Written by Harold Oster, MD. Results suggest that early-life exposure to aspartame and diet soda is associated with autism and autism spectrum disorder in males.
Autism is a lifelong neurologic developmental disorder starting in childhood. Patients typically display deficits in social communication, restricted interests, and repetitive behaviors. Most children with autism present in early childhood with mild to severe symptoms1. Regressive autism refers to a subgroup of children who initially develop normally and later lose learned skills2. In 2013, the term autism spectrum disorder (ASD) was created, combining autistic disorder with related conditions. Prevalence in the United States has increased since 2000, at least in part due to the changes in definitions. No single cause of autism has been proven, and current evidence suggests that the developing brain is affected by environmental and genetic factors1. Aspartame is a common sweetener of foods and beverages, particularly in diet sodas. Studies have suggested that aspartame is a risk factor for several neuropsychiatric conditions3
Sharon Fowler et al. studied whether daily maternal exposure to diet soda or aspartame during pregnancy and breastfeeding was associated with the development of autism or ASD in her offspring. Children with autism and ASD were recruited from the Autism Tooth Fairy Study, a large study examining shed deciduous teeth of children with ASD for possible environmental causes of their condition. A neurologically normal control group included siblings of autistic children and offspring of their parents’ friends and relatives. Parents provided information about their children, including whether they were given the diagnosis of autism, Asperger’s disorder, pervasive developmental disorder, or childhood disintegrative disorder. Participants with any of these diagnoses were defined as having any ASD. Parents were also asked whether their children had spoken three words daily and later regressed to a point that they did not. If the response was in the negative, the child was classified as non-regressive. Biological mothers completed questionnaires regarding their intake of diet soda, other diet drinks, and sweetener packets during pregnancy and breastfeeding. They listed the brands and quantities consumed. Daily early-life consumption of diet soda was defined as having consumed at least 12 ounces per day. Daily early-life aspartame consumption was defined as a maternal daily intake of at least 177mg of aspartame, the amount in a can of diet soda, from the above sources.
The authors noted the following:
- Among the boys, 203 had any ASD, and 54 were controls.
- Among the girls, 32 had any ASD, and 67 were controls.
- Boys with autism were significantly more likely to be offspring of mothers with daily exposure to diet soda and aspartame than controls. (19.3% and 20.7% vs. 7.4%)
- Boys with non-regressive ASD were more likely to have daily aspartame exposure than controls. (19.1% vs. 7.4%)
- Boys with non-regressive autism were more likely to have daily exposure to diet soda and aspartame. (22.1% and 23.3% vs 7.4%)
- In girls, there was no significant relationship between diet soda or aspartame exposure and autism or ASD.
- In boys, the adjusted odds ratio for early diet soda exposure was 3.1 for autism and 3.5 for non-regressive autism.
- In boys, the adjusted odds ratio for early aspartame exposure was 3.4 for autism and 3.7 for non-regressive autism.
Results of the study suggest that early life exposure to diet soda and aspartame gestationally and through breastfeeding is associated with autism and autism spectrum disorder in males. Limitations include the retrospective nature of the questionnaires and lack of ascertainment of covariables, including maternal diabetes and obesity.
Source: Fowler, Sharon Parten, David Gimeno Ruiz de Porras, Michael D. Swartz, Paula Stigler Granados, Lynne Parsons Heilbrun, and Raymond F. Palmer. “Daily Early-Life Exposures to Diet Soda and Aspartame Are Associated with Autism in Males: A Case-Control Study.” Nutrients 15, no. 17 (2023): 3772.
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Posted September 25, 2023.
Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.
References:
- Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr. Feb 2020;9(Suppl 1):S55-s65. doi:10.21037/tp.2019.09.09
- Thompson L, Gillberg C, Landberg S, et al. Autism With and Without Regression: A Two-Year Prospective Longitudinal Study in Two Population-Derived Swedish Cohorts. J Autism Dev Disord. Jun 2019;49(6):2281-2290. doi:10.1007/s10803-018-03871-4
- Shaher SAA, Mihailescu DF, Amuzescu B. Aspartame Safety as a Food Sweetener and Related Health Hazards. Nutrients. Aug 18 2023;15(16)doi:10.3390/nu15163627
