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Study of the Reversibility of Glucose Intolerance Caused by Chronic Aspartame Consumption

Primary Purpose

Glucose Metabolism Disorder

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Oral glucose tolerance test (OGTT)
Diet soda containing aspartame only
Sponsored by
Rockefeller University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Glucose Metabolism Disorder focused on measuring artificial sweeteners, obesity, diabetes, metabolic syndrome, aspartame

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male or female aged 18 - 45
  2. Weight stable for at least 3 months prior to screening (< 5% weight change)
  3. BMI of 21 - 29
  4. Cohort 1 - Aspartame Consumers: Primary dietary sweetener is aspartame; consumes at least 36 ounces of diet soda in which aspartame is a primary ingredient (Diet Coke or Diet Dr Pepper) a day for at least 6 months duration prior to study enrollment (Primary dietary sweetener is aspartame" should be defined as: "840g per week sucrose equivalent from aspartame and less than 280 grams per week sucrose equivalent from all other sweeteners (non-caloric and caloric sweeteners). For reference, one 12oz soda is 40g sucrose equivalent, and one teaspoon (one packet) of artificial sweetener is 4g sucrose equivalent.)"

    Cohort 2 - Aspartame Naïve Participants: Consumes less than or equal to 2 cans of diet soda per week

  5. Screening Visit #2 OGTT Outcome:

    • 0-h plasma glucose < 110 mg/dl AND
    • 2-h plasma glucose < 140 mg/dl
  6. Abnormal OGTT during the screening phase of the study (area under curve on the high end of distribution)
  7. Must be able to comply with a metabolic Prudent diet
  8. Willing to fast 10 hours before each OGTT and BodPod
  9. Current level of exercise (aerobic and/or resistance training) must be able to be sustained while an in-patient

Exclusion Criteria:

  1. Any evidence of US National Cholesterol Education Program Adult Treatment Panel III

    Clinical Identification of the Metabolic Syndrome (must have 3 or more of the following risk factors):

    Abdominal Obesity, given as a waist circumference:

    • Men >102 cm (>40 in)
    • Women > 88 cm (>35 in)

    Triglycerides >150 mg/dl

    HDL Cholesterol:

    • Men < 40 mg/dl
    • Women <50 mg/dl

    Blood Pressure >130/ >85 mm Hg

    Fasting Glucose > 110 mg/dl

  2. Average systolic blood pressure (SBP) > 150 mmHg and / or diastolic blood pressure (DBP) > 90 mmHG (based on 3 BPs taken at screening visit #1),
  3. LDL-C > 240mg/dl
  4. Triglycerides > 400 mg/dl
  5. Evidence of a liver disorder (ALT > three fold of the ULN)
  6. Evidence of any renal disease
  7. Currently on a weight-loss diet
  8. Diabetes
  9. Self-reported history of thyroid dysfunction
  10. Sugar sweetened beverage consumption (> 84 ounces per week)
  11. Hemoglobin <13.0 g/dl for males and 12.0 g/dl for females
  12. Current, prior (within 2 months), or anticipated use of any of the following medications:

    antihyperlipidemic, hyperglycemic medications, Antineoplastics, Antiretrovirals, Selective Serotonin Reuptake Inhibitors, Diuretics, Antihypertensives, Anticonvulsants, Hormone therapy, Birth control

  13. Self-reported antibiotic use within the previous 3 months
  14. Currently pregnant or lactating
  15. History of cardiac disease
  16. Active illegal drug user (self-reported)
  17. History of GI surgery (gastric bypass, bariatric, Roux-en-Y, colon resection, etc.)
  18. Habitual ingestion of > 2 alcoholic beverages/day
  19. Ever diagnosed with an eating disorder (self-reported)
  20. Use of steroids or beta agonists (orally, intranasal or inhaled) within a week of any OGTT
  21. Positive Hepatitis Serology (Hep. B surface Antibody; Hep. B surface antigen; Hep. C surface antibody)
  22. HIV Positive
  23. Tobacco use within the past 3 months
  24. Any medical or social condition that, in the opinion of the Investigator, might pose additional risk to the participant or confound the results of the study

Sites / Locations

  • The Rockefeller University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Aspartame Consumers - Cohort 1

Aspartame Naive Participants - Cohort 2

Arm Description

Experimental Group/Arm Phase I - Questionnaires and fasting oral glucose tolerance test (OGTT). Phase II - (If OGTT results are abnormal, participants will be invited to participate in Phase II) Five (5) week study phase with Prudent Metabolic Diet and Intervention of diet soda containing aspartame only; Week 1: Prudent Metabolic Diet and 36oz diet soda po daily, Week 2-4: Prudent Metabolic Diet and no diet soda, Week 5: Prudent Metabolic Diet and 36 oz diet soda po daily.

Control Group/Arm Phase I - Questionnaires and fasting oral glucose tolerance test (OGTT). Phase II - Not applicable for this cohort.

