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"Diet" Products: Are these the Healthier choice?

Recent studies have pronounced dietary supplements ineffective, coffee and chocolate healthy, and low fat diets unhelpful in reducing cardiovascular disease or cancer risk. Before celebrating, it may be wise to evaluate whether industries funded or benefited from the conclusions.
Researchers, clinicians, and cardiologists have established that obesity is a major risk factor in the development of cardiovascular disease, and other chronic disease processes. Dietary counseling and appropriate weight loss strategies are paramount in health care management. Reducing caloric intake is a large part of this counseling, leading to the use of artificial sweeteners.

Aspartame, marketed as Equal, Nutrasweet, Equal Measure, Spoonful, and Canderal, was FDA approved for use in dry foods in 1981, after previous refusals due to evidence this drug produced seizures and brain tumors in lab animals. In 1996 the FDA reclassified aspartame as safe for use as a food additive without restrictions. The FDA calls aspartame, “one of the most thoroughly tested and studied food additives the agency has ever approved.” Aspartame is found in such popular products as Diet Coke, Diet Pepsi, Diet Snapple and Sugar Free Kool-Aid. Hundreds of millions of people consume it worldwide.

Controversy has swirled around this prolific food additive. Health advocates have railed against the additive claiming it’s carcinogenic (cancer-causing) and the source of over 90 reported health effects. Loosely associated multiple neurological, gastrointestinal, cardiovascular, and respiratory symptoms have been reported to the Department of Health and Human Services. Aspartame accounted for more than 75% of all adverse reactions voluntarily reported to the FDA's Adverse Reaction Monitoring System (ARMS). The sweetener industry has vigorously defended the safety record of aspartame and cites multiple studies as evidence of its safety.

The controversy centers on chemical make-up of aspartame and its metabolic breakdown products phenylalanine, aspartic acid and methanol. Absorption of methanol is sped up considerably when free methanol is ingested. Free methanol is created from aspartame when heated above 86° Fahrenheit. This occurs when an aspartame-containing product is improperly stored or heated (e.g., as part of a product such as Jello). Methanol is broken down into formic acid and formaldehyde, a deadly neurotoxin. An EPA assessment of methanol notes it "is considered a cumulative poison due to the low rate of excretion once absorbed. The controversy surrounding aspartame questions whether enough methanol is present in order to cause health risks.

A study published in March 2006 by the Cesare Maltoni Cancer Research Center of the European Ramazzini Foundation may help to clarify facts about aspartame. The Center conducted a 7-year, million dollar study on aspartame. The researchers reported the sweetener was associated with unusually high rates of lymphomas, leukemias and other cancers in rats given doses starting at what would be equivalent to four to five 20-ounce bottles of diet soda a day for a 150-pound person. This study may compel further review of this highly controversial food additive.
Imposing restrictions on aspartame would come at a significant cost. Consumers around the world bought about $570 million worth of the chemical in food products last year. New regulatory action would jeopardize billions of dollars of products containing aspartame.

Other artificial sweeteners have also been fraught with controversy. Saccharin, available under trade names such as Sweet 'n Low, is used widely in fountain sodas. Unlike aspartame, which degrades when heated, its stability at high temperatures makes saccharin an option for sweetening baked goods. But should consumers use it? "We know for certain that it causes cancer in animals," says Andrew Laumbach, Ph.D., consumer safety officer in FDA's Office of Premarket Approval. He acknowledges, however, that animal studies do not always predict the behavior of substances in the human body.

Stevia, an inexpensive herb from Africa, imparts a sweet taste to foods, but cannot be sold as a sweetener since it’s considered an unapproved food additive by FDA. "The safety of stevia has been questioned by published studies," says Martha Peiperl, a consumer safety officer in FDA's Office of Premarket Approval. "And no one has ever provided FDA with adequate evidence the substance is safe." When a journalist asked the agency in 1997 for a list "of all studies the FDA is aware of alleging a detrimental effect from stevia or steviosides," it cited 19 studies. (FDA officials would not confirm if the "studies" mentioned had been reviewed, some of which were brief reports and one a letter to the editor of a foreign journal).

Natural sweeteners, including honey, molasses, evaporated cane juice, rice syrup, barley malt, and fructose, contain about the same amount of calories as refined table sugar. Unrefined sugars contain trace minerals, natural flavor and coloring, are approximately 60% as sweet as refined sugar, and raise blood sugar more slowly than refined sugar.

In spite of industry claims, lowering caloric intake and combating obesity, may not be best accomplished using artificial sweeteners. The potential health risks appear to outweigh the benefits. Accurate and thorough dietary counseling remains the foundation of health care management. Use natural unrefined sweeteners in moderation, increase fiber intake with fruits and vegetables, and reduce fat and carbohydrate intake. Increase caloric consumption by increasing daily exercise. Laugh, love, and live!