Nutritive and Non-Nutritive Sweeteners

NNNS: Aspartame (2008)

• Assessment
  In adults, does aspartame affect appetite or food intake?

  • Conclusion

    There is good evidence that aspartame does not affect appetite or food intake.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults, does aspartame affect appetite or food intake?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Beridot-Therond ME, Arts I, Fantino M, De La Gueronniere V.  Short-term effects of the flavor of drinks on ingestive behaviors in man. Appetite. 1998 Aug; 31(1) : 67-81.
      • Black RM et al. Soft drinks with aspartame: effect on subjective hunger, food selection, and food intake of young adult males. Physiology and Behavior, 1991, vol. 49 803-810.
      • Black RM et al. Consuming aspartame with and without taste: differential effects on appetite and food intake of young adult males. Physiol Behavior. 1993 March 53; (4) 459-66.
      • Blackburn GL et al, The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight, Am J Clin Nutr. 1997:65:409-18.
      • Canty DJ, Chan MM. Effects of consumption of caloric vs. non caloric sweet drinks on indices of hunger and food consumption in normal adults. Am J Clin Nutr. 1991; 53: 1159-64.
      • Drewnowski A et al. Comparing the effects of aspartame and sucrose on motivational ratings, taste preferences, and energy intakes in humans. Am J Clin Nutr. 1994; 59:338-45.
      • Kanders BS et al, An evaluation of the effect of aspartame on Weight Loss. Appetite, 1988; 11, supplement 73-84.
      • Lapierre KA, Greenblatt DJ, Goddard JE, Harmatz JS, Shader RI. The neuropsychiatric effects of aspartame in normal volunteers. J Clin Pharmacol. 1990; 30 (5): 454-460.
        
      • Mattes R. Effects of Aspartame and Sucrose on Hunger and Energy Intake in humans. Physiology and Behavior, 1990, vol. 47, 1,037-1,044.
      • Rodin J. Comparative effects of fructose, aspartame, glucose, and water preloads on calorie and macronutrient and macronutrient intake. Am J Clin Nutr. 1990; 51: 428-435
      • Rogers PJ, Pleming HC, Blundell JE. Aspartame ingested without tasting inhibits hunger and food intake. Physiol Behav. 1990 Jun; 47(6): 1,239-1,243.
      • Rogers PJ, Keedwell P, Blundell JE. Further analysis of the short-term inhibition of food intake in humans by the dipeptide L-aspartyl-L-phenylalanine methyl ester (aspartame). Physiol Behav. 1991 Apr; 49(4): 739-743.
      • Rogers PJ, Carlyle JA, Hill AJ, Blundell JE. Uncoupling sweet taste and calories: Comparison of the effects of glucose and three intense sweeteners on hunger and food intake. Physiol Behav. 1988; 43 (5): 547-552.
      • Rogers PJ, Blundell JE. Reanalysis of the effects of phenylalanine, alanine, and aspartame on food intake in human subjects. Physiol Behav. 1994 Aug; 56(2): 247-250.
      • Rogers PJ, Burley VJ, Alikhanizadeh LA, Blundell JE.  Postingestive inhibition of food intake by aspartame: importance of interval between aspartame administration and subsequent eating. Physiol Behav. 1995, Mar; 57 (3): 489-493. PMID: 7753886.
      • Rolls BJ, Laster LJ, Summerfelt A. Hunger and food intake following consumption of low-calorie foods. Appetite. 1989 Oct; 13 (2): 115-27.
        
      • Rolls BJ, Kim S, Fedoroff IC. Effects of drinks sweetened with sucrose or aspartame on hunger, thirst and food intake in men. Physiol Behav. 1990 Jul; 48 (1): 19-26.
      • Ryan-Harshman M, Leiter LA, Anderson H. Phenylalanine and aspartame fail to alter feeding behavior, mood and arousal in men. Physiology and Behavior. 1987; 39(2): 247-253.
      • Tordoff MG, Alleva AM, Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. Am J Clin Nutr 1990; 51:963-9.
  In adults, does aspartame affect energy balance (weight)?

