Weight Loss and Artificial Sweeteners: Are They Safe- A Doctor's Perspective
Weight Loss and Artificial Sweeteners: A Physicians Unbiased Review
People really like the taste of sugar, we are born with the desire and it only seems to increase as we age. Diabetic and individuals seeking to prevent weight related medical complications have switched to consuming more and more artificial sweeteners (AS) not only in soft drinks but in almost every food possible. In 1977 4.8% of the population used AS’s daily, it has quadrupled to more than 15% today. Still not has high as one might assume given their popularity. During the same period the number of overweight children has exploded from 5% to 34% and the adults from 44 to 67%.
The safety and efficacy of artificial sweeteners for weight control have been the subject of continued controversy in the press and all over the Internet. Numerous health problems have been blamed on the use of AS ranging from multiple sclerosis, cellulite to cancer and kidney stones. When the FDA and the National Cancer Institute and such consumer organizations as Center for Science in the Public Interest settle one issue, another arises. Who should the consumer believe and what should he do? Should the consumer avoid artificial sweeteners because of fear of cancer only to get diabetes, heart disease and other obesity related problems?
It’s hard to know who to believe because there are some many voices. Safety issues long ago settled by the regulatory agencies are brought up by anti-artificial activists who spend a great degree of effort alerting the public as to what they perceive as the dangers of AS. Most are hypothetical questions totally lacking scientific evidence? While they claim to be unbiased and “independent” they simply are not qualified to be able to scientifically evaluate the numerous safety evaluations, complex toxicological studies and expert committee reports. Instead of using peer reviewed medical reports their conclusions are based on person experience and anecdotal stories. As in all life sciences false positives and false negatives are a fact of life and expertise is required to properly interpret data from such studies. Over-simplistic interpretations lead to incorrect conclusions.
What is the consumer to do in this situation? Like any issue, the consumer needs to seek out the most trusted, experienced and educated experts he can find. This is not difficult since there is literally a mountain of reliable scientific studies, some old and some very recent. Here are the issues to answer:
1. Based on the most reliable, scientifically proven studies are artificial sweeteners safe?
2. Do artificial sweeteners help people lose weight and prevent the complications of obesity?
To answer these questions I have relied on the best scientific studies I was able to find over the past 20 years. Here are the guidelines I have used to evaluate the data.
1. Only scientific studies written by MD’s or PhD from recognized university medical centers are even considered.
2. The scientific evidence had to be presented in a scientific, recognized, peer reviewed medical journal, containing not only the qualifications of the authors, the location of the studies, pertinent medical references as well as any disclosures of conflict of interests of the authors.
3. Evidence from regulatory agencies both US and European, and position papers from expert committees of scientific associations.
Surprisingly, the answers are much simpler than one would think: Of the two issues, safety and efficacy, the safety issue has been settled by all reasonable individuals: AS’s ARE SAFE FOR JUST ABOUT EVERYONE
There are published safety standards for consumption of AS. The term ADI(Acceptable Daily Intake) is used. by the FDA, the Joint Commission of Experts on Food Additives of the World Health Organization, the Food and Agriculture Organization, the European Food Safety Agency. In general the ADI’s include about 20 cans (12 oz.) per day of diet cola for aspartame, 12 packets of saccharin sweetener and 6 cans of diet cola for sucralose. Here are some of the issues on the use of artificial sweeteners and the generally accepted conclusions regarding their safety:
Aspartame and Headaches:
Randomized, double blind controlled studies in individuals who were convinced that aspartame caused their headaches done in a clinical research center failed to show that aspartame produced headaches. Numerous long terms, high dose aspartame studies showed no evidence of headaches from aspartame.
Aspartame and Cancer:
Researchers examined the relationship between aspartame and lymphoma, leukemia, and malignant brain cancers and found no increase rate of any malignancy due to consumption of artificial sweeteners in animals or humans. After an Italian report of increased cancer in rats fed large doses of AS, the FDA and the European Food Safety Authority (EFSA) re-examined all of the human and animal evidence again and confirmed the safety of AS and rejected the need for further studies. The National Cancer Institute examined human data from the NIH-AARP Diet and Health Study of over half a million retirees which included participants drinking from 1-2 cans of soda to day to as much as 11 cans a day (the average was 2 cans per day or about 7% of the ADI) .Even at this high level of intake there was no increase risk of cancer or any other medical problems. (see http://www.cancer.gov/cancertopics/factsheet/risk/aspartame)
Aspartame and multiple sclerosis, seizures, chronic fatigue, visual disturbances:
Again all of these reports are based on anecdotal stories. No reliable reports have proven any connection between aspartame and these disorders.
Aspartame does carry a cautionary note, however. It isn’t safe for people who have the rare hereditary disease phenylketonuria (PKU). Products that contain aspartame must carry a PKU warning on the label.
Here are the position papers of the major academic institutions involved in the safety issue of artificial sweeteners:
“Available evidence suggests that consumption of aspartame by normal humans is safe and is not associated with serious adverse health effects.” American Medical Association Council on Scientific Affairs report, published in The Journal of the American Medical Association, July 19, 1985
“Present levels of aspartame consumption appear to be safe for those who do not have PKU. . . . The blood phenylalanine levels reported in response to loading doses of aspartame in normal adults and those heterozygous for the PKU gene do not seem to be sufficiently high to warrant concern of toxicity to the individual or even to a fetus during pregnancy.”American Academy of Pediatrics Committee on Nutrition, Task Force on the Dietary Management of Metabolic Disorders, December 1985 Final Report
“The American Diabetes Association finds the use of the two commercially available non-caloric sweeteners saccharin and aspartame to be acceptable. The use of both sweeteners is encouraged for the particular advantages of each.” Position statement of the American Diabetes Association,
“Use of No caloric Sweeteners,” 1990 (issued prior to the approval of acesulfame K)
“Evidence indicates that long-term consumption of aspartame is safe and is not associated with any adverse health effects.” American Dietetic Association “Use of Nutritive and Nonnutritive Sweeteners” position statement, July 1993
The finest scientists from all over the world have agreed that artificial sweeteners used in moderation are safe for adults, children, pregnant women and even breast feeding women. The regulatory agencies across the world as do all of the professional societies have reached a similar conclusion. Substituting artificial sweetened beverages and foods for naturally sweetened ones, especially the juices and sodas, can lead to a significant reduction in calories for those on calorie-reduced diets but who still crave sweets.
However, adding more calories because the sugar calories are reduced defeats the whole purpose.
The debate about the safety and efficacy of artificial sweeteners will most likely continue for years until more conclusive studies come up with a definitive answer. In the meantime, artificial sweeteners can be found in everything from cookies to ice cream to sodas.
Anybody who wants to avoid foods containing aspartame can identify its presence from the label. Consumers can make informed choices because food manufacturers are required to list food additives and other ingredients, including sweeteners, on labels.
Source by richard Lipman M.D.