- Click here for explanation of classification scheme.

To evaluate appetite, food intake and usefulness of aspartame in weight control.

• Electronic databases such as Medline, chemical abstracts, science citation index, Biosis, food science and technology abstracts, Agricola and Toxline
• 1970 to 2002
• Published worldwide in peer reviewed journals
• Scientists as reviewers
• Search terms: Aspartame, nutrasweet, aspartic acid, phenylalanine, methanol, diketopiperazine.

Not meeting the above.

Review of articles.

1970 to 2002 review of articles.

Human studies.

Weight Change

• Stellman, Garfinkel, 1986: Users of artificial sweeteners were more likely than non-users to gain weight, regardless of initial weight. Obese users lost significantly more weight than non-users. Lavin criticized this study for experimental design, for use of data from an unrelated study which they were not intended, the failure to correct for bias as a result of convenience sampling, unvalidated use of data from a homogeneous subpopulation and stratification of subjects by BMI that was determined from outcome data which was gathered near completion of a 10-year retrospective study.

Appetite, Hunger and Food Intake

• Blundell, Hill, 1986, 1987: Suggested aspartame may stimulate appetite, however they did not measure the effect of aspartame on food intake.
• Rogers et al, 1988: Reported subjects had an increase in hunger after drinking water or solutions of saccharin, acesulfame-k and aspartame compared to glucose solutions.
• Rogers et al, 1990: Reported aspartame ingested without tasting (capsule form) inhibited hunger and food intake.
• Black et al, 1993: Compared the effects of different volumes of beverage, beverages with aspartame in solution and beverages with aspartame in capsules on appetite and food intake, finding that the capsules had no effect on appetite. They reported that any appetite reduction after consumption of an aspartame-sweetened beverage is likely due to the volume of the drink and not the aspartame.
• Anderson et al, 1989; Birch et al, 1989: Replacing sucrose with aspartame in foods or beverages has not been shown to increase food intake or hunger in children.
• Blundell, Hill, 1987; Rolls et al, 1989, 1990; Black et al, 1991; Canty, Chan, 1991; Drewnowski et al, 1994: Not shown to increase food intake in normal-weight or in men and women who are overweight
• Rodin, 1990; Drewnowski, 1994: During one three-week control period, subjects received no experimental drink. The aspartame was delivered in a solid or liquid medium.
• Wilson, 2000: Compared the effect of plain milk, sucrose-sweetened milk and aspartame-sweetened milk on mealtime caloric intake in young children. They consumed more sweetened milk than plain milk. Authors found that children do not reduce caloric intake at a meal to compensate for the extra calories resulting from sucrose-sweetened milk.
• Other reviews in detail: Rolls, 1991; Renwick, 1994; Drewnowsk, 1995; Rolls, Shide, 1996.

Inpatient Studies in Metabolic Wards

• Porikos et al, 1977: Aspartame replaced sucrose (about 25% of total calories). Energy intake decreased significantly to 77% of baseline intake during the first three days and remained at 86% of baseline during the next three days.
• Poikos et al, 1982: A significant reduction was seen in caloric intake during a 12-day period on an aspartame-sweetened diet. Intake was lowest in the first three-day period, with stabilization at 85% of baseline during the subsequent nine days of the caloric-diluted diet.
• Porikos, PiSunyer, 1984: A 15% reduction in energy intake was observed when aspartame was substituted for sucrose in the diet. These data show that there is no short-term physiologic drive to replace all calories removed through the use of aspartame.

Studies have been criticized because the baseline diet encouraged overeating and weight gain and did not reflect the subject’s normal diet.

• Tordoff, Alleva 1990: Outpatient study looked at the effect of adding aspartame in a blinded manner to a normal diet in free-living normal-weight subjects. During two three-week experimental periods, subjects received four bottles of beverage (40oz or 1,135g) sweetened with either aspartame or high-fructose corn syrup each day. There was a significant reduction in caloric intake in both females and males and decreased body weight in males during the period when aspartame-sweetened soda was consumed. The high-fructose corn syrup treatment led to a significant increase in caloric intake and body weight.
• Astrup et al, 2002: Reported large amounts of sucrose (mean 152g per day) added to diets of subjects who were overweight for 10 weeks resulted in increases in total energy intake, body weight, fat mass and blood pressure, compared to decreased body weight, fat mass and blood pressure in subjects who were overweight and were supplemented with artificial sweeteners.

Weight Control

• Kanders et al, 1988, 1996: Aspartame did not cause weight gain and may be beneficial in promoting weight loss and maintenance when used as part of a multi-disciplinary weight-control program.
• 12-week multi-disciplinary diet program
• 59 men and women who were obese (937kg/m²)
• Subjects were randomly assigned to consume a balanced-deficit diet (1,200kcal per day) with or without aspartame-containing products.
• Not statistically significant, however women in the aspartame group lost 3.7 pounds more than women in no-aspartame group. Men showed the opposite trend: Those in no-aspartame group lost about four pounds more than those in the aspartame group.
• 46 of these subjects participated in a one-year follow-up.
• Increased levels of physical activity, increased consumption of aspartame and a decreased desire for sweets were associated with maintenance of weight loss at the one-year follow-up.
• Blackburn et al, 1997: A randomized controlled prospective clinical study to investigate whether the addition of aspartame to a multi-disciplinary weight program would improve weight loss and long-term control of body weight in obese women. The authors concluded that aspartame, as part of a multidisciplinary weight control program, may facilitate weight control.
• Initially, 168 women aged 20 to 60 years, who were obese, were placed on a diet consisting of 1,200kcal per day for three weeks.
• At the end of this period, 163 subjects were randomized to either consume aspartame-sweetened foods and beverages during the remaining 16 weeks of active weight loss phase or to avoid these products.
• During the one- and two-year follow-up periods, subjects were encouraged to do their original group.
• Parameters, measured at baseline, 19, 71 and 156 weeks, included body weight, aspartame intake, exercise level and subjective ratings of hunger, desire for sweets and eating control.
• 136 subjects completed the weight-loss phase, 125 completed the maintenance phase and 86 subjects completed the follow-up.
• Both treatment groups lost a mean of about 10% of body weight during the 19 weeks of active weight loss.
• Hunger did not differ, although the desire for sweets decreased significantly in the aspartame group.
• In maintenance weeks 19 and 71, hunger and desire for sweets remained unchanged.
• At the end of maintenance week 71, subjects in the aspartame group had a mean 3.15 pounds of weight regain and those in the no-aspartame group regained a mean of 4.9%.
• By week 156, the aspartame group regained an additional 2.4% in contrast to a 5.4% regain in the no-aspartame group.

• Nutritional surveys estimate that added sugars account for about 15% to 20% of calories in the American diet. High-intensity sweeteners such as aspartame can provide sweetness and palatability without adding calories and may facilitate control of body weight in individuals who are motivated.
• The few studies that indicate an increased motivation to eat following the consumption of aspartame were not replicated by a number of other studies.
• Inpatient studies of non-dieting obese and normal-weight individuals have demonstrated incomplete caloric compensation after covert replacement of sucrose with aspartame.
• A multi-disciplinary weight control program that included the use of aspartame-sweetened food and beverages facilitated weight loss and long-term maintenance of a reduced body weight. These results suggest that aspartame, when incorporated with a multi-disciplinary weight management program including exercise and behavior modification, may aid in the long-term control of body weight.

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Nice review of articles.