TDNet Discover

Background: Low-calorie sweeteners are found in a variety of products commonly consumed by those attempting to reduce caloric intake, body weight, and postprandial glycemia. Aspartame is a commonly used sugar alternative deemed safe by the U.S. Food and Drug Administration, but some evidence suggests negative effects on metabolic health. Purpose: This evidence-based medicine systematic review aimed to assess whether daily aspartame intake contributes to the cause of metabolic disease in adults in order to provide clinical guidance to healthcare providers. Three researchers collaborated to seek out the highest level of evidence in an evidence-based medicine systematic review to answer the question, “Does daily aspartame intake contribute to the cause of metabolic disease in adults, compared with adults who do not consume aspartame daily?” Methods: Three databases were searched using prespecified search terms, search parameters, and inclusion criteria. Articles were required to include only adults, isolated measures of aspartame, and assess metabolic outcomes. The articles were reviewed and assessed independently and in duplicate, resulting in three randomized controlled trials of the highest quality. The articles were selected without conflict of interest, and data was extracted using a previously established tool. The data underwent an independent in duplicate qualitative analysis as a body of evidence. The three researchers then convened to review the analysis, finalize data points, and present the results in a manuscript to answer the research question. Results: The primary metabolic effects of aspartame consumption measured across the three studies included body weight, glycemia, and dietary intake. Daily aspartame consumption measured at four weeks and twelve weeks did not have significant effect on glycemic control nor body weight in healthy weight, overweight, and obese adult populations. There was no METABOLIC EFFECTS OF ASPARTAME v significant change in metabolic hormones measured at baseline and after twelve weeks of daily aspartame consumption. A lack of effect on overall dietary intake was also seen;however, underreporting and bias may have played a role in this measure. Conclusion: The highest levels of evidence in the currently available literature support the previous body of evidence rendering aspartame to be a safe alternative to sugar. The research shows that daily aspartame consumption does not have negative metabolic effects. It is therefore safe for providers to recommend aspartame to their patients looking to control blood glucose levels and maintain a healthy body weight. Future research isolating aspartame’s effects from possible metabolic modifiers included in products and including participants with preexisting metabolic disease, such as type 2 diabetes mellitus, should be conducted in order to further clinical understanding and application.