  • Conclusion

    Use of aspartame by individuals consuming a hypocaloric diet may be associated with increased weight loss. In some cases aspartame did not affect weight loss.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults, does aspartame affect energy balance (weight)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Blackburn GL et al, The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight, Am J Clin Nutr. 1997:65:409-18.
      • Kanders BS et al, An evaluation of the effect of aspartame on Weight Loss. Appetite, 1988; 11, supplement 73-84.
      • Knopp RH, Brandt K, Arky RA. Effects of aspartame in young persons during weight reduction. J Toxicol Environ Health. 1976 Nov; 2 (2): 417-428.
      • Tordoff MG, Alleva AM, Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. Am J Clin Nutr 1990; 51:963-9.
  In children, does aspartame affect appetite or food intake?

  • Conclusion

    Limited evidence indicates that aspartame consumption does not affect appetite or food intake in children.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In children, does aspartame affect appetite or food intake?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Anderson GH, Saravis S, Schacher R, Zlotkin S, Leiter LA. Aspartame: effect on lunch-time food intake, appetite and hedonic response in children. Appetite. 1989 Oct; 13 (2): 93-103.
      • Wilson JF. Lunch eating behavior of preschool children. Effects of age, gender, and type of beverage served. Physiol Behav. 2000 Jul 1-15; 70 (1-2): 27-33.
  In children, does aspartame affect energy balance (weight)?

  • Conclusion

    To date, adequately powered studies have not been conducted to evaluate the effect of aspartame consumption by children on energy balance (weight).

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  What is the evidence from human subjects research that aspartame consumption is associated with adverse effects in special populations, including children?

  • Conclusion

    A limited number of human studies published in peer reviewed journals that involved children or special adult populations were available for this question. 

    Limited evidence suggests that aspartame consumption is not associated with detrimental effect on blood methanol, eye problems, acne, blood pressure, seizure disorder, or attention deficit disorder in children.

    There is limited evidence for three special population adult groups. In patients with diabetes, aspartame consumption is not associated with elevated plasma phenylalanine and tyrosine levels, fasting glucose control, intolerance to aspartame, opthalmologic effects, heart rhythm or weight. In patients with chronic alcoholic liver disease, portal systemic encephalopathy index was unchanged. Levodopa levels were not significantly different in individuals with Parkinson's disease.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the evidence from human subjects research that aspartame consumption is associated with adverse effects in special populations, including children?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bunin GR, Kushi LH, Gallagher PR, Rorke-Adams LB, McBride ML, Cnaan A. Maternal diet during pregnancy and its association with medulloblastoma in children: a children's oncology group study (United States). Cancer Causes Control. 2005 Sep; 16 (7): 877-891. 
      • Camfield PR, Camfield CS, Dooley JM, Gordon K, Jollymore S, Weaver DF. Aspartame exacerbates EEG spike-wave discharge in children with generalized absence epilepsy: a double-blind controlled study. Neurology, 1992 May; 42 (5): 1,000-1,003.
      • Frey GH. Use of aspartame by apparently healthy children and adolescents. J Toxicol Environ Health. 1976 Nov; 2 (2): 401-415.
      • Gupta V, Cochran C, Parker TF, Long DL, Ashby J, Gorman MA, Liepa GU. Effect of aspartame on plasma amino acid profiles of diabetic patients with chronic renal failure. Am J Clin Nutr. 1989 Jun; 49 (6): 1,302-1,306.
      • Hertelendy ZI, Mendenhall CL, Rouster SD, Marshall L, Weesner R. Biochemical and clinical effects of aspartame in patients with chronic, stable alcoholic liver disease. Am J Gastroenterol. 1993 May; 88(5): 737-743. 
      • Karstaedt PJ, Pincus JH. Aspartame use in Parkinson's disease. Neurology, 1993 Mar; 43 (3 Pt 1): 611-613.
      • Nehrling JK, Kobe P, McLane MP, Olson RE, Kamath S, Horwitz DL. Aspartame use by persons with diabetes. Diabetes Care. 1985, Sep-Oct; 8 (5): 415-417.
      • Saravis S, Schachar R, Zlotkin S, Leiter LA, Anderson GH. Aspartame: effects on learning, behavior and mood. Pediatrics. 1990; 86 (1): 75-83.
      • Shaywitz BA, Sullivan CM, Anderson GM, Gillespie SM, Sullivan B, Shaywitz SE. Aspartame, behavior, and cognitive function in children with attention deficit disorder. Pediatrics. 1994; 93: 70-75. 
      • Stegink LD, Lindgren SD, Brummel MC, Stumbo PJ, Wolraich ML. Erythrocyte L-aspartyl-L-phenylalanine hydrolase activity and plasma phenylalanine and aspartate concentrations in children consuming diets high in aspartame. Am J Clin Nutr. 1995 Dec; 62 (6): 1,206-1,211.
      • Stern SB, Bleicher SJ, Flores A, Gombos G, Recitas D, Shu J. Administration of aspartame in non-insulin-dependent diabetics. J Toxicol Environ Health. 1976 Nov; 2 (2): 429-439.
  What is the evidence from human subjects research that aspartame consumption is associated with adverse effects in the general population?

