Aspartame and Cancer
Untitled Document
Key Points
- A study of about half a million people, published in 2006, compared people
who drank aspartame-containing beverages with those who did not. Results
of the study showed that increasing levels of consumption were not associated
with any risk of lymphomas, leukemias, or brain cancers in men or women.
(Question 2)
- Researchers examined the relationship between aspartame intake and 1,888
lymphomas or leukemias and 315 malignant brain cancers among the participants
of the NIH-AARP Diet and Health Study from 1995 until 2000. Development
of these cancers was not associated with estimated aspartame consumption,
refuting a recent animal study with positive findings for lymphomas and
leukemias and also contradicting claims regarding brain cancer risk. (Questions
3 and 8)
- Why was an aspartame study initiated?
Researchers* from the National Cancer Institute (NCI)
initiated this research because an earlier study showed that female rats
fed the artificial sweetener aspartame developed more lymphomas and leukemias
than rats that received no aspartame in their feed (Soffritti et al. 2005;
Soffritti et al. 2006). The risk of cancer in that study grew with the increased
amount of aspartame given to the rats. Some of the dosages
may have been relevant to human intake (as low as 20 milligrams
per kilogram
of body weight, which would be equivalent to a 165-pound person consuming
about eight cans of diet soda).
Other questions regarding the safety of aspartame were raised by a 1996
report (Olney et al. 1996) suggesting that an increase in the number of
people with brain tumors between 1975 and 1992 might be associated with
the introduction and use of this sweetener in the United States. However,
this report was later criticized by the scientific community for committing
"ecological fallacy" (Ross 1998). Ecological fallacy refers to
making a wrong conclusion about cause and effect in one person based on
collection of data from a group of people; i.e., relating two things that
happen at the same time, such as aspartame use and an increase in the number
of brain cancer cases seen in a population, without examining whether individuals
who consume aspartame also develop brain cancer.
- What did the researchers find in this current study?
Researchers examined the consumption of aspartame-containing beverages
among the participants of the NIH-AARP Diet and Health Study and reported
that, in a comparison of people who drank aspartame-containing beverages
with those who did not, increasing levels of consumption were not associated
with an increased risk of lymphomas, leukemias, or brain cancers in men
or women.
An increase in cancer risk was not found for the main subtypes of lymphoid
cancers (Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple
myeloma), non-Hodgkin lymphoma subtypes (including small
lymphocytic lymphoma and chronic
lymphocytic leukemia, immunoblastic lymphoma and lymphoblastic lymphoma/leukemia),
or non-lymphoid leukemias.
- How was the study done?
NCI researchers examined data from the NIH-AARP Diet and Health Study
to investigate questions about aspartame and risk for lymphoma, leukemia,
and brain cancers. The NIH-AARP Diet and Health Study is an observational
study where people provide information on a questionnaire about their
recent intake of various foods and then are followed up for subsequent development
of cancer. Specifically, about half a million AARP members (285,079 men
and 188,905 women) who were 50 to 71 years old and living in eight study
areas across the U.S. were given a questionnaire in 1995 and 1996. The participants
were followed until the end of 2000 by linkage of their records with cancer
registries that track the occurrence of new cancers.
The questionnaire inquired about consumption frequency and diet drink-type
preference for three potentially aspartame-containing beverages (soda, fruit
drinks, and iced tea), as well as aspartame added to coffee and hot tea.
The researchers then computed daily consumption of aspartame, taking into
account aspartame content, portion size, and consumption frequency of each
beverage. The estimated aspartame intake was next compared with the occurrence
of 1,888 lymphomas or leukemias and 315 malignant brain cancers to see if
there was any correlation between intake and cancer.
- What is the significance of the current study?
As the largest study of diet and cancer to date in the U.S., the NIH-AARP
Diet and Health Study allowed researchers to examine even relatively rare
cancers and their subtypes. The information on people's food consumption
was collected at the beginning of the study and before anyone was diagnosed
with cancer. This particular study design makes the findings more reliable
because it reduces the chance that cancer patients remember their beverage
consumption differently or report any changes after diagnosis.
Although this is how epidemiologic studies typically determine the relationship
between diet and diseases, aspartame estimated this way may or may not reflect
lifetime consumption. Also, most diet beverage consumers in the study drank
moderate amounts of aspartame, ranging from none to 3400 mg
daily—and on average 200 mg daily—which is a little over a can
of diet soda. While this moderate consumption is reflective of the average
consumption in the U.S., these findings limit any conclusions about cancer
risk in people who consume very high amounts of aspartame.
- Does the general population drink as much diet soda as the study
participants?
The participants of the NIH-AARP Diet and Health Study were recruited
from six states and two metropolitan areas around the U.S. that have highly
reliable cancer registry data. Thus, the study participants are a good sample
of older adults in the U.S. The study questionnaire included questions to
identify consumers of diet beverages and aspartame users for coffee and
hot tea, which is information rarely available in most large population
studies. The average aspartame consumption among diet beverage consumers
in the study was about 200 mg per day, which is similar to a survey of U.S.
consumers done by the Food and Drug
Administration (FDA).
