A Special Report by the Feingold Association

According to a new Grocery Manufacturers Association survey, almost half of all grocery shoppers now look for product with reduced sugar, and last year, the food industry introduced 2,225 no-sugar or low-sugar food products, including diet sodas, cerealsfruit juices, cookies, ice cream, bread, flavored milk, maple syrup and even bottled water.

With so many low-sugar foods available, the Feingold Association (www.feingold.org) has found that many parents are increasingly concerned about whether synthetic sweeteners are safe for their children.

"I've never seen as much interest and confusion over sweeteners as I have recently," says Jane Hersey, the association's Director. "New sweeteners are coming on the market, manufacturers are slugging it out, and most parents are having a hard time keeping track of what their options are. We're offering the 'real skinny' on these sweeteners."


NutraSweet, Equal (Aspartame)
According to Hersey, the Food & Drug Administration has received thousands of reports of adverse reactions to aspartame (NutraSweet) since its approval in 1981. (It stopped collecting these reports in early 1996.) The Feingold Association has also received many negative reports, leading it to add aspartame to the list of additives eliminated on the Feingold Program in 2004.

Aspartame, which is 200 times as sweet as sugar, is the most profitable synthetic sweetener ever used. It is estimated that over 100 million people in the United States, including a large percentage of children and adolescents, drink aspartame-sweetened drinks on a regular basis. It is also used in low-calorie foods, pediatric medicine, and other products.

"Unfortunately, some parents try to help their kids lose weight by giving them sugar-free foods and diet sodas that are sweetened with aspartame," says Hersey. "This is a huge mistake, because aspartame has been associated with hyperactivity, irritability, aggression, and concentration problems - not to mention brain tumors."

Aspartame has a long list of critics, including government scientists. After investigating the industry-funded studies, FDA toxicologist Dr. M. Adrian Gross found that at least one of them "established beyond any reasonable doubt that aspartame is capable of inducing brain tumors in experimental animals." According to Dr. Russell Blaylock, a board-certified neurosurgeon, the first safety study of aspartame produced a rate of brain tumors in the aspartame-fed rats that was 25 times higher than would be expected to occur naturally.

The studies on aspartame were so fraught with irregularities that the FDA Chief Counsel recommended a grand jury be convened to investigate them (the first such request in the agency's history), and a public board of inquiry found they were inadequate on the issue of brain tumors. Three FDA scientists called the studies into question just weeks before a new FDA commisioner approved NutraSweet in 1981. The irregularities included surgery to remove tumors from the test animals and failure to determine if they were cancerous.

From 1973 to 1990, there was a 67 percent increase in brain tumors in people over 65, with a 10 percent increase in all age groups. (The greatest increase started four years after aspartame's approval - in 1985, 1986 and 1987.)

Aspartame is made of the amino acids aspartic acid and phenylalanine, as well as methanol, also known as wood alcohol. Products that contain aspartame are required to include a caution for people who cannot tolerate phenylalanine. According to Hersey, some manufacturers hide aspartame in foods, supplements, and medicines by simply saying "contains phenylalanine."

The most frequent complaint attributed to aspartame use is migraine headaches (see www.neurology.org/cgi/content/abstract/44/10/1787).

Neotame

As its patent for aspartame was running out, the manufacturer developed a new, more potent version of the synthetic sweetener. By adding 3-dimethylbutl (a chemical the Environmental Protection Agency lists as hazardous) to aspartame, scientists drastically increased its sweetening power.

Hersey also weighs in on the controversy surrounding the FDA's approval of neotame, including some critics' claims that some of the industry-funded studies had few subjects, flawed protocols, and were extremely short-term (as short as one day). Evidently, some subjects reported headaches after ingesting neotame, but the industry researchers concluded that they were not related to neotame ingestion. (The fact that migraine headaches are the most commonly reported negative reaction to aspartame in the FDA's files was not mentioned in their report.)

Hersey points out that although the FDA approved neotame in 2002, Europe has still not accepted it.

Neotame is not marketed directly to consumers as a tabletop sweetener but is used in several hundred different food products (including baked goods), often combined with other artificial sweeteners. Because this sweetener is 7000 to 13000 times as sweet as sugar (and 30 times sweeter than aspartame) only a tiny amount is needed.