  • Conclusion

    Aspartame consumption is not associated with adverse effects in the general population. Studies have found no evidence of an effect of aspartame on a wide range of adverse effects including hypersensitivity reactions, elevated blood methanol or formate levels, hematopoeitic or brain cancers. Neurological changes tested included cognitive functions, seizures, headaches and changes in memory or mood.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the evidence from human subjects research that aspartame consumption is associated with adverse effects in the general population?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Garriga MM, Berkebile C, Metcalfe DD. A combined single-blind, double-blind, placebo-controlled study to determine the reproducibility of hypersensitivity reactions to aspartame. J Allergy Clin Immunol. 1991 Apr; 87 (4): 821-827.
      • Geha R, Buckley CE, Greenberger P, Patterson R, Polmar S, Saxon A, Rohr A, Yang W, Drouin M. Aspartame is no more likely than placebo to cause urticaria/angioedema: Results of a multicenter, randomized, double-blind, placebo-controlled, crossover study. J Allergy Clin Immunol. 1993 Oct; 92 (4): 513-520.
      • Knopp RH, Brandt K, Arky RA. Effects of aspartame in young persons during weight reduction. J Toxicol Environ Health. 1976 Nov; 2 (2): 417-428.
      • Lapierre KA, Greenblatt DJ, Goddard JE, Harmatz JS, Shader RI. The neuropsychiatric effects of aspartame in normal volunteers. J Clin Pharmacol. 1990; 30 (5): 454-460.
        
      • Leon AS, Hunninghake DB, Bell C, Rassin DK, Tephly TR. Safety of long-term large doses of aspartame. Arch Intern Med. 1989 Oct; 149 (10): 2,318-2,324.
      • Lim U, Subar AF, Mouw T, Hartge P, Morton LM, Stolzenberg-Solomon R, Campbell D, Hollenbeck AR, Schatzkin A. Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies. Cancer Epidemiol Biomarkers Prev. 2006 Sep; 15 (9): 1,654-1,659.
      • Pivonka EEA, Grunewald KK. Aspartame- or sugar-sweetened beverages: effects on mood in young women. J Am Diet Assoc. 1990; 90: 250-254.
      • Rowan AJ et al. Aspartame and seizure susceptibility: results of a clinical study in reportedly sensitive individuals. Epilepsia. 1995 Mar; 36 (3): 270-275.
      • Ryan-Harshman M, Leiter LA, Anderson H. Phenylalanine and aspartame fail to alter feeding behavior, mood and arousal in men. Physiology and Behavior. 1987; 39(2): 247-253.
      • Schiffman SS, Buckley CE III, Sampson HA, Massey EW, Baraniuk JN, Follett JV, Warwick ZS. Aspartame and susceptibility to headache. N Engl J Med. 1987 Nov 5; 317(19): 1,181-1,185.
      • Spiers PA et al, Aspartame: neuropsychologic and neurophysiologic evaluation of acute and chronic effects. Am J Clin Nutr. 1998 Sep; 68 (3): 531-537.
      • Stokes AF, Belger A, Banich MT, Taylor H. Effects of acute aspartame and acute alcohol ingestion upon the cognitive performance of pilots. Aviat Space Environ Med. 1991; 62: 648-653.
      • Stokes AF, Belger A, Banich MT, Bernadine E. Effects of alcohol and chronic aspartame consumption upon performance in aviation relevant cognitive tasks. Aviation, Space and Environmental Medicine. 1994; 65(1): 7-15.