- Were there differences in the relationship between aspartame and
cancer by racial group, ethnicity, age, or gender?
Researchers examined the relationship between aspartame and lymphoma,
leukemia, and malignant brain cancers by different races and age groups
and also in men and women separately, and found no difference from the overall
finding. However, it should be noted that the study included older adults
who were mostly whites.
- Do animal studies of aspartame show the same results as human studies?
The NIH-AARP study findings match those of previous animal studies by
the FDA and coincide with the conclusion of an earlier study on childhood
brain cancers (Gurney et al. 1997).
Shortly before this most recent study of aspartame and cancer was published,
the European Food Safety Authority reviewed the recent animal data and urged
caution when interpreting results (The European Food Safety Authority 2006):
"The increased incidence
of lymphomas/leukemias reported in treated rats was unrelated to aspartame,
given the high background incidence of chronic
inflammatory
changes in the lungs
and the lack of a positive dose-response relationship."
- What are some facts about aspartame?
- Aspartame, distributed under several trade names (e.g., NutraSweet®
and Equal®), was approved in 1981 by the FDA after numerous tests
showed that it did not cause cancer or other adverse
effects in laboratory animals (Council on Scientific Affairs 1985;
Flamm 1997; Koestner 1997).
- In the NIH-AARP Diet and Health Study, aspartame consumption ranged
from 0 to 3400 mg per day (about 19 cans of soda at the high end; however,
the upper limit is not absolute because investigators asked multiple-choice
questions on frequency and the highest option was "6-plus times a
day"). There are 180 mg of aspartame in a 12 ounce
can of diet soda.
- The highest aspartame category in the NIH-AARP Diet and Health Study
was "600 mg and above per day," or about three or more cans
of diet soda; researchers also examined higher categories (more than 1200
mg per day or 2000 mg per day, which is equivalent to approximately seven
to 11 cans of soft drinks daily) with fewer people and found similar results
of no elevated risk.
- FDA's Acceptable Daily Intake (ADI) of aspartame is 50 mg per kilogram
of body weight or about 3,750 mg (21 cans of diet soda) for an adult weighing
75 kilograms (165 lb). ADI is the amount of substance (e.g., food additive)
like aspartame that can be consumed daily over a lifetime without appreciable
health risk to a person on the basis of all the known facts at the time
of the evaluation.
- The average aspartame consumption among diet beverage consumers in the
NIH-AARP Diet and Health Study was 200 mg per day, or about 7 percent
of the ADI, which is the same as a survey of U.S. consumers done by the
FDA.
- An animal study that fed 0, 4, 20, 100, 500, 2500, and 5000 mg per kilogram
of body weight of aspartame to rats saw lymphoma/leukemia increase in
female rats, starting from about twice the risk with 20 mg per kilogram
of body weight (a person weighing 75 kilograms or 165 lbs, consuming 1500
mg aspartame, or about 8 cans of diet soda) compared with a control group
that was not fed aspartame.
* Lim U., Subar A.F., Mouw T., Hartge P., Morton L.M., Stolzenberg-Solomon R., Campbell D., Hollenbeck A.R., & Schatzkin A. Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies. Cancer Epidemiol. Biomarkers Prev. 2006. Vol. 15.
References
-
Council on Scientific Affairs (1985) Aspartame. Review of safety issues.
JAMA 254, 400-402.
-
Flamm W.G. (1997) "Increasing brain tumor rates: is there a link to aspartame?"
J. Neuropathol. Exp. Neurol. 56, 105-106.
-
Gurney J.G., Pogoda J.M., Holly E.A., Hecht S.S., & Preston-Martin S. (1997)
Aspartame consumption in relation to childhood brain tumor risk: results
from a case-control study. J. Natl. Cancer Inst. 89, 1072-1074.
-
Koestner A. (1997) "Increasing brain tumor rates: is there a link to aspartame?" J. Neuropathol. Exp. Neurol. 56, 107-109.
-
Olney J.W., Farber N.B., Spitznagel E., & Robins L.N. (1996) Increasing
brain tumor rates: is there a link to aspartame? J. Neuropathol. Exp.
Neurol. 55, 1115-1123.
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Ross J.A. (1998) Brain tumors and artificial sweeteners? A lesson on not
getting soured on epidemiology. Medical and Pediatric Oncology
30, 7-8.
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Soffritti M., Belpoggi F., Esposti D.D., & Lambertini L. (2005) Aspartame
induces lymphomas and leukaemias in rats. Eur J Oncology 10, 107-116.
-
Soffritti M., Belpoggi F., Esposti D.D., Lambertini L., Tibaldi E., & Rigano
A. (2006) First experimental demonstration of the multipotential carcinogenic
effects of aspartame administered in the feed to sprague-dawley rats. Environ.
Health Perspect. 114, 379-385.
-
The European Food Safety Authority (2006) Opinion of the Scientific Panel
AFC related to a new long-term carcinogenicity study on aspartame. The
EFSA Journal 356, 1-44.
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