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Bernadene MagnusonNon-caloric sweeteners and special groups: children and pregnant women
Non-caloric sweeteners and special groups: children and pregnant women Bernadene Magnuson PhD, FATS  University of Toronto, Canada
Introduction – why special? ,[object Object]
Need calories and nutrients.
Generally -recommend intake of nutrient-rich foods and beverages.,[object Object]
Control weight gain
Control blood sugar,[object Object]
The controversies
The data
Children
Pregnant women
Conclusions,[object Object]
The answer -  “Aspartame breaks down into methanol and excitatory amino acids that affect the brain  - TRUE – aspartame is completely digested in the intestine, and amino acids are used by body, including brain. ……so that is why aspartame is toxic.”FALSE!  – levels of amino acids and methanol in aspartame are no higher than the amount found in common foods.
Phenylalanine, Aspartic Acid & Methanol Content of Foods Aspartic Acid* Phenylalanine* Methanol *amino acids All amounts in mg
Controversy “Aspartame breaks down into methanol and methanol can cause methanol poisoning. Therefore aspartame is toxic because it causes methanol poisoning.” TRUE OR FALSE??
The answer “Aspartame breaks down into methanol –  TRUE – aspartame contains a methyl group.  As with many foods, methanol is released during digestion. “Methanol can cause methanol poisoning”.  TRUE – at HIGH levels which cause build-up in blood. “Therefore aspartame is toxic because it causes methanol poisoning.” FALSE! – Amount of methanol in aspartame & other foods is too low to change blood levels.
Methanol metabolism Tetrahydrofolate  intermediate Alcohol dehydrogenase  in liver CO2 + H20 Methanol Lowest blood level of methanol ever associated with toxicity = 126 mg/dL Conversion very rapid No accumulation Accumulation of formic acid = toxicity of methanol Formic acid  T½ = 3-6 hr  Formaldehyde T½ = 1.5 min Kostic and Dart, 2003
Formaldehyde – sounds scary! is a constituent of many foods! produced during metabolism of foods and many drugs Caffeine from 1 cup of coffee = 30 mg formaldehyde  is essential in one-carbon pool metabolism.  Formic acid used in synthesis of nucleotides for DNA Is calculated that  >50,000 mg formaldehyde is produced and metabolized daily in an adult human adult human liver can metabolize 22 mg formaldehyde per minute – so very rapid metabolism.  Also rapid metabolism in young humans Clary and Sullivan, 1999
Effect of aspartame on blood methanol and formic acid  Steginket al., 1981, 1983, 1989 Aspartame DOES NOT cause methanol poisoning Methanol toxicity > 126.0 mg/dL; and accumulation of formic acid
Controversy “Aspartame causes neurological damage, including behavior problems, headaches/migraines, dizziness, seizures, epilepsy, nausea, numbness, muscle spasms, depression, fatigue, irritability, insomnia, vision problems, hearing loss, breathing difficulties, anxiety attacks, slurred speech, loss of taste, vertigo, and memory loss” TRUE OR FALSE?? http://www.mercola.com/article/aspartame/dangers.htm
The answer “Aspartame causes neurological damage, ….. and memory loss.” FALSE - Many studies have been conducted and have found no effect, even at levels much higher than humans consume. Many accusations and individual reports - but an overwhelming number of research studies find no effect as discussed in next slides.
