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The following questions came into the Aspartame Resource Center. We asked Althea Zanecosky, MS, RD, LDN to respond.

How much aspartame is safe to consume in one day?

Many Americans have a "sweet" routine: a bowl of sugary breakfast cereal followed by a mid-morning donut, a lunch time soda, and an ice cream after supper. Then there are the seasonal goodies that are part of Valentine's Day, Halloween, and the winter holiday season. All this sweetness adds up -- so that the average American eats the equivalent of 20 teaspoons of sugar a day (according to figures from the most recent federal Continuing Survey of Food Intakes by Individuals ). Nearly 60 percent of this intake, says the trade group The Sugar Association, is from corn sweeteners, used heavily in sodas and other sweetened drinks. Another 40 percent is from sucrose (table sugar), and a small amount comes from other sweeteners, such as honey and molasses.

Humans naturally have a craving for sweets but in excess, sugary foods add up to extra calories, which can contribute to weight gain. And to lose weight, the total calories from foods must be decreased and physical activity increased. Many consumers seeking to control their weight have turned to low-calorie sweeteners, also known as sugar substitutes, as one way to help lower the daily calorie count without having to give up their favorite foods.

Weight loss is complex and can't be attributed to any one food, but anything that can safely help people cut back on excess calories is good. Sugar substitutes like aspartame can help certain people lose and maintain a weight. Because aspartame is about 200 times sweeter than sugar, it takes much less to create the same sweetness without any calories.

According to a 2004 survey by the Calorie Control Council, 180 million American adults regularly consume low-calorie, sugar-free products, including sodas and desserts. The U.S. Food and Drug Administration (FDA) has approved four sugar substitutes--saccharin, aspartame, acesulfame-K, and sucralose--for use in a variety of foods.

Approved by the FDA in 1981, aspartame is used as a tabletop sweetener and in food products like beverages, breakfast cereals, desserts, candy, and chewing gum. On the basis of extensive testing in animal and human subjects, the level of daily consumption that is judged to be safe is called the Acceptable Daily Intake or ADI. ADI is defined as the estimated amount (expressed in milligrams per kilogram of body weight per day) that a person can safely consume on average every day over a lifetime without risk. The ADI must be considered prior to approval for any food ingredient including low-calorie sweeteners like aspartame. Moreover, regulators around the world typically set ADIs at levels around 100 times less than levels found to be safe in key animal model studies. These studies include daily exposure for up to a lifetime. In the United States, the ADI is set by the FDA. Internationally, ADIs are set by the Joint Expert Committee on Food Additives (JECFA) of the United Nations' World Health Organization, the Food and Agriculture Organization and the European Union's Scientific Committee on Food (SCF).

The ADI for aspartame is 50 milligrams per kilogram (mg/kg) of body weight per day. At this level, for example, a 150-pound (60-kilogram) person would need to consume 3,000 mg of aspartame or about 16 12-ounce cans of a beverage containing aspartame to reach this level of intake.

The chart that follows describes the approximate number of servings of various aspartame-containing products that an adult and child would need to consume to reach the ADI for aspartame.

The FDA estimates that the average consumer ingests only about 4 percent to 7 percent of this amount each day, the larger amount being consumed by heavier users of aspartame or by those with lower body weights. It is important to note that the ADI is not a specific point at which safety ends and possible health concerns begin, and occasionally consuming levels above the ADA would not be expected to cause any negative health effects.

Aspartame in and of itself should have no effect on triglyceride levels, although to the extent that it helps individuals reduce dietary sugar, it may be a positive tool for those working to reduce triglyceride levels. Before being allowed on the market, aspartame underwent rigorous scrutiny and was shown to be safe when consumed by the public, including people with diabetes and heart disease. Studies have shown that aspartame has no effect on short-or long-term triglyceride, serum glucose or cholesterol concentrations and no effect on serum insulin (1-4). The American Diabetes Association and American Heart Association have both issued statements about the safe use of aspartame when consumed within the acceptable daily intake levels established by the FDA.

Lifestyle changes can help lower triglycerides and include the following:

Lose weight to decrease body fat. Triglycerides are stored as fat in tissues and muscles.

Increase physical activity.

Eat fewer calories. Excess calories are converted to triglycerides.

Reduce unhealthy fats in the diet, especially saturated fat.

Reduce or eliminate alcohol, which has a particularly strong effect on triglycerides.

Eat a healthy, balanced diet that limits high-calorie foods and carbohydrates, especially high-sugar foods.

Consuming foods high in simple sugars significantly contributes to high triglycerides. The Cleveland Clinic has published guidelines to limit simple sugars in the diet and several include the use of sugar substitutes including aspartame:

Substitute beverages like colas, fruit drinks, iced tea, lemonade, Hi-C and Kool-Aid with beverages labeled "sugar-free" or "diet."

Limit hard candies, chocolates, candy bars and gummy bears and substitute with sugar-free.
Avoid adding table sugar and brown sugar to hot and cold cereals. Instead, substitute Equal, Splenda, Sweet-n-Low, Sugar Twin or Brown Sugar Twin.

