Aspartame

Is it a no-brainer then to use artificial sweeteners given that they have no calories? Aspartame has been rather controversial and a lot of online movements and some research has suggested that it can have adverse health effects ranging all the way from cancer to weight gain. Other purported adverse health benefits include seizures, depression, MS (multiple sclerosis), lupus and congenital disabilities. However, none of these claims have been substantiated and are not backed by any reasonable studies.

According to the US FDA there are no serious side effects and aspartame is safe. Further, people consume far less than the ADI (acceptable daily intake) which is already a very cautious metric. It is possible that there may be some allergies in individual cases, but these are extremely rare. 

While it can be said that aspartame is largely safe, making claims about health benefits is more fraught. Large scale observational studies have not pointed to adverse health effects but have been neutral about benefits too. 

All in all, aspartame is a good choice for this with diabetes since it undoubtedly translates to fewer calories by itself. However, it can’t be thought of as a sure shot way of losing weight-- no single step can. Adequate exercise and a balanced diet which includes aspartame is better for your overall health and is a more holistic approach to weight loss.

(Read about what makes a healthy diet and how to lose weight).

The artificial sweetener is sold as a tablet that can be added to foods or beverages as desired. It is also present in many low calorie products such as drinks, chewing gum, dairy products, desserts and sauces. 

While aspartame is quite versatile and can deliver a high amount of sweetness it is not recommended for baking products as the excessive heat breaks it down causing it to lose its properties. 

Aspartame can be a good idea for diabetics since it can add sweetness without the presence of carbohydrates and will not cause an increase in blood sugar by itself. Organic sugar on the other hand is laden with energy and will cause a spike in blood sugar levels. 

A 2018 review study looked at 29 randomized control trials involving over 700 participants which looked at the effect of aspartame on blood glucose. It found that the artificial sweetener did not increase blood glucose levels when compared to baseline. There were some differences based on age, weight and diabetic status but these expected given the complicated nature of blood glucose. 

Having said that, some large observational studies have shown the opposite results as well; those on low calorie sweeteners were found to be at greater risk for type 2 diabetes. For example, a study involving 2856 adults found that those on aspartame had greater obesity-related impairments in glucose tolerance. Similar observational studies have periodically shown these results as well.

However, it is important to remember that correlation does not imply causation. A criticism of these studies has often included the failure to account for confounders such as obesity. 

Overall, it is reasonable to say that aspartame does not adversely influence blood sugar by itself. The ambiguity in the studies can be explained by large amounts of variability in the participants since they were not controlled studies. Further, there are many factors that determine blood glucose levels so it cannot be said that aspartame alone caused the spike.

While the link between low calorie sweeteners and weight loss should be straightforward, this is not the case. There is good evidence to suggest that it may assist with weight loss, but the difference is modest. 

One study with 300 participants showed that those on an artificial sugar diet lost 6 kgs over one year as opposed to 2.5 kgs in the control group. 

Several observational studies have reported an increase in weight on switching to artificial sweeteners. This can perhaps be attributed to behavioural reasons. For example, people may end up consuming more calories since they feel they have removed excess sugar from their diets. One may take a low calorie drink but end up having heavy dessert and undo the effects of the diet. 

There has also been concern that aspartame can increase hunger by activating reward pathways and not delivering the energy associated with sugar. Some animal studies have confirmed these suspicions and shown that appetite related hormones were elevated after consuming it. However, the same results have not been replicated in human studies. In fact, the few studies that have been conducted showed that there actually is a decrease in hunger after consuming artificial sweeteners-- but only to a modest degree. 

More research is needed to understand this relationship, though. So far however, the evidence is strong that aspartame will not adversely affect weight loss plans and may even contribute to some weight loss. 

The subtext of these findings is more significant than the results themselves. As is well known but not practiced, weight loss is not a simple matter of changing aspects of your diet. It must be a holistic approach consisting of a balanced diet and adequate exercise. Simply switching to artificial sugar is not a magic bullet to lose weight.

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Aspartame is not recommended for those who have PKU (Phenylketonuria). This is a rare genetic disorder in which the amino acid phenylalanine is not able to be properly metabolized. Phenylalanine is present in aspartame so those with PKU should avoid it. 

Severe systems include issues with cognitive development, seizures and psychiatric disorders. Milder cases consist of skin problems and body odor. Treatment involves a protein restricted diet as well as a blanket avoidance of aspartame.

(Here are some tips for reducing body odor).