Learningand behavior? Animal studies  Up to 4% of diet (4000 mg/kg/d), no effect on neuronal function, learning or behavior despite changes in blood and brain amino acids levels (many studies). At 9% diet, impaired learning as have nutritional imbalance with high levels of 2 amino acids.  Controlled Human studies Normal children, hyperactive children, children with PKU, aggressive school boys, sugar-sensitive children (many references) Healthy adults, airline pilots, adults with Parkinsons disease, adults with depression. No effect in all except 1 study on depression – not replicated Reviewed in Magnuson et al., 2007
Seizures? ,[object Object]
Evaluated in a variety of animal models to induce convulsions and seizures (Pinto and Maher, 1988; Guisoet al., 1988; Cane et al.,1989; Tilsonet al., 1989; Helaiet al., 1996)
Genetically epilepsy-prone rats (Daily et al., 1991)
No significant effect on seizures observed in controlled human studies with doses of 34-50 mg/kg
Children diagnosed with petite mal seizures, individuals with epilepsy, self-reported aspartame-sensitive adults (Camfieldet al., 1992; Shaywitzet al., 1994, Rowan et al., 1995)Reviewed in Magnuson et al., 2007
Headaches? Have been several, conflicting results with most showing no effect; however some small studies suggesting may be a susceptible subset. There is no known mechanism. Is a difficult endpoint to study as there is no objective measure for headache – must be self reported, susceptible to power of suggestion. Reviewed in Magnuson et al., 2007
[object Object]

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Bernadene magnuson día2

  • 1. Bernadene MagnusonNon-caloric sweeteners and special groups: children and pregnant women
  • 2. Non-caloric sweeteners and special groups: children and pregnant women Bernadene Magnuson PhD, FATS University of Toronto, Canada
  • 3.
  • 4. Need calories and nutrients.
  • 5.
  • 7.
  • 12.
  • 13. The answer - “Aspartame breaks down into methanol and excitatory amino acids that affect the brain - TRUE – aspartame is completely digested in the intestine, and amino acids are used by body, including brain. ……so that is why aspartame is toxic.”FALSE! – levels of amino acids and methanol in aspartame are no higher than the amount found in common foods.
  • 14. Phenylalanine, Aspartic Acid & Methanol Content of Foods Aspartic Acid* Phenylalanine* Methanol *amino acids All amounts in mg
  • 15. Controversy “Aspartame breaks down into methanol and methanol can cause methanol poisoning. Therefore aspartame is toxic because it causes methanol poisoning.” TRUE OR FALSE??
  • 16. The answer “Aspartame breaks down into methanol – TRUE – aspartame contains a methyl group. As with many foods, methanol is released during digestion. “Methanol can cause methanol poisoning”. TRUE – at HIGH levels which cause build-up in blood. “Therefore aspartame is toxic because it causes methanol poisoning.” FALSE! – Amount of methanol in aspartame & other foods is too low to change blood levels.
  • 17. Methanol metabolism Tetrahydrofolate intermediate Alcohol dehydrogenase in liver CO2 + H20 Methanol Lowest blood level of methanol ever associated with toxicity = 126 mg/dL Conversion very rapid No accumulation Accumulation of formic acid = toxicity of methanol Formic acid T½ = 3-6 hr Formaldehyde T½ = 1.5 min Kostic and Dart, 2003
  • 18. Formaldehyde – sounds scary! is a constituent of many foods! produced during metabolism of foods and many drugs Caffeine from 1 cup of coffee = 30 mg formaldehyde is essential in one-carbon pool metabolism. Formic acid used in synthesis of nucleotides for DNA Is calculated that >50,000 mg formaldehyde is produced and metabolized daily in an adult human adult human liver can metabolize 22 mg formaldehyde per minute – so very rapid metabolism. Also rapid metabolism in young humans Clary and Sullivan, 1999
  • 19. Effect of aspartame on blood methanol and formic acid Steginket al., 1981, 1983, 1989 Aspartame DOES NOT cause methanol poisoning Methanol toxicity > 126.0 mg/dL; and accumulation of formic acid
  • 20. Controversy “Aspartame causes neurological damage, including behavior problems, headaches/migraines, dizziness, seizures, epilepsy, nausea, numbness, muscle spasms, depression, fatigue, irritability, insomnia, vision problems, hearing loss, breathing difficulties, anxiety attacks, slurred speech, loss of taste, vertigo, and memory loss” TRUE OR FALSE?? http://www.mercola.com/article/aspartame/dangers.htm
  • 21. The answer “Aspartame causes neurological damage, ….. and memory loss.” FALSE - Many studies have been conducted and have found no effect, even at levels much higher than humans consume. Many accusations and individual reports - but an overwhelming number of research studies find no effect as discussed in next slides.