Choose sugar-free gum or mints instead of the regular versions.

Try sugar-free gelatin and puddings instead of their regular versions.

Spread breads and crackers with no-sugar-added jelly or preserves.

The Cleveland Clinic also advices those with high triglycerides to limit daily sugar intake to no more than 8 percent of your total each day. One way to reach this guideline is through the use of sugar substitutes such as aspartame.

Additional Background on Triglycerides: Triglycerides are the form in which most fat exists in food as well as in the body. Triglycerides are an important part of the lipid profile and have a close relationship with HDL cholesterol. Guidelines for triglyceride levels in healthy adults are:

Many of the factors that effect lowering HDL also effect the elevation of triglycerides. It is not uncommon to see elevated triglycerides (greater than 200) and low HDL (less than 40 for men, or less than 45 for women) occur together. The combination of elevated triglycerides and low HDL may increase the risk of coronary heart disease. High triglyceride levels may also be indicative of diabetes, or may be an indicator of sensitivity to simple carbohydrates and alcohol.

Triglycerides in plasma are derived from fats eaten in foods or made in the body from other energy sources like carbohydrates. Calories ingested in a meal and not used immediately by tissues are converted to triglycerides and transported to fat cells to be stored. Hormones regulate the release of triglycerides from fat tissue so they meet the body's needs for energy between meals.

References:
1. Singleton M, Heiser C, Jamesen K, and Mattes R: Sweetener Augmentation of Serum Triacylglycerol during a Fat Challenge Test in Humans. Journal of the American College of Nutrition, Vol. 18, No. 2, 179-185 (1999)

2. Blades B and Garg A: Mechanisms of increase in plasma triacylglycerol concentrations as a result of high carbohydrate intakes in patients with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 62: 996-1002, 1995.

3. Teff KL, Devine J, Engelman K: Sweet taste: Effect on cephalic phase insulin release in men. Physiol & Behav 57: 1089-1095, 1995.

4. Abdallah L, Chabert M, Louis-Sylvestre J: Cephalic phase responses to sweet taste. Am J Clin Nutr 65: 737-743, 1997.

Resources:
American Diabetes Association Position Statements--Nutrition Principles and

Recommendations in Diabetes. Diabetes Care 27:S36, 2004

http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s36
American Heart Association Artificial Sweeteners

http://www.americanheart.org/presenter.jhtml?identifier=4447
Cleveland Clinic How Foods Affect Triglycerides

http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/nutrition/triglycerides.htm
Questions from the ARC Hotline: Aspartame-Sweetened Products
The following questions came into the Aspartame Resource Center. We asked Gail Frank, PhD, RD to respond.
Is there a list of aspartame-sweetened products?

It is estimated that aspartame is an ingredient in more than 6,000 products worldwide. Knowing the general categories of foods commonly sweetened with aspartame is a good guide for healthcare professionals who educate their patients about calorie control with sweet-tasting foods.

The Web address http://www.aspartame.org/aspartame_products.html provides the following list of reduced calorie products which contain aspartame:

Breath Mints
Carbonated Soft Drinks
Cereals
Chewing Gum
Flavored Syrups for Coffee
Flavored Water Products
Frozen Ice
Frozen Ice Cream Novelties
Fruit Spreads
Gelatin, Sugar Free
Hard Candies
Ice cream Toppings
Ice Creams, No Sugar Added or Sugar Free
Iced Tea, Powder
Iced Tea, Ready to Drink
Instant Cocoa Mix
Jams & Jellies
Juice Blends
Juice Drinks
Maple Syrups
Meal Replacements
Mousse
No Sugar Added Pies
Non-Carbonated Diet Soft drinks
Nutritional Bars
Powdered Soft Drinks
Protein Nutritional Drinks
Pudding
Soft Candy Chews
Sugar Free Chocolate Syrup
Sugar Free Cookies
Sugar Free Ketchup
Table Top Sweeteners
Vegetable Drinks
Yogurt, Drinkable
Yogurt, Fat Free
Yogurt, Sugar Free
Food and beverage labels always will list aspartame in the ingredient list if it is used as a sweetener. For direct product lists, healthcare professionals also can check with specific food companies. Complete product lines are often available on the company homepage and can be printed as handouts or educational materials. Non-profit health organizations like the American Diabetes Association prints research and application articles that name products recommended for use. This is especially useful for individuals with obesity or Type 2 diabetes who seek calorie-control or sugar-free foods. The American Diabetes Association even has the following statement on its Web site:

Don't throw away your low-calorie sweeteners just because sugar is safer than you thought. Low-calorie sweeteners are "free foods." They make food taste sweet, and have no calories and do not raise blood glucose levels. They do not count as a carbohydrate, a fat, or any other exchange. They can be added to your meal plan instead of substituted.

