Is there an association between Aspartame (artificial sweetener) and dementia?

From the Guidelines

There is currently no established scientific evidence linking aspartame consumption to dementia. Aspartame is an artificial sweetener found in many diet sodas, sugar-free products, and as a tabletop sweetener, and has been extensively studied for safety. The FDA has approved aspartame as safe for consumption at levels typically consumed in the diet (acceptable daily intake is 50 mg/kg body weight) 1. While some observational studies have suggested associations between artificially sweetened beverages and cognitive decline, these studies show correlation rather than causation and often have methodological limitations. The biological mechanisms by which aspartame might affect brain health remain theoretical. Aspartame breaks down into phenylalanine, aspartic acid, and methanol in the body, but at normal consumption levels, these compounds are processed without harmful effects in most people.

Key Points to Consider

• The current evidence does not support a link between aspartame and dementia 1
• Established protective factors for brain health include regular physical activity, a Mediterranean-style diet rich in fruits, vegetables, and omega-3 fatty acids, maintaining social connections, and challenging your brain with new activities
• People with phenylketonuria (PKU) should avoid aspartame as they cannot properly metabolize phenylalanine, but for the general population, moderate consumption of aspartame is not considered a risk factor for dementia based on current evidence 1

Recommendations for Patients

• Focus on established protective factors for brain health, such as a healthy diet and regular physical activity
• If you're concerned about brain health, discuss your individual risk factors with a healthcare professional
• For the general population, moderate consumption of aspartame is not considered a risk factor for dementia based on current evidence 1

From the Research

Aspartame and Dementia: Research Findings

• The relationship between aspartame consumption and dementia has been investigated in several studies, with some findings suggesting a potential link between the two 2, 3, 4, 5.
• A prospective cohort study published in 2017 found that higher recent and cumulative intake of artificially sweetened soft drinks, which often contain aspartame, was associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer's disease dementia 2.
• Another study published in 2018 reviewed the substantial research findings related to aspartame intake and found that it may be associated with various health issues, including metabolic disorders and clinical conditions 3.
• A review of neurophysiological symptoms and aspartame consumption found that aspartame may be responsible for adverse neurobehavioral health outcomes, including learning problems, headache, seizure, migraines, irritable moods, anxiety, depression, and insomnia 4.
• A review of the safety of aspartame published in 2017 found that the literature suggests there are potential side effects associated with aspartame consumption, and that the safety of this sweetener should be revisited 5.

Key Findings

• Aspartame consumption has been linked to an increased risk of stroke and dementia 2.
• Aspartame may be associated with various health issues, including metabolic disorders and clinical conditions 3.
• Aspartame consumption may be responsible for adverse neurobehavioral health outcomes 4.
• The safety of aspartame is still debatable, and more research is needed to evaluate its effects on human health 5.

Study Limitations

• Most of the literature available on the safety of aspartame is based on animal models, as data from human studies are limited 5.
• The existing animal studies and limited human studies suggest that aspartame and its metabolites may disrupt the oxidant/antioxidant balance, induce oxidative stress, and damage cell membrane integrity 5.