Some worry that activating reward pathways without delivering calories to the body may have unintended consequences, and the effects of low-calorie sweeteners on appetite and food cravings is a developing area of ​​research. As noted in a recent review, some animal model studies have shown changes in food intake and appetite-related hormones following consumption of low-calorie sweeteners. However, similar effects have not been found in humans. So far, there is no strong evidence that low-calorie sweeteners (including aspartame) can enhance appetite or cravings in humans, and some randomized trials have demonstrated the opposite effect - including compared to people who drank water. Less hunger and less dessert intake. and reduced dessert intake.

These differences underscore the fundamental differences between animals and humans as subjects of study. In humans, the connections between physiology, psychology, personal experience, and food are undoubtedly complex, and translating animal studies into this field of research should be approached with caution.

What about the gut microbiome?

Although research on the gut microbiome is still in its infancy, the microorganisms that live in our guts are already recognized as potentially important contributors to our health. There is a lack of research on the effects of aspartame on the gut microbiome, and its digestive pathway and location may be factors in the lack of research. Because aspartame is digested in the small intestine to its component amino acids and small amounts of methanol, it is unlikely that intact aspartame will reach gut microbes, which mostly cluster in the end of the gut. An animal study published in 2014 demonstrated an interaction between dietary pattern type and aspartame intake, in which rats that consumed aspartame water along with a high-fat diet had an increase in total bacterial counts and several Changes in the abundance of each bacterial species compared with rats that consumed a high-fat diet plus plain water, a standard chow diet plus aspartame water, or a standard chow diet plus plain water. A very small human study published in 2015 compared the microbial profiles of aspartame consumers and non-consumers. There were no differences in the abundance of gut bacteria, although bacterial diversity varied between groups. Each person's microbiome profile differs significantly, and research shows that the gut microbiome changes with normal changes in food choices. Much research is still needed to determine the microbiome profile and degree of diversity that is considered "optimal" across populations and individuals. A 2019 literature review found no conclusive evidence that low-calorie sweeteners negatively impact the gut microbiome. In 2020, an expert panel on low-calorie sweeteners came to a similar conclusion, that current data on the effects of low-calorie sweeteners on the human gut microbiome are limited and do not provide sufficient evidence that they are beneficial in relation to human consumption. at doses that can affect gut health.

Is it possible to be sensitive to aspartame?

Although the safety of aspartame has been approved by many international regulatory agencies, anecdotal reports detailing symptoms associated with aspartame ingestion, most commonly headaches, continue to emerge. Only a few studies of this possible link have been conducted, all of which have been hampered by small sample sizes and methodological difficulties. In a 2016 narrative review, two-quarters of the studies found that aspartame intake was associated with increased headache frequency, but two others found no difference between aspartame and control groups. It's important to remember that aspartame breaks down in the intestines into aspartate, phenylalanine, and methanol, all of which are naturally found in other foods and beverages in much higher amounts. This makes the biological mechanisms underlying specific symptoms and/or sensitivity to aspartame difficult to hypothesize. Each study used doses of aspartame that were higher than normal intake. Additionally, a 2015 randomized controlled trial conducted by the UK Food Standards Agency found no differences in physical, biochemical or psychological symptoms after taking aspartame in self-reported aspartame-sensitive participants.

What's the bottom line?

All types of foods and beverages have a place in a healthy eating pattern, including those made with aspartame. Aspartame has been approved by the FDA since 1981, and its safety has been recognized by many international health agencies. However, people with phenylketonuria (PKU) should avoid or limit their intake of aspartame (and other sources of phenylalanine).

The effects and associations of aspartame on chronic metabolic diseases such as obesity and diabetes have been extensively studied. Observational studies linking low-calorie sweeteners to weight gain inherently fail to prove cause and effect and suffer from methodological issues such as confounding and reverse causation. Additionally, randomized controlled trials have consistently supported the use of low-calorie sweeteners such as aspartame in nutritional strategies to help achieve weight loss and weight maintenance goals. In randomized trials, aspartame had no effect on glucose or insulin levels and had no effect on appetite. There is little evidence for sensitivity to aspartame and no biological mechanism for aspartame-specific symptoms. Research into the effects of aspartame on the gut microbiome has been conducted – although since it is consumed in small amounts and absorbed in the small intestine, intact aspartame is unlikely to reach the gut microbiome.

Adopting a healthy, active lifestyle that suits personal goals and priorities is essential to supporting a person's well-being. Choosing foods and beverages sweetened with low-calorie sweeteners (such as aspartame) is one way to reduce consumption of added sugar and control calories, which is important for staying healthy and reducing the risk of diet, weight and lifestyle-related diseases component.

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