The Calorie Control Council reported that 180 million people in the U.S. consumed foods or beverages with sugar substitutes in 2004, and the number may reach 200 million people today. Healthcare professionals may assume many products are easily available and visible on grocery shelves to meet this demand. As a rule, think sweet and the names of products with aspartame will come to mind.

Experience a creative tool called, "The Calorie Calculator," available on the homepage of this site. "The Calorie Calculator" allows substitution of regularly sweetened products with ones containing aspartame. The amazing result is two-fold: first, you see the calorie savings and the potential weight loss over time, and second, you see the product name. The next step is to obtain and incorporate the product into a healthy eating pattern for the beneficial reduction in calories!
How can you tell if a product contains aspartame?

Simply looking on the back of the product label in the ingredient list is the first step to tell if the product contains aspartame. The Food and Drug Administration (FDA) requires that all ingredients be listed on the label. The word 'aspartame' will be in the ingredient list if it is in the product.

Products containing aspartame have a message that alerts individuals with phenylketonuria, or PKU. Individuals with this genetic condition must limit the amount of phenylalanine, an essential amino acid, in their diets. This label message also is an indication that a product contains aspartame.

Questions from ARC Hotline: Aspartame Safety

The following questions came into the Aspartame Resource Center. We asked Jennie McCary, MS, RD, LD to respond.

Simply put, yes it is. This is a common question as consumers are bombarded with misinformation about the safety of low-calorie sweeteners, particularly aspartame. The Internet abounds with myths surrounding aspartame, making it difficult for consumers to decipher fact from fiction. Despite the controversy, aspartame is one of the most widely studied ingredients in our food supply, with hundreds of scientific studies documenting its safety. Leading health organizations, including the American Dietetic Association and the American Medical Association Council on Scientific Affairs, confidently confirm.
Aspartame has a long history of safety. It was first approved by the FDA in 1981 for use as a tabletop sweetener in dry foods, expanded to beverages a couple years later, and was approved for use in all foods in 1996. Now aspartame can be found in over 6,000 food products on supermarket shelves, helping to meet consumer demands for lower-calorie products.
Often, aspartame is referred to as an "artificial sweetener," and the term may actually cause unnecessary concern among consumers because there is a tendency to be more cautious about "artificial" products compared to "natural" products. However, the truth is that aspartame is made up of two amino acids--aspartic acid and phenylalanine--which are found naturally in greater amounts of common foods, such as chicken, milk, and vegetables. Critics cite the small amount of methanol produced from the breakdown of aspartame as a safety issue, but again compared to a serving of diet soda, fruit and vegetables juices produce more methanol.

The FDA's Acceptable Daily Intake for aspartame is set at 50 mg/kg of body weight. Translated into food product this equals 20 cans of diet soda a day for a 150 pound adult. It is important to note that this is not a specific cut-off point, but a conservative safe exposure level over a lifetime. Adult consumption is well below the ADI, and consuming in excess of this amount on occasion will not cause harm.

The bottom line: Products containing aspartame are safe to consume in moderation as part of a healthful diet. They are an effective tool for managing weight and can help individuals with diabetes effectively control their carbohydrate intake.

Does the heat affect the safety of aspartame or the quality of ingredient?

One of the attractive qualities of this sweetener is that it can be used in baking and cooking. Substituting sugar with an aspartame-sweetened low-calorie sweetener can lower calories and carbohydrates in favorite baked goods and snacks, allowing more flexibility in the diets of consumers, particularly those with diabetes.

Because aspartame is composed of two amino acids, it can lose some of its sweetness when cooked or baked at high temperatures for a long period of time. The heat does not affect its safety; it just may not result in a product as sweet as desired.

Your best bet to creating lower-calorie dishes with aspartame that maintain sweetness is to add the sweetener at the end of the heating process and to use recipes designed just for this low-calorie sweetener, such as those found at www.equal.com.

The following questions came into the Aspartame Resource Center. We asked Vicki Shanta Retelny, RD, LD to respond.

Are cookies and candies made with aspartame safe for children?

More than 200 scientific studies confirm aspartame’s safety, and it can be consumed with confidence by both children and adults. Many professional organizations, such as the Food and Drug Administration, the Joint Expert Committee on Food Additives of the World Health Organization, the Scientific Committee for Food of the European Community and regulatory agencies in more than 100 countries, have found it safe for use. In addition, the American Medical Association, the American Dietetic Association and the American Diabetes Association also have found aspartame safe.

With childhood obesity on the rise, replacing high–calorie sweets with low–calorie varieties is a positive step toward weight management and disease prevention (i.e., diabetes, elevated triglycerides and obesity) at any age. With taste tests revealing that aspartame tastes similar to sugar, substituting it for sugar in a wide variety of foods and drinks can virtually go unnoticed–for children that is a bonus. The Dietary Guidelines for Americans encourage consumers to Choose and prepare foods and beverages with little added sugars or caloric sweeteners.

