What is Aspartame?

[Guest guest]

it's it the 'new' Coke Zero and probably other diet sodas as well, but most

people i run into don't realize that 'diet' doesn't equate to better.

Aspartame (commonly misspelled as aspertame) Aspartame,

a dipeptide of aspartic acid and a methyl ester of

phenylalanine, is approved for use in pharmaceutical

products and is being used increasingly in chewable

tablet and sugar-free formulations. Labels for both

prescription and nonprescription products must include

the phenylalanine content. The major consideration in

the use of aspartame in children is in patients with

autosomal recessive phenylketonuria. Although heterozygotes

do not appear to have clinically significant increases

in phenylalanine after ingestion of even large amounts

(equivalent to 24 12-oz cans of diet beverages), homozygotes

with

strict dietary restrictions should avoid aspartame.

Children without dietary restrictions could safely ingest

10 mg/kg/d. [37-40]. Dietary consumption of aspartame

is typically less than 5 mg/kg/d[41]; young children,

however, could ingest considerably more. For example,

a 2-year-old child weighing 12 kg consumes 17 mg/kg

from drinking one 12-oz can of diet soda and one

serving of a sweetened product (eg, cereal, pudding,

gelatin, or frozen dessert).

Headache is the most common adverse side effect

attributed to aspartame but is seldom confirmed by

single-dose double-blind challenge. Up to 11% of

patients with chronic migraine headaches reported

headaches triggered by aspartame; however, a

double-blind challenge with three doses of 10 mg/kg

given every 2 hours triggered no more headaches than

did placebos in patients with vascular headaches

believed to be exacerbated by aspartame. A small, double-blind

4-week trial showed an increase in frequency of headaches

after ingestion of 1200 mg/d, indicating that a longer

challenge period may be necessary.

In anecdotal reports, aspartame has been linked to

various neuropsychiatric disorders, including panic

attacks, mood changes, visual hallucinations, manic

episodes, and isolated dizziness. A small, double-blind

crossover study of patients with major depression revealed

a higher incidence of reactions in these patients compared

with nondepressed volunteers after administration of

30 mg/kg for 7 days; symptoms included headache, nervousness,

dizziness, memory impairment, nausea, temper outbursts,

and depression. None of these conditions has been rigorously

proven to be caused by aspartame, but carefully conducted

double-blind challenges may be indicated in

patients with histories that suggest aspartame as a

cause. Patients with underlying mitral valve prolapse

or affective disorders may be at increased risk for

neuropsychiatric effects; several studies have shown

that individuals without psychiatric or seizure

disorders do not demonstrate these effects.

Seizures have been reported via passive surveillance

data collected by the FDA and in a few case reports.

A recent analysis of FDA reports showed 41 cases of

rechallenge with a temporal relationship to aspartame

consumption. Most seizures occurred in patients who

had an acceptable dietary intake, except for a 16-year-old

who ingested up to 57 mg/kg of aspartame. Aspartame

is generally considered safe for children with epilepsy.

One study found increased spike-wave discharges in children

with untreated absence seizures after a high dose of

aspartame and suggested that children with poorly controlled

absence seizures avoid aspartame.