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Expert Opinions

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My husband and I have been using Equal instead of regular sugar on cereals, in drinks, and even in recipes. We're recently hearing comments like "aspartame causes Alzheimer's" and "you're ingesting formaldehyde if you use those sugar substitutes." Is any

M.M. Granite Bay, CA
According to chief medical consultant David Edelberg, M.D., FDA approval is no guarantee that a substance is risk-free. For example, the artificial sweetener cyclamate was approved for years until studies showed that in high doses it could cause cancer in laboratory animals. Possible cancer links, based on animal studies, have also been reported with saccharin (Sweet 'n Low). Though there have not been any direct links between the use of artificial sweeteners and cancer in people, some health experts remain concerned.

Dr. Edelberg notes that both NutraSweet and Equal contain aspartame, a compound that is made from amino acids and methyl alcohol. Once it is absorbed, aspartame can decrease the availability of the amino acid tryptophan and reduce the brain level of the neurotransmitter serotonin. Because these changes are associated with sleep disturbances and mood disorders, patients with high blood pressure, Parkinson's disease, attention deficit disorder, and probably mood disorders should be careful about using aspartame. However, such changes do not result in Alzheimer's disease, the cause of which remains unknown.

Most people probably don't notice a thing when using these sweeteners. However, Dr. Edelberg comments that "some people who use lots of aspartame might discover that their headaches, memory loss, mood swings, or fainting spells clear up when they sweeten with a little honey instead. In my practice, which covers a lot of people who just don't feel well, I routinely take patients off aspartame if they tell me they're using it."

Actually, you're not ingesting formaldehyde when you use aspartame, but rather methyl alcohol, which is converted into formaldehyde by the liver. Methyl alcohol is, of course, used in antifreeze, and it's the formaldehyde conversion that causes all the unpleasantness associated with drinking the stuff. Dr. Edelberg notes, however, that the amount of methyl alcohol contained in Equal is very small, so using it is not the same as sipping antifreeze!

Instead of aspartame and other artificial sweeteners, Dr. Edelberg usually recommends that his patients use stevia (a natural sweetener that is extracted from a South American plant), honey, molasses, maple syrup, or Sucanat, an organic granulated sweetener evaporated from freshly squeezed sugarcane juice.

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