Although aspartame is 200 times sweeter than sugar, it is not a carbohydrate, so it doesn’t compromise oral health the way sugar does. The bacteria in the mouth that ferment carbohydrate to produce the acids that can cause tooth decay do not attack aspartame, making it a tooth–friendly sweetener. The American Dental Association has noted it welcomes the development and FDA approval of new artificial sweeteners that are shown to be safe and non–contributory to tooth decay …Aspartame is an FDA–approved, safe sweetening agent and flavor enhancer that can be substituted for sugar in the diet.

At the same time, parents should be aware that any carbohydrate–containing food or beverage can contribute to tooth decay. It is important to have regular visits with a dental professional to make sure kids have the proper diets and oral hygiene to protect their teeth for a lifetime.

The following questions came into the Aspartame Resource Center. We asked Molly Gee, MEd, RD, LD to respond.

What is the metabolic breakdown of aspartame?

Aspartame is made by joining two amino acids, aspartic acid and phenylalanine, with a third component as a methyl ester. Amino acids are the building blocks of protein and aspartame is digested as a protein. Aspartic acid and phenylalanine are also found naturally in protein containing foods, including meats, grains and dairy products. Methyl esters are also found naturally in many foods such as fruits and vegetables and their juices.

During digestion, aspartame breaks down into three components (aspartic acid, phenylalanine and a small amount of methanol), which are then absorbed into the blood and used in normal body processes. The amounts of these components from aspartame are small. For example, a serving of nonfat milk provides about 6 times more phenylalanine and 13 times more aspartic acid compared to an equivalent amount of diet beverage sweetened 100% with aspartame. Likewise, a serving of tomato juice provides about 6 times more methanol as compared to an equivalent amount of diet beverage with aspartame. These components are used in the body in the same ways as when they are also derived from common foods and beverages. Neither aspartame nor its components accumulates in the body over time.

How many milligrams of aspartame are in a diet soda?

One can of diet soda contains about 160 mg of aspartame. The acceptable daily intake (ADI) is established by the FDA and is the amount of a food additive that can be consumed daily for a lifetime without adverse affects. The ADI of aspartame is 50 mg/kg of body weight per day (22 cans of a diet soft drink for a 175 pound man; 15 cans for a 120 pound woman). This far exceeds the typical consumption of diet soft drinks

The following questions came into the Aspartame Resource Center. We asked Kate Geagan, MS, RD to respond.

What is the difference between Splenda and aspartame?

Splenda and aspartame are two of the low calorie sweeteners that are FDA approved, and both are found in thousands of foods in supermarkets and consumed my hundreds of millions of people around the world. Splenda and aspartame actually have a lot in common from the consumer standpoint-both provide sweetness in a low calorie package, both can be used as a substitute for sugar in many baking recipes, and both have been shown to be a helpful tool for maintaining blood glucose control and a healthy body weight. Their differences lie in their structure and the types of foods in which they are found.

Aspartame is about 200 times sweeter than sugar and is made up of three dietary components that are commonly found in a variety of foods: Aspartic acid and phenylalanine (which are amino acids-the building blocks of protein) and methanol. Numerous studies have shown that when aspartame breaks down in the body these three common dietary components are absorbed and metabolized in the same way whether derived from aspartame or other foods that contain these components, such as orange juice or chicken.

Splenda, which is the commercial name for sucralose, is about 600 times sweeter than sugar and takes shape when a sugar molecule undergoes changes to its structure and three of its hydroxyl (OH) groups are substituted for chlorine. Research suggests that sucralose is minimally absorbed from food and is excreted from the body within 24 hours. While Splenda is very heat stable, which has made it a favorite for baking, aspartame too can be used in many different recipes to provide sweetness without the calories or the impact on blood sugar.

The leading regulatory bodies around the globe have deemed both aspartame and Splenda to be safe. While many consumers think that Splenda somehow seems more "natural" than aspartame because it involves sugar in its production (and thus somehow "safer"), in reality both of these compounds are low calorie sweeteners and one is no more "natural" than the other. In fact, the history of safety testing for aspartame actually dates back further than Splenda simply due to the fact that it's been on the market (and hence on consumer's plates) for a longer period of time.

In terms of safety, aspartame is one of the most extensively tested food ingredients on the market. Over 200 studies and 30 years of consumer use have all shown overwhelmingly that aspartame is safe for use for nearly all subgroups (the possible exception being individuals with who want to consult with their healthcare provider before consuming any foods containing phenylalanine). Aspartame is approved for use in 134 countries and has been approved for use by virtually all of the national and global health and regulatory bodies.

Splenda has also been approved by the FDA and numerous regulatory bodies around the globe and approved in over 80 countries, but is a more recent addition to the U.S. food supply (since 1998) and is thus far in significantly fewer products around the globe than aspartame. As it is a newer addition to the low calorie sweetener lineup there are fewer studies about Splenda than aspartame, however it too has been shown to be overwhelmingly safe in over 100 studies. Both sweeteners have been found safe and approved for diabetics, children, pregnant and nursing mothers, adolescents and adults.

Both Splenda and aspartame are convenient, delicious and safe ways to help you meet your health and nutrition goals.