Outcomes

Primary Outcome Measures

Interval changes in blood glucose
Phase II (cohort 1): Interval changes in blood glucose will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Blood glucose
Phase I (both cohorts): Blood glucose will be quantified from incremental area under the curve calculated from averaged oral glucose tolerance tests (OGTT)

Secondary Outcome Measures

Interval changes in Glucagon
Phase II (cohort 1): Interval changes in glucagon will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Glucagon
Phase I (both cohorts): glucagon will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Peptide Tyrosine Tyrosine (PYY)
Phase II (cohort 1): Interval changes in PYY will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Peptide Tyrosine Tyrosine (PYY)
Phase I (both cohorts): PYY will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Leptin
Phase II (cohort 1): Interval changes in Leptin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Leptin
Phase I (both cohorts): Leptin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Insulin
Phase II (cohort 1): Interval changes in Insulin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Insulin
Phase I (both cohorts): Insulin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Ghrelin
Phase II (cohort 1): Interval changes in Ghrelin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Ghrelin
Phase I (both cohorts): Ghrelin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Glucagon-like peptide-1 (GLP-1)
Phase II (cohort 1): Interval changes in GLP-1 will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Glucagon-like peptide-1 (GLP-1)
Phase I (both cohorts): GLP-1 will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval changes in Glucose-dependent insulin-releasing peptide (GIP)
Phase II (cohort 1): Interval changes in GIP will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Glucose-dependent insulin-releasing peptide (GIP)
Phase I (both cohorts): GIP will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Interval Changes in C-peptide
Phase II (cohort 1): Interval changes in C-peptide will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
C-peptide
Phase I (both cohorts): C-peptide will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)

Full Information

First Posted
July 30, 2015
Last Updated
June 3, 2020
Sponsor
Rockefeller University
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1. Study Identification

Unique Protocol Identification Number
NCT02520258
Brief Title
Study of the Reversibility of Glucose Intolerance Caused by Chronic Aspartame Consumption
Official Title
Study of the Reversibility of Glucose Intolerance Caused by Chronic Aspartame Consumption
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
August 2015 (Actual)
Primary Completion Date
June 25, 2019 (Actual)
Study Completion Date
June 25, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Rockefeller University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Experiments have shown that some artificial sweeteners like those in diet soda can cause changes in how the body responds to and uses sugar. These changes increase the chance of obesity, type 2 diabetes, and other metabolic diseases. In this study, the investigators plan to see if the most common artificial sweetener, aspartame (brand name Equal, NutraSweet), causes these changes. The investigators believe that if metabolic changes are observed in a person who consumes aspartame, then removing all aspartame from the diet might lead to a reversal of the changes and a normalization of test results.This would impact sweetener additives in our foods and thus decrease the incidence of obesity, diabetes, and the metabolic syndrome.
Detailed Description
Experiments have shown that some artificial sweeteners like those in diet soda can cause changes in how the body responds to and uses sugar. These changes increase the chance of obesity, type 2 diabetes mellitus, and other metabolic diseases. In this study, the investigators plan to see if the most commonly used artificial sweetener, aspartame, affects the body's response to sugar. The investigators believe that if metabolic changes are observed in a person who consumes aspartame, then removing all aspartame from the diet might lead to a reversal of the changes and a normalization of test results. The investigators plan to study two (2) cohorts of healthy volunteers: 1) Those who regularly drink at least three cans per day of diet soda that contains aspartame (Cohort 1, Aspartame Consumers) and 2) participants who consume less than or equal to two (2) cans of diet soda per week (Cohort 2, Aspartame Naïve Participants). Phase I of the study, the investigators will ask participants questions about their usual diet, including how much diet soda they usually drink. Participants will be screened by a test called the oral glucose tolerance test, or OGTT. This test involves coming to the hospital to drink sugary syrup, then have blood sugar checked every thirty (30) minutes for five (5) hours. Before the test, participants must refrain from eating or drinking anything for ten (10) hours. If the OGTT shows a high value, then the participant in cohort 1 (Aspartame Consumers) who regularly drink 3 or more cans per day of diet soda will be approached about continuing into the second phase of the study. For the participants in cohort 2 (consume less than or equal to two (2) cans of diet soda per week; Aspartame Naïve Participants), this will be the end of their participation in the study. Phase II of the study, blood tests, OGTT, stool samples, and weight and body fat measurements a few times a week will track any changes in the participants during the study. During the phase II five (5) week study, participants will receive all of their meals from the Rockefeller University Hospital and should not have any outside food or drinks. The diet used throughout this study phase (II) is the Prudent Metabolic Diet. Participants can leave the hospital and continue to work, but must come for all tests and to receive meals. During Week One, participants will eat only food provided by the hospital but will continue to drink three (3) cans of diet soda per day. In Weeks Two through Four, participants will continue to eat food given to them by the hospital and will not be allowed to consume any foods or drinks that contain aspartame. In Week Five, participants will continue on the hospital diet, but will again start drinking three (3) cans of diet soda per day.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glucose Metabolism Disorder
Keywords
artificial sweeteners, obesity, diabetes, metabolic syndrome, aspartame

