Aspartame: Is it a safe sweetener or a risk to your health?

Barb Marks' grandfather was diabetic. Her father was diabetic. Five of her seven siblings are diabetic. Family history shaped her outlook long before she was diagnosed with diabetes 15 years ago.

Lately, it's shaped her reading habits also. She reads food labels on everything when she shops for groceries, particularly products touted as "sugar-free."

"Anything that's sugar-free for diabetics, you may as well look for aspartame," she says. "It's in everything, and that's not a good thing."

Marks' newfound concerns about the safety of aspartame put her in the middle of a bitter and long-running controversy.

On one side, a collection of health-conscious renegades say aspartame is bad and should be banned. They blame it for causing leukemias, lymphomas and other cancers. They claim it exacerbates problems with lupus, multiple sclerosis and diabetes and may even be responsible for the epidemic of diabetes. That's just the beginning. Web sites with names like sweetpoison.com and aspartamekills.com leave no doubt about their position.

The artificial sweetener industry with support from the mainstream medical/health establishment - including the American Diabetes Association, American Dietetic Association and the American Medical Association - holds down the other side.

As the Calorie Control Council, an industry trade group, likes to point out, "Aspartame is one of the most thoroughly studied food ingredients ever, with more than 200 scientific studies supporting its safety." The Food and Drug Administration, the World Health Organization, and "regulatory agencies in more than 100 countries have reviewed aspartame and found it to be safe."

Aspartame, better known as NutraSweet or Equal, is the most popular sugar substitute. Found in some 6,000 food products, it's the sweetness alternative for millions of people watching their weight, if by no other means than drinking diet soda. Sugar-free products are of particular interest for diabetics who must control their sugar and carbohydrate intake to remain healthy.

Popular as it is, the sugar-free industry is in an uphill battle with the Internet and the politics of word-of-mouth, which is how aspartame came to Marks' attention. As part of a public relation strategy to change perceptions, the leading manufacturer of aspartame recently changed its brand name to AminoSweet.

Marks' daughter, Brenda Marks, was talking to a friend, a nurse, who mentioned possible problems with aspartame. Brenda Marks told her mother. Together, they went online to see what information they could find. Then they threw out almost all of the food in Marks' kitchen that had aspartame on the label.

A 2008 Harris Poll found 61 percent of respondents believe artificial sweeteners are somewhat or not at all safe, compared to 21 percent who said they were extremely or very safe.

Both Marks and her daughter, who is also a diabetic, say they mentioned their fears to their doctors, neither of whom said much more than there's a big debate. "They just kind of leave you on your own," Brenda Marks says.

Local dieticians say they don't get many queries or doubts from patients about aspartame's safety.

"When we do, it's usually from people who are more motivated, more involved in their care," says Meghann Schwartz, a licensed dietician at Joslin Diabetes Center at OSF Saint Francis Medical Center in Peoria, Ill. But the seemingly never-ending parade of dueling research has changed how dieticians and diabetes educators talk to patients.

Five years ago, questions about the safety of aspartame would have been answered with a 'Don't worry, be happy' response. Now, Schwartz says, "The diabetes establishment has become more wary, but it hasn't changed its position."

Schwartz and her colleague Ruth Towns urge patients to use moderation in all foods and ingredients.

"The American Dietetic Association and the American Medical Association say aspartame is safe for consumption," Towns emphasizes. "However, if someone wants to cut it out or cut it down, I say go for it."

Marks' decision wouldn't have changed no matter what her doctor told her. She has switched to Splenda, another sugar alternative gaining popularity.

At 71, she has seen her generation live longer with diabetes, and with fewer complications than her father's generation. She and her siblings, she says, have learned more about exercising and managing what they eat, which is why the safety of sugar substitutes is important to her, even though she uses them in moderation.

"In my family, we want to live a long time, and we want to keep our legs and feet," she says.

Pam Adams can be reached at padams@pjstar.com.