Questions from ARC Hotline: Aspartame and Weight Loss
The following questions came into the Aspartame Resource Center. We asked Althea Zanecosky, MS, RD, LDN to respond.

The U.S. Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) is a rich source of information about our country's health. In NCHS's most recent survey (2003-2004) of the American population called the National Health and Nutrition Examination or NHANES, the percent of people age 20 years and over who are overweight or obese was 66.3 or 2 out of 3 adults. And the news for our children is also alarming: 17% of adolescents age 12-19 years are overweight and 19% of children age 6-11 years are overweight.

Another organization, The Trust for America's Health, also released a distressing evaluation of Americans weight. This group found that the rate of obesity continues to climb in thirty-one states and has remained the same (since their report two years ago) in eighteen other states and the District of Columbia. Although the group focuses primarily on government actions to counteract this trend, the bottom line is that it is still the individual who must make changes in lifestyle to either prevent or treat obesity.

Consumers who are trying to lose weight or maintain weight loss should be happy to learn that recent scientific evidence found that the use of aspartame as a sugar substitute to reduce the calorie content of foods and beverages can help people lose weight. A recent review published in the British Nutrition Foundations June 2006 Nutrition Bulletin examined the results of sixteen studies that compared the calorie intake of healthy adults between nineteen and fifty years old who consumed either aspartame-sweetened beverages or foods, or who ate the same items sweetened with sugar. What they found was a 10 percent reduction in calorie intake by the aspartame users as compared to that of the sugar consumers. This reduction averaged to a calorie deficit of about 222 calories per day. While 200 less calories daily may not seem like a major change, if maintained over the course of a year, this would lead to a potential weight loss of over twenty-three pounds of body weight.

In a few of the studies within this meta-analysis, there was some compensation for the calorie deficit. Some research found that people using aspartame consumed more calories from other foods or beverages, but it amounted to less than one-third of the calorie reduction. So in spite of replacing calories from the sugar substitute, people did lose weight when they used aspartame to reduce calorie intake.

The review authors emphasized that "using foods and drinks sweetened with aspartame instead of those sweetened with sucrose is an effective way to maintain and lose weight without reducing the palatability of the diet." So while government and the public health community are working to slow down or reverse the obesity epidemic, individuals can include aspartame-sweetened food products into their diets to help themselves.

Using aspartame instead of sugar is one way Americans can help reduce the number of calories consumed daily without any loss of taste. And while most people know aspartame as a tabletop sweetener, it is also found in many foods that can help individuals lose weight, including carbonated and powdered soft drinks, hot chocolate, chewing gum, candy, desserts, and yogurt.

The Bottom Line: People who substitute aspartame-sweetened foods and beverages for those that are sweetened with caloric sweeteners should definitely see a weight loss over time, as long as other food intake and activity levels are kept constant. A new scientific review of the data fills a gap in the science behind the sweetener. In addition, increased activity and/or exercise is an important adjunct to any weight management program.

http://www.cdc.gov/nchs/fastats/overwt.htm
http://healthyamericans.org/reports/obesity2006/
Why would I use aspartame instead of regular sugar?

Carbohydrates are part of a healthful diet. Experts recommend about 45 to 65 percent of total calories come from carbohydrates. Carbohydrates come in two forms - sugars and starches - which supply energy to the body in the form of glucose. Glucose is the only energy source for red blood cells and is the preferred energy source for the brain, central nervous system, placenta and fetus. Sugars can be naturally present in foods (such as the fructose in fruit or the lactose in milk) or added to the food. Added sugars, also known as caloric sweeteners, are sugars and syrups that are added to foods at the table or during processing or preparation (such as high fructose corn syrup in sweetened beverages and baked products). Although the body's response to sugars does not depend on whether they are naturally present in a food or added to the food, added sugars supply calories but few or no nutrients.

It is important to choose carbohydrates wisely. Foods in the basic food groups that provide carbohydrates - fruits, vegetables, grains, and milk - are important sources of many nutrients. Choosing plenty of these foods, within the context of a calorie-controlled diet, can promote health and reduce chronic disease risk. However, the greater the consumption of foods containing large amounts of added sugars, the more difficult it is to consume enough nutrients without gaining weight. Consumption of added sugars provides calories while providing little, if any, of the essential nutrients.

Below is a table showing the major sources of added sugars (caloric sweeteners) in the American diet:

Source: Guthrie and Morton, Journal of the American Dietetic Association, 2000.

Humans are born with a taste for sweets - a fact that can serve us well. For example, breast milk is naturally sweet and packed with nutrients. The same is true for fruit. But sweetness in the form of refined table sugar packs plenty of calories. But how can consumers satisfy their sweet tooth without calories? There's a safe option - aspartame - and many people are choosing it instead of sugar. Here's how aspartame can help:

To save calories: one teaspoon of sugar contains 16 calories, whereas aspartame has less than 1 calorie per teaspoon in aspartame

For dental health: sugar substitutes do not cause cavities

To help control blood sugar: sugar substitutes reduce the total carbohydrate in meals and snacks and therefore can be a help in managing blood sugar levels.

