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The trouble with sweeteners, of particular concern for Diabetics

By H J Roberts, M.D.  Posted by Stephen Fox (about the submitter)       (Page 1 of 2 pages)   8 comments
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Roberts talks about the role of the pancreas, the chemical aspartame, and how sweeteners containing aspartame affect the pancreas, in support of the Senate Concurrent Resolution 191, by Senator Suzanne Chun Oakland, asking FDA Commissioner to Rescind Approval for Aspartame, and this Resolution remains stalled in the Senate Health Committee, with hearing yet to be scheduled.
Q. What is the role of the pancreas?
A. The pancreas is a vital organ with several major functions. It has a digestive function by virtue of making the pancreatic enzymes that digest the food and an important endocrine function by virtue of having the islets that secrete insulin and other hormones.
Q. What are some of these hormones?
A. In addition to insulin, there is glucagon, along with several others.
Q. What is aspartame?
A. Aspartame is a chemical that originally was conceived as a treatment for peptic ulcer. The molecule closely simulates the hormone gastrin, which is involved with hydrochloric acid secretion. Aspartame consists of three components-phenylalanine and aspartic acid (both amino acids) and a methyl ester, which becomes free methyl alcohol when it enters the stomach. The combination is approximately 50 percent phenylalanine, 40 percent aspartic acid, and 10 percent methyl alcohol. Around 1965, this chemical was found to taste sweet. It was therefore submitted as a sweetening supplement and the drug application with-drawn.
Q. Was aspartame ineffective as a drug?
A. It was never really marketed as a drug for a peptic ulcer, although that was the original intent.
Q. Are artificial sweeteners that contain aspartame safe?
A. A number of artificial sweeteners, including saccharin, have been around for a long time. In my opinion, aspartame has many hazards. Saccharin is essentially safe. The sweetener called stevia, which is increasingly being used, comes from a shrub found in Paraguay, South America. It tastes very sweet. In my experience, it is also safe. I have reservations about the other sweeteners, such as acesulfame-K (e.g., Sunette, Sweet One(R)), sucralose (Splenda(R) No Calorie Sweetener), and the cyclamates. Then there are the analogues of aspartame, such as the high-intensity product Neotame(R). For example, acesulfame-K induces chromosomal aberrations; sucralose is associated with several effects in animals, is weakly mutagenic, and
increases the glycosylated hemoglobin in diabetic patients. The cyclamates were initially withdrawn in the U.S. because of concern about bladder tumors. The National Academy of Science has subsequently concluded that cyclamates were not carcinogenic in humans. However, there is a great deal of concern in Europe about their wide-spread use, especially in children. As for Neotame(R) and other analogues of aspartame, they pose problems similar to those of aspartame. Again, stevia and saccharin appear to be safe.
Q. How do sweeteners affect the pancreas?
A. They can have direct and indirect effects. One result, of course, is the secretion of insulin. When humans take something that is sweet, the body infers that sugar is being ingested. In anticipation of its arrival, pancreas reflexively releases insulin. This is one way in which aspartame affects the pancreas. It can also cause considerable stimulation of the exocrine part of the pancreas that involves the pancreatic juices. This may even produce pancreatitis-inflammation of the pancreas-which in the process might disturb the islet cells.

There is an enormous reserve of pancreatic juices. At least 60 percent or more of the pancreas would have to be destroyed before interfering with pancreatic function would occur. One way to stimulate the pancreas to produce its secretions is to give amino acids, including phenylalanine, with or without another amino acid.

In my experience, aspartame products have produced clinical pancreatitis. To my knowledge, neither the long-term effects to the secretory pancreas nor the relationship to the subsequent overstimulation of the pancreas, in terms of tumors, has been studied.

Q. If the safety of aspartame has been questioned, why has no one been able to prove the dangers?
A. To me, it is quite clear that aspartame products can cause severe illness. Indeed, I feel that this product should not have been approved for human consumption, as it was in 1981. The sweetener was released over the violent objections of in-house FDA [Food and Drug Administration] scientists, consultants for the General Accounting Office, and even a public board of inquiry in 1980-all of whom were emphatic that it should not be released, especially in light of the high incidence of brain tumors in animals.

I have repeatedly listed and detailed the many complications and side effects of aspartame products. My recent book, Aspartame Disease, has more than 1000 pages of what I consider direct complications of the use of these products.

In regard to those who say this is not so, it seems to be a phenomenon of denial on the part of the FDA. This is a multibillion-dollar industry that has proponents for self-serving economic interests who maintain that all reservations are nonsense. There is an overwhelming input of complaints indicating that this is a frequent and severe disorder, which I call "aspartame disease." Now the problem with many of these studies they refer to is that protocols were flawed in terms of how the product was prepared and administered and how subjects were followed. It has been very difficult to detail these objections about published studies asserting that aspartame is safe for various reasons, including the power of this industry.

In my opinion, those "negative studies" all require confirmation by corporate-neutral investigators using real-world products taken from market shelves that have been exposed to excessive temperatures or prolonged storage. Indeed, that is currently the subject of considerable interest by the European Parliament as to whether aspartame should be considered unsafe.

Q. What do you think will come about from that?
A. Ultimately, I think there will be no question-with the anecdotal information that has already been accrued-that aspartame products are found unsafe for many individuals. These products are being consumed by more than two thirds of the population. This is a very large number in terms of the many neurologic and neuropsychiatric problems, the allergic problems, the effects on patients with diabetes and hypoglycemia, and the long-term effects in pregnancy and infants... along with numerous other problems, including the issue of brain tumors in humans.

Q. Should diabetic patients, in particular, be concerned about aspartame?
A. Yes. I believe that aspartame can aggravate diabetes and its complications, especially eye problems and neuropathy, or it can simulate the complications of diabetes. In other words, aspartame disease can simulate diabetic retinopathy or peripheral neuropathy. When patients discontinue these products, they usually get better. In terms of aggravating diabetes, consuming aspartame either can bring out latent diabetes clinically or can lead to insulin resistance, which would require patients to take oral drugs to increase the amount of insulin required. The bottom line is that when people stop ingesting these products, the symptoms usually improve.

Q. Have there been cases in which people did not improve after discontinuing aspartame?
A. There are certain criteria for diagnosing aspartame disease...similar to the Koch postulates for infection:

* Patients either took or increased the amount of aspartame products, such as drinking more presweetened iced tea in hot weather.

* Patients then experienced symptoms and realized that they might be related to aspartame.

* When the aspartame products were discontinued, these features either totally subsided or improved in a relatively short period of time.

* Finally, patients re-challenged themselves, either knowingly (saying it was just a coincidence) or inadvertently (with a prompt return of symptoms).

This sequence would happen five, ten, or twenty times, and the patients realized a cause-and-effect relationship. These criteria hold true for many of the disorders related to aspartame. In most instances, there would be marked improvement. If there were severe ocular or other damage, especially in the nervous system, much of the harm might have already been done.

Q. How does aspartame affect the pancreas in diabetic patients?
A. There can be several outcomes. First, patients might be making too much insulin and can have severe hypoglycemia (low blood sugar) attacks. Aspartame can release almost as much insulin as glucose. It has been known for many years that oral and intravenous phenylalanine and other amino acids cause marked elevation of insulin. In my books, I go into this in great detail. On the one hand, we are talking about the stimulation of more insulin and hypoglycemia. Further study is needed to determine whether, over the long term, this will overstimulate the islets that make insulin.
The other aspect is the diabetogenic state and loss of diabetic control through various mechanisms that include the wasting of insulin, the impairment of glucose transport, the increase of the growth hormone and glucagon, and perhaps blocking insulin receptors.

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