In those who experience migraines, large amounts of aspartame (900-3,000 mg/kg body weight/day) have been found to induce headaches or make headaches worse. Alternatively, formaldehyde, which is a byproduct of aspartame, could do the same.
Researchers of one randomized, controlled study--in what probably amounts to the best among low-powered studies on the topic--reported the following:
"There was no significant treatment difference in the length or intensity of headaches or in the occurrence of side effects associated with the headaches. This experiment provides evidence that, among individuals with self-reported headaches after ingestion of aspartame, a subset of this group report more headaches when tested under controlled conditions. It appears that some people are particularly susceptible to headaches caused by aspartame and may want to limit their consumption."
In the trial, 18 participants were randomized to receive aspartame (~30 mg/kg/d) and placebo in a 2-treatment, 4-period crossover design. Upon aspartame exposure, participants reported headaches on 33% of treatment days, compared with only 24% with placebo (P = 0.04). Notably, patients who were "very sure" before beginning the study that aspartame led to headaches were more likely to experience treatment differences. Interestingly, this trial was cut short by participant attrition, with seven patients finding the headaches unbearable.
Cardiovascular effects
Other artificial sweeteners aside from aspartame have been implicated as factors in cardiovascular events. Some of these other low-calorie sweeteners found in food and drink include acesulfame potassium (ace-K), saccharin, and sucralose.
According to results from the high-powered, prospective Women's Health Initiative Observational Study that included over 80,000 participants, consumption of artificially sweetened beverages predicted stroke--especially among those with small artery occlusion, coronary heart disease, and all-cause mortality. Notably, 64.1% of participants never or hardly consumed artificially sweetened beverages, with only 5.1% consuming à "degrees ¥ 2 such drinks a day.
Bottom line
Because emerging evidence on the adverse health effects of diet drinks with artificial sweeteners is largely being supported by low-powered studies, further investigation with higher powered, randomized, controlled trials is needed. However, those with migraine and cardiovascular risk factors should probably err on the side of caution and avoid drinking such beverages.
(Article changed on December 3, 2019 at 15:28)
(Article changed on December 4, 2019 at 01:49)
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