No matter what your reason, low-calorie sweeteners including aspartame are commonly purchased staples. Nearly 1,500 foods are sweetened with sugar substitutes. Hundreds of studies conducted with animals and humans support aspartame's safety. In 1996, the Food and Drug Administration (FDA) approved aspartame for use in all foods and beverages; aspartame is also approved in 100 other nations. Leading health authorities, including the American Dietetic Association and the American Diabetes Association agree that aspartame is safe for the general population. The only individuals identified who need to monitor aspartame intake are those with the rare genetic condition known as Phenylketonuria (PKU), for which extremely rigid restrictions of almost all protein-containing foods are imposed.
As you sort out the sweeteners in your life, you'll find wise counsel in the Dietary Guidelines for Americans, published in 2005 by the U.S. Departments of Health and Human Services and Agriculture. These guidelines suggest that you:

Remember that foods with sugar substitutes can still have calories and fat. Read product nutrition labels.

Get most of your calories from whole grains, fresh fruits and vegetables, low-fat or nonfat dairy products, and lean meats or meat substitutes.

Exercise regularly to control your weight.

Dietary Guidelines for Americans 2005 U.S. Departments of Health and Human Services and Agriculture.
http://www.health.gov/dietaryguidelines/dga2005/document/html/brochure.htm
"Sweeteners." MedlinePlus. U.S. National Library of Medicine. National Institutes of Health.

http://www.nlm.nih.gov/medlineplus/ency/article/002444.htm
Questions from ARC Hotline: Aspartame and Diabetes

The following questions came into the Aspartame Resource Center. We asked Gail Frank, PhD, RD to respond.

Why do people with diabetes use aspartame?

Individuals who have diabetes face the daily challenge of maintaining an acceptable blood glucose level. They may use aspartame or products sweetened with aspartame for several immediate reasons of taste, food variety and blood sugar control. Health care professionals may identify three rather broad-based reasons why individuals use aspartame:

1. DESIRE FOR SWEETNESS. Individuals with diabetes may still have a sweet tooth and just don't want to be deprived of this flavor sensation. Their bodies, however, can not handle the rapid rise in blood glucose which occurs after consuming products and beverages sweetened with sucrose. Their desire to eat 'normal' and 'sweetened' foods is strong. As a sugar-substitute with sweetening power 200 times that of sucrose, only a minute amount is needed and it does not elevate the blood glucose level.
2. KEEP TOTAL CALORIES BALANCED DAILY. Individuals do not want to gain more body weight and have their blood sugar out of control. HbA1C needs to stay within 4-6%. The amount of oral agent or insulin prescribed by the physician is based on the individual's body weight, activity and average blood sugar levels to assure that all the cells of the body have sufficient energy for normal functioning. Having a set amount of calories each day gives the individual an eating plan with carbohydrate, fats and proteins balanced and calories maintained. This way the blood sugar doesn't spike high or low. Using aspartame can be a major contributor to keeping total calories balanced and the body functioning well with a healthy pattern of eating, exercising and taking medication.
3. BE ACTIVELY INVOLVED IN TAKING CARE OF THEMSELVES TO ELIMINATE OTHER HEALTH PROBLEMS. Although it may not be stated, some individuals use aspartame as part of an overall plan to manage and/or reduce body weight, which subsequently can decrease their risk for other negative health conditions. These include damaging effects on the eyes, nerves and kidneys or microvascular changes. Other major health conditions can evolve, such as, hypertension and coronary heart disease, and many individuals with diabetes have one or more of these conditions. They may also be facing insulin resistance with every excess pound of body weight. The heavier they are, the higher their blood sugar is likely to stay. Some individuals face a combination of these diseases leading to a condition called, the 'metabolic syndrome.' When people believe even the slightest of their efforts can reduce their risk for further problems, they feel better about their future. Using aspartame is a proactive tool people use to help take better care of themselves. By using aspartame combined with a daily plan, which includes healthy eating and exercise, several positive things can happen. The amount of insulin or oral agent needed to control the blood sugar will be less and this may limit the development of insulin resistance; body weight can be maintained or weight loss may occur; and nerves and arteries will be healthier so feelings in the hand and feet and vision as well as blood pressure can be as close as possible to normal.

