Diet Vows Or Diet Crimes?

4. July 2017
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Sweetener instead of sugar: those struggling with being overweight happily try to switchover to sugar-free products. Yet the body of data on aspartame is contradictory. Should one support patients in their attempts, or slow them down?

It is summer. By now at the latest, many patients, especially female patients, want to lose weight. However, what advice should doctors and pharmacists give to overweight patients when these exclaim excitedly that they have switched over from cola to cola light, or now sweeten their coffee with sweetening agents instead of sugar? It’s no easy task for a doctor.

Of course sugar substitutes such as aspartame have some advantages. They contain fewer calories than do sugars, are usually suitable for diabetics and contribute less to caries formation. Nevertheless, the disadvantages of these sugar substitutes have also increasingly been described in recent years. Several studies report that they are believed to trigger cancer, promote stroke and even dementia. The question arises: What’s the phenomenon known as aspartame all about? Is the stuff really harmful? And should we now dissuade patients from using diet products, or should we encourage patients in their enthusiasm?

Stroke and dementia: Is the sweetener striking back?

What supposedly speaks against aspartame and sugar substitutes is able to be read in various studies. In undertaking the so-called Framingham Study, for example, 2,888 persons under 45 years of age and 1,484 persons over 60 years of age were observed over a period of 10 years. A food-frequency questionnaire was used in this context to determine and quantify the drink intake of participants in cohort studies.

During the following seven years, 97 of the participants who at the beginning of the study were among the under 45 year-olds had had a stroke; 81 of these had had an ischaemic stroke. Surprisingly, the subjects who at the beginning of the study had reported a consumption of more than one diet drink per week in the questionnaire were three times more likely to be affected by an ischaemic stroke than those participants who had previously indicated that they consume no dietary drinks.

A similar picture emerged in the group who at the beginning of the study were over 60 years old. During the following seven years, 81 participants became ill with dementia. The increased risk in the group of diet-drink consumers was also striking: a Hazard Ratio of 2.89. Overall, the study found that individuals who frequently consumed artificially sweetened drinks at a later point in time fell victim three times more frequently to stroke or dementia.

This is actually not very surprising; for years it has been discussed in various studies that artificially sweetened drinks could be related to an increased risk of cardiometabolic disorders. When looking at sugary sweet drinks, however, no association with stroke or dementia was able to be found in this study.

Aspartame and cancer

Further study results from recent years attest to aspartame also having a carcinogenic effect. This sugar substitute consists mainly of aspartic acid and phenylalanine. It is particularly popular in the industry because its sweetening power is nearly 200 times greater than that of sugar. Accordingly, the substance need only be used in small quantities in order to achieve a corresponding sweetness in the product.

The energy content of the product is thus clearly below the level attained from an equivalent amount of sugar required to achieve the same level of sweetness. This is probably one of the main reasons why aspartame is used today in many diet drinks, as well as in chewing gum, other confectionery, bakery products and partly also in processed ready-made foods. Moreover, products sweetened with aspartame have the advantage over sugar-containing products that the development of cavities is significantly reduced and the product is also more suitable for diabetics.

That aspartame, in addition to these advantages, however may also potentially bring with it many disadvantages is indicated by various studies suggesting a link between aspartame and cancer.

Men are affected

Working with data from two studies US researchers investigated the influence of aspartame consumption on the risk of cancer. Over an analysis period of 22 years, approximately 120,000 persons were examined. Among these subjects, the scientists were able to determine various forms of cancer over the study period. Cancer cases were more common among male subjects who had an intake of aspartame-sweetened drinks. With women, however, such a relationship was not able to be established.

These results initially seem relatively convincing. Although the authors state in their conclusion at the end of the article itself that the results of the study do indeed indicate an association of sweeteners such as aspartame with the development of certain types of cancer, the differentiated gender effects and the occurrence of a cancer risk in persons who consume diet drinks could also simply be a matter of coincidence.

A question of lifestyle

A further factor to be considered in such studies also seems to be the consideration that people who generally consume soft drinks largely also pay less attention to their health or nutrition. Based on this assumption, a generally unhealthy lifestyle could have led to an increased formation of certain types of cancer.

How carcinogenic are sweeteners such as aspartame in actual fact? No conclusive final answer to this question can be found for humans at this time. Nevertheless it must be noted that studies in which aspartame has been tested on rodents reinforce the thesis of carcinogenicity associated with this substance. In rats, for example, the carcinogenic effect of the sweetener was able to be ascertained.

Here I save calories

In fact, it seems that even the motivation which leads to patients buying drinks containing sugar substitutes, specifically to reduce calories and keep their weight down, is actually just a farce. This is because the argument itself for the purchase of dietary drinks has now been invalidated. A study by the Massachusetts General Hospital shows that aspartame drinks clearly have exactly the opposite effect. Although the drink itself, as promised, contains hardly any calories, the frequently contained aspartame is converted in the body to phenylalanine. This blocks so-called alkaline phosphatase (IAP), which is normally responsible for preventing obesity and diabetes.

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3 comments:

T S
T S

Stay calm and ask the dietitian…you cannot isolate one component of a lifestyle pattern like this. There are so many different sugar subs, doses different, overall diet and exercise different.

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Dra Fraga Cristina
Dra Fraga Cristina

What about stevia, can we recommend?

#2 |
  0
Dr. André Deutsch
Dr. André Deutsch

If it is true that Aspartame can increase cardio-vascular disease and even cancer, it is also true that Sugar has killed more persons than Sugar substitutes !

#1 |
  1


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