  • 22. Learningand behavior? Animal studies Up to 4% of diet (4000 mg/kg/d), no effect on neuronal function, learning or behavior despite changes in blood and brain amino acids levels (many studies). At 9% diet, impaired learning as have nutritional imbalance with high levels of 2 amino acids. Controlled Human studies Normal children, hyperactive children, children with PKU, aggressive school boys, sugar-sensitive children (many references) Healthy adults, airline pilots, adults with Parkinsons disease, adults with depression. No effect in all except 1 study on depression – not replicated Reviewed in Magnuson et al., 2007
  • 23.
  • 24. Evaluated in a variety of animal models to induce convulsions and seizures (Pinto and Maher, 1988; Guisoet al., 1988; Cane et al.,1989; Tilsonet al., 1989; Helaiet al., 1996)
  • 25. Genetically epilepsy-prone rats (Daily et al., 1991)
  • 26. No significant effect on seizures observed in controlled human studies with doses of 34-50 mg/kg
  • 27. Children diagnosed with petite mal seizures, individuals with epilepsy, self-reported aspartame-sensitive adults (Camfieldet al., 1992; Shaywitzet al., 1994, Rowan et al., 1995)Reviewed in Magnuson et al., 2007
  • 28. Headaches? Have been several, conflicting results with most showing no effect; however some small studies suggesting may be a susceptible subset. There is no known mechanism. Is a difficult endpoint to study as there is no objective measure for headache – must be self reported, susceptible to power of suggestion. Reviewed in Magnuson et al., 2007
  • 29.
  • 30. No difference between children and adult
  • 31. Effect on behavior extensively assessed
  • 32. No effect even with habitual use
  • 34. No association (Bruin et al. 2005)Aspartame is safe for children (>1 yr) at levels currently consumed Is aspartame safe for children?
  • 35.
  • 36. Animal studies found no effects of purified steviol glycosides on development and growth.
  • 37. Few studies have been reportedon steviol glycosides and children.Are steviol glycosides safe for children?
  • 38. Are sweeteners safe for pregnant women? Aspartame – Many animal studies conducted demonstrate no effect on reproduction, pregnancy outcome, development of offspring. Two recent reports need to be addressed: 1. Rat study by Soffritti et al., (2010) 2. Cohort study by Halldorsson et al., (2010) EFSA reviewed and concluded these studies do not provide evidence that aspartame was causative factor. (EFSA Journal 2011;9(2):2089)
  • 39. Aspartame Administered in Feed, BeginningPrenatally ….. in Male Swiss Mice Pregnant mice were fed aspartame in ‘‘Corticella diet’’ at doses equivalent to 242, 987,1919 and 3909 mg/kg/day. Offspring then fed same diets as mothers. Main finding reported by authors – increase in liver and lung tumors in male offspring of rats fed highest doses. This group has published several studies on aspartame and each time, report increased cancer at different site/sex. Methodology and interpretation has been reviewed and criticized by many authorities, including EFSA. NOTE - 14 other animal studies and 6 epidemiological studies have found no evidence of increased cancer. Soffrittiet al. (2010)
  • 40. “Artificially sweetened soft drinks and risk of preterm delivery” Large study of 59,334 Danish pregnant women Reported higher odds ratio for risk of preterm delivery in women who consumed >4 servings/d Strengths – large study, diet information collected Limitations - Small number report >4 servings, also differences in BMI, smoking, social status, single – authors state was adjusted for. propose effect due to methanol from aspartame did not consider other dietary factors, or determine which sweetener was consumed. Halldorsson et al. 2010
  • 41.
  • 42. Crude extracts of Stevia plant are NOT recommended as adverse effects have been reported.
  • 43.
  • 44. body weight, body weight gain, food consumption.
  • 45. reproductive performance: mating performance, fertility, gestation lengths, estrous cycles, or sperm motility, concentration, or morphology.
  • 46. Survival, reflex development, body weight, sexual maturation
  • 47.
  • 48.