"Unfortunately, it's possible that neotame could be used in some foods without being listed, since the FDA doesn't require labels to include ingredients that make up less than one percent of a product" says Hersey.


Splenda (Sucralose)
The no-calorie sweetener Splenda is made by treating sugar with chlorine, which appears to prevent the body from metabolizing it in the same way as sugar. The result is 600 times as sweet as sugar.

Hersey points out that McNeil Nutritionals, the company that makes Splenda, is now embroiled in controversy over its slogan that it "is made from sugar, so it tastes like sugar." Both the Sugar Association and Merisant (which now makes Equal and NutraSweet) claim that McNeil's ad is misleading, giving consumers the impression that Splenda is natural. The Texas Consumer Association has asked the FTC to investigate McNeil's marketing campaign.

Other critics claim that animal studies have shown that sucralose can cause shrunken thymus glands, as well as enlarged livers and kidneys, and call for long-term human studies on its safety. They also question the manufacturer's claim that it does not break down in the digestive system, saying that it decomposes into small amounts of 1,6-dichloofructose, a chemical that has not been adequately tested in humans.

According to Hersey, although Splenda does not deteriorate in high temperatures, it can be difficult for home cooks to manage. She reports that when the San Francisco Chronicle challenged pastry chefs to use it in their creations, they were all disappointed with theresults.


Shugr (Tagatose and Erythritol)
Shugr, a brand new sugar substitute, may pose serious competition to the diet products now on the market, although its cost ($10.00 to $13.00 for a 3.4 ounce bottle) may be a drawback, according to Hersey.

Marketed under the name Swiss Diet Shugr, this sweetener is made from erythritol and tagatose.

Although Tagatose (also called Naturlose) is derived from milk, it is reportedly tolerated by people who are lactose intolerant. It looks and tastes like sugar, and can be used in the same ways. It is 92 percent assweet as sugar but has just one-fourth of the calories. Like yogurt, it contains beneficial bacteria.In addition to being used in Shugr, Tagatose has been added to a few of Pepsi's and Kellogg's low calorie products.

Erythritol is a sugar alcohol, but unlike some of the others, large amounts do not cause digestive upset. It has the appearance and texture of sugar, is 70 percent as sweet, does not promote tooth decay and has almost no calories.


Sugar Alcohols
Sugar alcohols are also known as "sugar polyols" and "rare sugars." They include sorbitol, manitol, xylitol, and maltitol, lactitol, and isomalt, erythritol, and hydrogenated starch hydrolysates (a blend of several sugar alcohols).

Hersey points out that there is a potential for adverse reactions from these sweeteners, including diarrhea, flatulence, and damage to various organs, if they are consumed in large amounts.

"My advice would be, don't go out of your way to consume sugar alcohols, because they're probably in many of the foods you're already eating. They're often added to packaged foods like sugar-free candies and cookies to add bulk and moisture, as well as sweetness."


Sunett (Acesulfame-K)
Sunett was first approved in 1988 as a tabletop sweetener and is now also used in baked goods, frozen desserts, candies and beverages. This noncaloric sweetener, which is 200 times as sweet as sugar, is stable under high temperatures and is often combined with other sweeteners.

"In order to hide acesulfame's unpleasant aftertaste, it is now being teamed up with aspartame in some products," says Hersey. "The scariest thing is that it's not clear if aspartame will need to be identified, because the small amount needed might allow it to get in under the radar. This is a common problem with synthetic sweeteners."

Critics claim that the safety studies required for Sunett's approval were badly flawed and that there is evidence that this sweetener has cancer-causing properties.


Sweet'N Low, Sugar Twin (Saccharin)
Saccharin, which was discovered in 1879, is 300 times sweeter than sugar.

When a 1977 study showed that saccharin caused bladder cancer in rats, the FDA tried to ban the sweetener. But after a public outcry (fueled in part by media reports that the lab rats were fed the equivalent of about 800 diet sodas daily), Congress passed a law placing a moratorium on the ban while additional safety studies were conducted. The law also mandated that any foods containing the sweetener carry a label warning that it "has been determined to cause cancer in laboratory animals."

