Educating Patients on the Potential Side Effects of Artificial Sweeteners
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- 1. EDUCATING THE PUBLIC ABOUT POTENTIAL SIDEEFFECTS OF ARTIFICIAL SWEETENERSDeborah Hong10/16/2014
2. What are some artificial sweetenersthat we know? Aspartame (better known as Equal and NutraSweet) Sucralose (better known as Splenda) Saccharin (better known as Sweet N Low) Acetasulfame K (better known as Sweet One) These chemicals arent just in those packets at thecoffee shop counter! Theyre in more than 6,000products, including foods, medications, and evencosmetics! Without the proper education andmotivation, it is very challenging to remove theseproducts from our diet. 3. Why are artificialsweeteners so popular? To aid in battling obesity, many individuals use low-calorieartificial sweeteners as a substitute for high-caloriefoods. Artificial sweeteners make the promise of providingas much sweetness of sugar without the unwantedcalories. 86% of Americans use low-calorie, reduced-sugar orsugar-free foods and beverages (Whitehouse, 253). 4. Case 114 year old boy complaining of severemigraines associated with photophobia(sensitivity to light) at least twicemonthlyCase 236 year old woman suffered frommigraines along with nausea, vomitingphotophobia, and osmophobia (severeaversion to smells) at least twicemonthly 5. By process of elimination of foods from theirdiets, both these patients migraines were foundto be triggered by aspartame-containing foodsusually within 2 hours following ingestion(Newman, 899). Both these patients were provided with oralrizatriptan pills and wafers to treat theirmigraines. After taking the rizatriptan pills, thepatients migraines resolved within 45 minutes.However, both these patients complained thatafter they took the rizatriptan wafers, theirmigraines steadily worsened, lasting up to 6hours. So what gives? How could the same exactmedication produce such different resultsdepending on what form it was given in? 6. A review of the two rizatriptan formulations revealedthat the wafer formula contains 3.75 mg of aspartame!! In 1981, the United States Centers for Disease Controlreviewed consumer complaints related to the use ofaspartame. 67% of those filed complaints concernedneurologic and behavioral symptoms. The most frequentlymentioned single complaint, headache, was reported in22% (Newman, 900). 7. What have studies shown aboutartificial sweeteners? In rats exposed to diets containing 5 or 7.5% saccharin from the time of conception todeath, an increased frequency of urinarybladder cancer was found (Whitehouse,3).Sacharrin(Sweet N Low) Toxicology studies of sucralose show littleeffect, the most significant finding beingshrunken thymus glands with diets ofsucralose (Whitehouse, 4)Sucralose(Splenda) Research on fetal rats demonstrated asignificant increase of malignant tumors, anincrease in the incidence of lymphomas andleukemias in males and femalesAspartame(Equal andNutrasweet) 8. So why are artificial sweeteners stillon the market?? Biologically, following ingestion, saccharin is not absorbed ormetabolized. It is excreted, unchanged, via the kidneys. Since saccharin isnot metabolized, the FDA considers this compound safe. All of the FDAs approval of acesulfame K were grounded onthe conclusion that safety studies carried out in the Netherlands in the1970s, were adequate and the test results indicated safety. However these tests carried out in rats are inadequate to establish lack ofpotential carcinogenicity, because subchronic tests were not conductedfor the rats and mice used in the tests (Karstadt, 1). Mice were held on test for only 80 weeks, rather than the 104 weekscharacteristic of National Toxicology Program (NTP) bioassay. 9. And now, a little history lesson! January 1981-- Donald Rumsfeld, CEO of Searle (the company that owns the patent to aspartame),states in a sales meeting that he will use his political pull in Washington, rather than scientificmeans, to make sure it gets approved (Murray, 1). January 21, 1981 Donald Rumsfeld is part of Reagan's transition team when he is elected president.Dr. Arthur Hull Hayes Jr. is selected to become the new FDA Commissioner. May 1981-- An FDA commissioner's panel is established to review issues raised by the Public Boardof Inquiry. Three of six in-house FDA scientists, Dr. Robert Condon, Dr. Satya Dubey, and Dr. DouglasPark, advise against approval of NutraSweet, stating on the record that the Searle tests areunreliable and not adequate to determine the safety of aspartame (Murray, 1). July 15, 1981 Dr. Arthur Hayes Jr., the new FDA commissioner, overrules the Public Board of Inquiryand approves NutraSweet for dry products. July 8, 1983-- The National Soft Drink Association says that Searle has not provided responsiblecertainty that aspartame and its' degradation products are safe for use in soft drinks. September, 1983-- FDA Commissioner Hayes resigns. Burson-Marsteller, Searle's public relation firmimmediately hires Hayes as senior scientific consultant. Fall 1983-- The first carbonated beverages containing aspartame are sold for public consumption. 10. WHAT CAN WE DO TO EDUCATE PATIENTS ABOUTARTIFICIAL SWEETENERS? 11. Knowledge is power! We can teach patients about healthier substitutes for artificial sweeteners such as honey, maple syrup,agave, sliced fruit, and date sugar. You know that saying that If its too good to be true, it probably is? The same goes for artificialsweeteners. We should always advocate that when it comes to diet, natural is always better than artificial.Yes, real sugar has more carbs but in the long run, it is always better than artificial sweeteners. Health isabout balance, so make up for sugar intake with consistent physical exercise! You are also less prone to getsugar cravings if you consume adequate protein and fiber throughout the day. We need to remember that all of our patients are adults and reserve the right to eat what they want.However when provided with complete education about the risks of artificial sweeteners and healthieralternatives, several patients will be motivated to make the lifestyle change. 12. QUESTIONS? 13. REFERENCESHANCOCK, M. (2004). SWEET, WHITE AND DEADLY. CANADIAN JOURNAL OF HEALTH & NUTRITION. 44-48.KARSTADT, M. (2006). TESTING NEEDED FOR ACESULFAME POTASSIUM, AN ARTIFICIAL SWEETENER.ENVIRONMENTAL HEALTH PERSPECTIVES. 114 (9), 516.NEWMAN, L.C & LIPTON, R.B. (2001). MIGRAINE MLT-DOWN: AN UNUSUAL PRESENTATION OF MIGRAINE INPATIENTSWITH ASPARTAME-TRIGGERED HEADACHES. THE JOURNAL OF HEAD & FACE PAIN. 41. 899-901.SCHERNHAMMER, E.S., BERTRAND, K.A., BIRMANN, B.M., SAMPSON, L., WILLETT, W.C., &FESKANICH, D. (2012). CONSUMPTION OF ARTIFICIAL SWEETENER AND SUGAR-CONTAININGSODA AND RISK OF LYMPHOMA AND LEUKEMIA IN MEN AND WOMEN. THE AMERICAN JOURNAL OF CLINICALNUTRITION, 96 (6), 1419-1428. HTTP://DRAWEB.NJCU.EDU:2371/CONTENT/96/6/1419.FULLWHITEHOUSE, C.R., BOULLATA, J., & MCCAULEY, L.A. (2008). THE POTENTIAL TOXICITY OF ARTIFICIALSWEETENERS. AAOHN JOURNAL. 56 (6), 251-261.