Evaluation of aspartame cancer epidemiology studies based on quality appraisal criteria

Given the widespread use of the low-calorie sweetener aspartame over the last 30 years, the current work was undertaken to evaluate aspartame epidemiology studies looking at cancer endpoints against quality appraisal criteria. The quality appraisal tool used was from the National Heart, Lung and Blood Institute (NHLBI) of the National Institute of Health. Studies identified included nine case-control studies and five prospective cohort studies. Most studies assessed low-calorie or diet beverages rather than aspartame intake specifically; however, common use of aspartame in diet sodas does allow for some general extrapolation of results. Following consideration of study quality, two case-control and five prospective studies were considered to meet the majority of the NHLBI criteria. The primary limitation of the other case-control studies was an inadequate sample size. Overall, the results of the studies do not support that exposures to low and no-calorie sweeteners and beverages, and by extension aspartame, are associated with an increased risk of cancer in humans.