While some scientists contend that animal studiesdon't always predict how a substance will affect humans, in the late 1970s, the Food & Drug Administration and the National Cancer Institute conducted a study finding "suggestive evidence" that heavy saccharin users (those using six or more servings a day) may have an increased risk of bladder cancer.

The requirement for warning labels was lifted in 2000 and saccharin continues to be widely used in soft drinks, baked goods, jams, canned fruit, candy, and dessert toppings, as well as a tabletop sweetener in restaurants.


High Fructose Corn Syrup
"Although high fructose corn syrup (HFCS) has become the major sweetener used in soft drinks and is commonly found in 'fruit drinks,' most people know little about its side effects," says Hersey.

These side effects can include loss of iron, magnesium, and zinc, as well as interference with the heart's use of magnesium, copper and chromium. Critics contend that HFCS may also contribute to childhood diabetes.

In addition, HFCS has been linked to obesity, according to the April 2004 American Journal of Clinical Nutrition article entitled "Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity." The authors note, "The increased use of HFCS in the United States mirrors the rapid increase in obesity ... The digestion, absorption and metabolism of fructose differs from those of glucose."


Traditional Sweeteners
Hersey encourages people who are nervous about the risks of synthetic sweeteners to use traditional sweeteners, such as granulated and confectioner's sugar, brown sugar, honey, molasses, and pure maple syrup. Those looking for a no-calorie choice can use stevia.

Some health-conscious consumers prefer to use less processed forms of sugar, including evaporated cane juice, cane sugar crystals, and raw sugars such as Turbinado. Other natural sweeteners include barley malt and rice syrup.

"The Feingold Association is not anti-sugar," says Hersey. "Some people have vilified sugar so much that it has backfired to the point where parents are giving their kids foods loaded with synthetic sweeteners like aspartame, assuming that 'sugar-free' means 'healthy.' We recognize that most people eat too much sugar, which can lead to cavities and other health problems. But that's the point -- we know what sugar does. We don't know enough about these synthetic sweeteners, and what we do know is very disturbing."

"Any new chemical that is added to our food should first have to pass rigorous testing by independent laboratories (not by the manufacturer) to ensure that it is safe. Much of the 'testing' now taking place is being conducted on millions of unwary consumers, including our children."

The Feingold Association
The Riverhead, New York-based Feingold Association (www.feingold.org) was founded in 1976 by parent volunteers to help families of children with learning and behavioral problems, as well as chemically sensitive adults. The charity's advisory board includes medical professionals from a variety of institutions, such as Johns Hopkins University, the University of Rochester, Stony Brook University, and Sinai Hospital in Baltimore.

The Feingold Association offers a dietary program developed by the late Benjamin Feingold, M.D., Chief of Allergy at the Kaiser Permanente Medical Center in San Francisco. The Feingold Program eliminates certain synthetic food additives and foods that have been shown to trigger hyperactivity, attention deficits, and other problems. Many studies back the link between diet and behavior/learning problems (www.diet-studies.com/adhd.html).

The Feingold Association researches brand name foods and provides members with information about which foods are free of harmful additives. Its Foodlists contain thousands of acceptable brand name products and its newsletter, Pure Facts, provides monthly updates. Members of the association also receive a book on the Feingold Program (which includes recipes and a menu plan), a Fast Food Guide, Mail Order Guide, e-newsletter and product alerts, as well as access to telephone and email help-lines. An online message board, recipe board and chat room are also available.



Jane Hersey
A former teacher and Head Start consultant, Jane Hersey has been Director of the Feingold Association since 1985. She is the editor of the Association's newsletter, Pure Facts , and author of Why Can't My Child Behave? and Healthier Food for Busy People , both of which have been recommended by The Washington Post.

Hersey has frequently lectured at educational associations, universities, hospitals, medical groups, and other organizations and has testified before the National Institutes of Health and the U.S. Department of Agriculture. In the 1980s, she helped initiate a low-additive school food program that lasted for several years in Fairfax County, Virginia, which has one of the largest school districts in the country.

She has been interviewed by Woman's World, Baltimore's Child, the Des Moines Register , Cincinnati Enquirer, Fort Myers News-Press, Richmond Times-Dispatch, Charleston Post and Courier, ABC's Nightline, and countless radio programs. Her articles have appeared in publications such as Mothering Magazine, Welcome Home , Fostering Perspectives , and New Living.