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Increased Urinary Calcium Excretion after Acute Aspartame Ingestion in Healthy Subjects—Authors’ Response

Service d’Explorations Fonctionnelles Rénales Métaboliques et Endocriniennes C.H.U. Jean Minjoz 25030 Besancon Cedex, France

In their correspondence Leon et al. (1) reported the effects of long-term, large doses of aspartame on urinary excretion of calcium. The results of their study document the safety of chronic consumption of large doses of aspartame including no effect on calcium homeostasis.

In our study, we observed, in the fasting state and after an overnight fast, an increase in calciuria during the 3 h after an oral load of either 250 mg aspartame or 75 g glucose (2).

These results suggest some comments:

1. It is well known that, besides calcium, several nutrients of a normal diet, especially proteins, carbohydrates, and sodium are able to increase markedly urinary excretion of calcium.

2. Indeed, it has been repeatedly shown that urinary excretion of calcium increased after either an acute carbohydrate load or a short-term consumption of high carbohydrate diet (3, 4, 5, 6). However, the daily urinary excretion of calcium is not significantly different after either long-term low or high carbohydrate diet (7).

3. Protein ingestions have also been known to induce a rise in calciuria (8, 9). In the same way, transcient increases in urinary calcium 30 min after ingestion of aspartame (2) are likely weakened in the 24-h urinary samples. Thus, long-term high doses of aspartame could fail to reveal a significant daily excess urinary calcium excretion (1).

4. The transcient increase in calciuria following an acute load of aspartame may augment the urinary calcium saturation and then increase the theoretical risk of kidney stone formation. However, as aspartame induces an increase in calciuria similar to that induced by glucose but with no change in oxaluria (2), substituting aspartame for glucose appears to have some potential benefit.

Footnotes

Received October 2, 1998. Address correspondence to: Uyen N. Nguyen, Service d’Explorations Fonctionnelles Rénales Metabolique et Endocriniennes, C. H. U. Jean Minjoz, 25030 Besancon Cedex, France.

References

1. Leon AS, Hunninghake DB, Bell C, Rassin DK, Tephly TR. 1989 Safety of long-term large doses of aspartame. Arch Intern Med. 149:2318–2324.[Abstract]
2. Nguyen UN, Dumoulin G, Henriet MT, Regnard J. 1998 Aspartame ingestion increases urinary calcium, but not oxalate excretion, in healthy subjects. J Clin Endocrinol Metab. 83:163–168.
3. Barilla DE, Townsend J, Pak CYC. 1978 An exaggerated augmentation of renal calcium excretion after oral glucose ingestion in patients with renal hypercalciuria. Invest Urol. 15:486–488.[Medline]
4. Ericsson Y, Angmar-Mansson, Flores M. 1990 Urinary mineral ion loss after sugar ingestion. Bone Miner. 9:233–237.[Medline]
5. Lemann J, Lennon EJ, Piering WF, Prien EL, Ricanati ES. 1970 Evidence that glucose ingestion inhibits net renal tubular reabsorption of calcium and magnesium in man. J Lab Clin Med. 75:578–585.[Medline]
6. Thom JA, Morris JE, Bishop A, Blacklock NJ. 1978 The influence of refined carbohydrate on urinary calcium excretion. Br J Urol. 50:459–465.[Medline]
7. Garg A, Bonanome A, Grundy SM, Unger RH, Breslau NA, Pak CYC. 1990 Effects of dietary carbohydrates on metabolism of calcium and other minerals in normal subjects and patients with non insulin-dependent diabetes mellitus. J Clin Endocrinol Metab. 70:1007–1013.[Abstract]
8. Arora B, Selby PL, Norman RW, Peacock M, Robertson WG. 1985 The effect of an increased intake of various constituents of a high animal protein diet on the risk of calcium oxalate stone formation in men. In: Schwile PO, Smith LH, Robertson WG, Vahlensieck W, eds. Urolithiasis and related clinical research. New York: Plenum Press; 85–88.
9. Robertson WG, Heyburn PJ, Peacock M, Hanes F, Swaminathan R. 1979 The effect of high animal protein intake on the risk of calcium stone formation in the urinary tract. Clin Sci. 57:285–288.[Medline]

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