In summary, healthcare professions may see and recommend that individuals with diabetes use aspartame for several long-term reasons, but quite simply, individuals may use it because it:

- is an effective way to limit the amount of sucrose consumed;

• offers the palatability of regularly sweetened foods without the added calories
• - can adding extra flavor to foods without extra calories;
  - promotes better control of blood sugar levels;
  - allows modification of favorite foods without having to eliminate them;
  - aids in weight loss due to the deficit in calorie intake from regularly sweetened foods;
  - slows weight gain;
  - prevents further complications and diseases; and
  - can prevent feelings of deprivation which may lead to binging on high sucrose foods.
  Is aspartame safe for people with diabetes?
  Yes, aspartame is safe for individuals with diabetes because it does not raise the blood sugar level. However, since aspartame entered the grocery shelves 25 years ago, consumer questions have mainly focused on safety from the perspective of cancer and phenylketonuria (PKU).
• For three decades, continuous well-designed research studies have cleared aspartame for use by all individuals --- including those with diabetes. Is this the real truth? Yes, because FDA scrutinizes products and requires a warning on food labels if any ingredient is deemed dangerous. Aspartame definitely does not fall into that category. It has been one of the most scrutinized ingredients in the U.S. food supply. As with other ingredients, however, FDA established an Acceptable Daily Intake, (ADI) or that level of the ingredient, which can safely be consumed on a daily basis throughout a person's lifetime. The FDA set the ADI for aspartame at 50 mg/kg/day. This is the equivalent of a 70 kg (154 lb.) person consuming about 20 cans of aspartame-sweetened beverage or about 100 sachets of tabletop sweetener with aspartame every day.
• The PKU statement that is currently visible on foods and beverages containing aspartame exists because it alerts individuals with this rare genetic condition about the presence of aspartame as an ingredient. Why?
• 1. Pricking the heel of a newborn is an immediate screening tool to tell if an infant can or can not handle phenylalanine. If not able to handle phenylalanine, then the infant is diagnosed with PKU, and all dietary sources of that essential amino acid must be closely monitored. Aspartame contains very low levels of phenylalanine, so the food label lets this group of people know if a food product contributes to their daily allotment. The presence of phenylalanine in the diet - from aspartame or other sources - is not of concern, however, to those without this rare condition, as confirmed by the American Academy of Pediatrics Committee on Nutrition (American Academy of Pediatrics Committee on Nutrition. Final Report: Task Force on the Dietary Management of Metabolic Disorders. Elk Grove Village, IL: American Academy of Pediatrics; 1985:37.)
• 2. Regarding cancer risk, numerous studies have confirmed that individuals using and consuming aspartame are not at an increased cancer risk. This past year the European food regulatory authority closely reviewed a large body of research from around the world. They concluded none of the research presented a definitive argument or reason to continue questioning the safety of aspartame. Further, they stated that there was no need to revise the Acceptable Daily Intake (ADI) in the European Union.
• In the U.S. the impressive National Institutes of Health (NIH)/National Cancer Institute (NCI) and American Association of Retired Persons (AARP) study followed 340,000 U.S. men and 227,000 U.S. women, 50-69 year old for five years. NCI reported no association between aspartame and lymphoma, leukemia or brain tumor incidence. Hence, regulatory groups in both the U.S. and Australia reconfirmed the ADI for aspartame and its safety as a non-nutritive sweetener.
• The Center for Science in the Public Interest and the American Beverage Association have issued statements of reassurance that the public's safety is not at risk when consuming beverages and foods with aspartame. The American Dietetic Association position paper on "Use of Nutritive and Nonnutritive Sweeteners" supports the use of aspartame in healthy weight management and diabetic menu plans. Lastly, individuals with diabetes should note that The American Diabetes Association has the following statement on its Web site:
• Don't throw away your low-calorie sweeteners just because sugar is safer than you thought. Low-calorie sweeteners are "free foods." They make food taste sweet, and have no calories and do not raise blood glucose levels. They do not count as a carbohydrate, a fat, or any other exchange. They can be added to your meal plan instead of substituted.
• Yes, aspartame is safe for individuals with diabetes!

The following questions came into the Aspartame Resource Center. We asked Victoria Shanta Retelny, RD, LD to respond.

Is aspartame always listed on the package when included in a food?

Absolutely. In the United States it is mandated that all food ingredients, including aspartame, be listed in the ingredient statement on the food label. Another key identifier on the package of aspartame-containing products is the statement, "Phenylketonurics: Contains Phenylalanine." That label appears because phenylalanine is one of two amino acids that make up aspartame. Individuals with the rare genetic condition known as phenylketonuria (PKU) lack the ability to break down this common protein component, so they must monitor even minor dietary sources of phenylalanine.

Where can I find a list of foods with aspartame?

Since 1983, when the U. S. Food and Drug Administration approved aspartame for general use in any food or beverage, it has been incorporated in over 6,000 products globally. Aspartame is in a wide variety of products, including tabletop sweeteners, carbonated and powered soft drinks, chewing gum, confections, gelatins, dessert mixes, puddings and fillings, frozen desserts, yogurt, and some pharmaceuticals, such as vitamins and sugar-free cough drops. For a complete list of reduced calorie products containing aspartame, visit the Aspartame Information Center at

http://www.aspartame.org/aspartame_products.html
Can you bake with aspartame?

Yes, tabletop sweeteners containing aspartame can be used in baking. For people with diabetes and/or those trying to manage their weight, using aspartame in home-baked goods allows them to satisfy a sweet tooth without unnecessary carbohydrates and calories. The one caveat is that prolonged baking at high temperatures required by some recipes can cause a loss of sweetness. There is no compromise in safety, just desired sweetness. Therefore, the remedy is to use aspartame containing sweeteners in specifically designed recipes available from the manufacturers of these tabletop sweeteners. Another simple solution is to add aspartame tabletop sweeteners at the end of the heating process to maintain optimal sweetness.

Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies Aspartame has been the predominant artificial sweetener in the U.S. for the past 25 years and is currently found in >6,000 food and beverage products (1). Throughout this period, however, there has been a controversy regarding whether or not aspartame is carcinogenic (2).

Speculation about an association between aspartame and brain cancer risk was raised in an article (3) which temporally linked increasing incidence rates in the U.S. during the period from 1975 to 1992, especially an upward shift of more aggressive glioblastomas during the 1980s, to the entry of aspartame in the food supply in 1981. The authors cited data from an earlier positive animal study reviewed by the Food and Drug Administration (4) and an in vitro nitrosation experiment (5) to support their hypothesis. The article was later criticized for committing ecological fallacy, wherein the temporal coincidence of two events observed at an ecological level without examination of individual data can lead to faulty conclusions regarding risk association (6), and the supporting evidence cited for the article was also refuted (7, 8). More recent and extensive animal trials have failed to show the carcinogenic activity of aspartame (1, 9-11). Additionally, a population-based case-control study found a null association between childhood brain tumors and aspartame intake among both children and their mothers during pregnancy and lactation (12). In contrast, however, a recent study found that female rats fed aspartame developed more lymphomas and leukemias than controls, in a dose-dependent manner, starting from a dose that may be relevant to human intake (as low as 20 mg per kg body weight;refs. 13, 14), which is lower than the acceptable daily intake established by the Food and Drug Administration at 50 mg per kg body weight (1). This study, compared with previous ones, had a large sample size (f1,800 rats) and was observed over a life span (13, 14).

Given the recent finding of an association between aspartame and hematopoietic cancers in rats, and past concerns about an association with brain cancers, we undertook a study to assess this relationship in a large prospective study of humans. We investigated the association between self-reported consumption of aspartame-containing beverages and incident hematopoietic and brain cancers in the prospective NIH-AARP Diet and Health Study.

The following two questions came into the Aspartame Resource Center. We asked Heidi McIndoo, RD to respond.

Does aspartame increase your apetite?

While there have been anecdotal reports that aspartame increases your appetite, science doesn't exactly back them up. Several studies over the last fifteen years have shown no increase in appetite after consuming drinks sweetened with aspartame. These studies compared aspartame-sweetened drinks to sugar-sweetened drinks and water. More importantly, aspartame-sweetened beverages were also shown not to increase food intake. In one study, aspartame users lost more weight and regained less weight than non-aspartame users. All of these results allow aspartame to fit into a healthy, balanced weight loss or weight maintenance eating plan.

Does aspartame inhibt fat burning?

No, aspartame does not inhibit fat burning. In fact the ingredient itself causes no changes in metabolism whatsoever. Aspartame does however help lower the calorie content of foods and drinks sweetened with it. This results in fewer calories being consumed. By reducing calories in and increasing calories out (burning more calories through exercise) a negative calorie balance is created which promotes fat burning and weight loss.

Aspartame Effective in Weight Loss: New Review The Trust for America's Health has just released a somewhat depressing new evaluation of the state of Americans' weight. In brief, the organization found that the rate of obesity continues to climb in thirty-one states and has remained the same (since their report two years ago) in eighteen other states and the District of Columbia. Although the group focuses primarily on government actions to counteract this trend, the bottom line is that it is still the individual who must make changes in lifestyle to either prevent or treat obesity.

Consumers who are trying to lose weight or maintain weight loss thus should be pleased to learn of recent scientific evidence that the use of aspartame as a sugar substitute to reduce the calorie content of foods and beverages can indeed help people lose weight. A recent review (published in the Nutrition Bulletin 31: 115, June 2006) examined the results of sixteen studies that compared the energy (calorie) intake of healthy adults (men and women between nineteen and fifty years old) who consumed either aspartame-sweetened beverages or foods, or who ate the same items sweetened with sugar.

As you'd expect, there was an overall reduction in energy intake by the aspartame users of about 10% compared to that of the sugar consumers. That doesn't seem like much, but on average it was a deficit of about 222 calories per day. If maintained over the course of a year, such a reduction would lead to a decrease of over twenty-three pounds of body weight.

In some of the studies, there was some compensation for the calorie deficit -- that is, people consumed more calories from other foods or beverages -- but it amounted to less than one-third of the calorie reduction. So in spite of the compensation, people did lose weight when they used aspartame to reduce calorie intake. In summary, the review authors emphasized that "using foods and drinks sweetened with aspartame instead of those sweetened with sucrose is an effective way to maintain and lose weight without reducing the palatability of the diet." Thus, whether or not the government or public health community manages to come up with policies to slow or reverse the obesity epidemic, there are effective means individuals can use to help themselves.

From HealthFactsandFears.com, a Web site produced by the American Council on Health