Q & A: Bingeing on NutraSweet

Q: I am an outpatient dietitian, and one of my patients, who has a history of anorexia nervosa, revealed that she consumed 100 packets of NutraSweet® daily for an entire year. She first did this three years ago; then she began bingeing on the packets again, this time for 9 months. She stopped 9 months ago. She now has a blood disorder and she is wondering if there is a connection. Her doctors haven’t related the blood disorder to the NutraSweet, although, I am not sure how much it has even been considered. (CF, Santa Rosa, CA)

A: believe that you can reassure your patient. Although there’s an extensive “urban legend” about the toxicity of aspartame (see, for example, http://www.snopes2.com), the active ingredient in Nutrasweet, all the rigorous studies that have been reported seem to support the fact that this substance is safe, even in large doses. This is true even for the equivalent of several dozen packets per day, taken over a long period. Although some migraine sufferers may be susceptible to having headaches triggered by aspartame (Neurology 1994; 44: 1787), controlled studies have shown that up to 10 times the usual amount causes no cognitive impairment in children with attention deficit hyperactivity disorder (Pediatrics 1994; 93:70). Also, nothing I could find in the medical literature linked aspartame to blood dyscrasias. At the same time, a variety of hematologic abnormalities with mild anemias and moderate leukopenias and thrombocytopenias and problems such as iron-deficiency anemias have been linked to the nutritional deficits caused by anorexia nervosa itself (Pediatr Res 1996; 40:108; Q J Med 1993; 86: 791; Acta Haematol 1998;100: 88). Of course, no one has data on what 100 packets per day can do to humans.

— J.Y.