EDUCATING THE PUBLIC ABOUT POTENTIAL SIDE EFFECTS OF ARTIFICIAL SWEETENERS

Deborah Hong10/16/2014

What are some artificial sweeteners that we know?

• Aspartame (better known as Equal and NutraSweet)• Sucralose (better known as Splenda)• Saccharin (better known as Sweet N’ Low)• Acetasulfame K (better known as Sweet One)

• These chemicals aren’t just in those packets at the coffee shop counter! They’re in more than 6,000

products, including foods, medications, and even cosmetics! Without the proper education and motivation, it is very challenging to remove these products from our diet.

Why are artificial sweeteners so popular?

• To aid in battling obesity, many individuals use low-calorie artificial sweeteners as a substitute for high-calorie foods.• Artificial sweeteners make the promise of providing

as much sweetness of sugar without the unwanted calories.

• “86% of Americans use low-calorie, reduced-sugar or sugar-free foods and beverages” (Whitehouse, 253).

Case 1

14 year old boy complaining of severe migraines associated with photophobia (sensitivity to light) at least twice monthly

Case 2

36 year old woman suffered from migraines along with nausea, vomiting photophobia, and osmophobia (severe aversion to smells) at least twice monthly

• By process of elimination of foods from their diets, both these patients’ migraines were found to be triggered by aspartame-containing foods “usually within 2 hours following ingestion” (Newman, 899).

• Both these patients were provided with oral rizatriptan pills and wafers to treat their migraines. After taking the rizatriptan pills, the patients’ migraines resolved within 45 minutes. However, both these patients complained that after they took the rizatriptan wafers, their migraines steadily worsened, lasting up to 6 hours.

• So what gives? How could the same exact medication produce such different results depending on what form it was given in?

• A review of the two rizatriptan formulations revealed that the wafer formula contains 3.75 mg of aspartame!!

• In 1981, the United States Centers for Disease Control reviewed consumer complaints related to the use of

aspartame. 67% of those filed complaints concerned neurologic and behavioral symptoms. “The most frequently mentioned single complaint, headache, was reported in 22%” (Newman, 900).

• In rats “exposed to diets containing 5 or 7.5 % saccharin from the time of conception to death, an increased frequency of urinary bladder cancer was found” (Whitehouse,

3).

Sacharrin (Sweet N’ Low)

• “Toxicology studies of sucralose show little effect, the most significant finding being shrunken thymus glands with diets of sucralose” (Whitehouse, 4)

Sucralose (Splenda)

• Research on fetal rats demonstrated a significant increase of malignant tumors, an increase in the incidence of lymphomas and leukemias in males and females

Aspartame (Equal and

Nutrasweet)

What have studies shown about artificial sweeteners?

So why are artificial sweeteners still on the market??• Biologically, following ingestion, saccharin is not absorbed or metabolized.

It is excreted, unchanged, via the kidneys. Since saccharin is not metabolized, the FDA considers this compound safe.

• All of the FDA’s approval of acesulfame K were grounded on the conclusion that safety studies carried out in the Netherlands in the 1970s, were adequate and the test results indicated safety.

• However these tests carried out in rats are inadequate to establish lack of potential carcinogenicity, because “subchronic tests were not conducted for the rats and mice used in the tests” (Karstadt, 1).

• Mice were held on test for only 80 weeks, rather than the 104 weeks characteristic of National Toxicology Program (NTP) bioassay.

And now, a little history lesson!

• January 1981-- Donald Rumsfeld, CEO of Searle (the company that owns the patent to aspartame), states in a sales meeting that “he will use his political pull in Washington, rather than scientific means, to make sure it gets approved” (Murray, 1).

• January 21, 1981– Donald Rumsfeld is part of Reagan's transition team when he is elected president. Dr. Arthur Hull Hayes Jr. is selected to become the new FDA Commissioner.

• May 1981-- An FDA commissioner's panel is established to review issues raised by the Public Board of Inquiry. “Three of six in-house FDA scientists, Dr. Robert Condon, Dr. Satya Dubey, and Dr. Douglas Park, advise against approval of NutraSweet, stating on the record that the Searle tests are unreliable and not adequate to determine the safety of aspartame” (Murray, 1).

• July 15, 1981– Dr. Arthur Hayes Jr., the new FDA commissioner, overrules the Public Board of Inquiry and approves

NutraSweet for dry products.

• July 8, 1983-- The National Soft Drink Association says that Searle has not provided responsible certainty that aspartame and its' degradation products are safe for use in soft drinks.

• September, 1983-- FDA Commissioner Hayes resigns. Burson-Marsteller, Searle's public relation firm immediately hires Hayes as senior scientific consultant.

• Fall 1983-- The first carbonated beverages containing aspartame are sold for public consumption.

WHAT CAN WE DO TO EDUCATE PATIENTS ABOUT ARTIFICIAL SWEETENERS?

Knowledge is power!• We can teach patients about healthier substitutes for artificial sweeteners such as honey, maple syrup, agave, sliced

fruit, and date sugar.

• You know that saying that “If it’s too good to be true, it probably is”? The same goes for artificial sweeteners. We should always advocate that when it comes to diet, natural is always better than artificial. Yes, real sugar has more carbs but in the long run, it is always better than artificial sweeteners. Health is about balance, so make up for sugar intake with consistent physical exercise! You are also less prone to get sugar cravings if you consume adequate protein and fiber throughout the day.

• We need to remember that all of our patients are adults and reserve the right to eat what they want. However when provided with complete education about the risks of artificial sweeteners and healthier alternatives, several patients will be motivated to make the lifestyle change.

QUESTIONS?

REFERENCES HANCOCK, M. (2004). SWEET, WHITE AND DEADLY. CANADIAN JOURNAL OF HEALTH & NUTRITION. 44-48. KARSTADT, M. (2006). TESTING NEEDED FOR ACESULFAME POTASSIUM, AN ARTIFICIAL SWEETENER. ENVIRONMENTAL HEALTH PERSPECTIVES. 114 (9), 516. NEWMAN, L.C & LIPTON, R.B. (2001). MIGRAINE MLT-DOWN: AN UNUSUAL PRESENTATION OF MIGRAINE IN PATIENTS WITH ASPARTAME-TRIGGERED HEADACHES. THE JOURNAL OF HEAD & FACE PAIN. 41. 899-901.

SCHERNHAMMER, E.S., BERTRAND, K.A., BIRMANN, B.M., SAMPSON, L., WILLETT, W.C., & FESKANICH, D. (2012). CONSUMPTION OF ARTIFICIAL SWEETENER– AND SUGAR-CONTAINING SODA AND RISK OF LYMPHOMA AND LEUKEMIA IN MEN AND WOMEN. THE AMERICAN JOURNAL OF CLINICAL NUTRITION, 96 (6), 1419-1428. HTTP://DRAWEB.NJCU.EDU:2371/CONTENT/96/6/1419.FULL

WHITEHOUSE, C.R., BOULLATA, J., & MCCAULEY, L.A. (2008). THE POTENTIAL TOXICITY OF ARTIFICIAL SWEETENERS. AAOHN JOURNAL. 56 (6), 251-261.

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