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Aspartame Consumers - Cohort 1
Arm Type
Experimental
Arm Description
Experimental Group/Arm Phase I - Questionnaires and fasting oral glucose tolerance test (OGTT). Phase II - (If OGTT results are abnormal, participants will be invited to participate in Phase II) Five (5) week study phase with Prudent Metabolic Diet and Intervention of diet soda containing aspartame only; Week 1: Prudent Metabolic Diet and 36oz diet soda po daily, Week 2-4: Prudent Metabolic Diet and no diet soda, Week 5: Prudent Metabolic Diet and 36 oz diet soda po daily.
Arm Title
Aspartame Naive Participants - Cohort 2
Arm Type
Active Comparator
Arm Description
Control Group/Arm Phase I - Questionnaires and fasting oral glucose tolerance test (OGTT). Phase II - Not applicable for this cohort.
Intervention Type
Other
Intervention Name(s)
Oral glucose tolerance test (OGTT)
Intervention Description
OGTT will be conducted following a ten (10) hour fast on Screening Visit 2 (Screening Visit 2 may be conducted between Day -42 to Day 1).
Intervention Type
Other
Intervention Name(s)
Diet soda containing aspartame only
Intervention Description
7 days of 36 oz diet soda po daily (Week 1), followed by 21 days washout (Weeks 2-4), and 7 days rechallenge (Week 5); Prudent metabolic diet; Oral glucose tolerance test (OGTT) on days (+/-2) 3, 7, 10, 14, 21, 28, 31, 35
Primary Outcome Measure Information:
Title
Interval changes in blood glucose
Description
Phase II (cohort 1): Interval changes in blood glucose will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Blood glucose
Description
Phase I (both cohorts): Blood glucose will be quantified from incremental area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Secondary Outcome Measure Information:
Title
Interval changes in Glucagon
Description
Phase II (cohort 1): Interval changes in glucagon will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Glucagon
Description
Phase I (both cohorts): glucagon will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Peptide Tyrosine Tyrosine (PYY)
Description
Phase II (cohort 1): Interval changes in PYY will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Peptide Tyrosine Tyrosine (PYY)
Description
Phase I (both cohorts): PYY will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Leptin
Description
Phase II (cohort 1): Interval changes in Leptin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Leptin
Description
Phase I (both cohorts): Leptin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Insulin
Description
Phase II (cohort 1): Interval changes in Insulin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Insulin
Description
Phase I (both cohorts): Insulin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Ghrelin
Description
Phase II (cohort 1): Interval changes in Ghrelin will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Ghrelin
Description
Phase I (both cohorts): Ghrelin will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Glucagon-like peptide-1 (GLP-1)
Description
Phase II (cohort 1): Interval changes in GLP-1 will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Glucagon-like peptide-1 (GLP-1)
Description
Phase I (both cohorts): GLP-1 will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in Glucose-dependent insulin-releasing peptide (GIP)
Description
Phase II (cohort 1): Interval changes in GIP will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Glucose-dependent insulin-releasing peptide (GIP)
Description
Phase I (both cohorts): GIP will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval Changes in C-peptide
Description
Phase II (cohort 1): Interval changes in C-peptide will be quantified from area under the curve calculated from oral glucose tolerance tests (OGTT)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
C-peptide
Description
Phase I (both cohorts): C-peptide will be quantified from area under the curve calculated from averaged oral glucose tolerance tests (OGTT)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Other Pre-specified Outcome Measures:
Title
Interval changes in glycated hemoglobin (HbA1C) - Phase II (Cohort 1)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Glycated hemoglobin (HbA1C) - Phase I (both cohorts)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in body mass index (BMI) - Phase II (Cohort 1)
Description
BMI is calculated from measured height and weight
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Body mass index (BMI) - Phase I (both cohorts)
Description
BMI is calculated from measured height and weight
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in body fat distribution - Phase II (Cohort 1)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Body fat distribution - Phase I (both cohorts)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in whole body densitometry (BodPod) - Phase II (Cohort 1)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Whole body densitometry (BodPod) - Phase I (both cohorts)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in blood pressure - Phase II (Cohort 1)
Time Frame
Interval 1: days 1 to 7; interval 2: days 8 to 28; interval 3: days 29 to 35
Title
Blood pressure - Phase I (both cohorts)
Time Frame
Screening Visit 2: conducted between day -42 up to Day 1.
Title
Interval changes in frequency distribution of microbes found in stool samples (Phase II - cohort 1)
Time Frame
Interval 1: days 6 to 7; interval 2: days 27 to 28; interval 3: days 34 or 35.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female aged 18 - 45 Weight stable for at least 3 months prior to screening (< 5% weight change) BMI of 21 - 29 Cohort 1 - Aspartame Consumers: Primary dietary sweetener is aspartame; consumes at least 36 ounces of diet soda in which aspartame is a primary ingredient (Diet Coke or Diet Dr Pepper) a day for at least 6 months duration prior to study enrollment (Primary dietary sweetener is aspartame" should be defined as: "840g per week sucrose equivalent from aspartame and less than 280 grams per week sucrose equivalent from all other sweeteners (non-caloric and caloric sweeteners). For reference, one 12oz soda is 40g sucrose equivalent, and one teaspoon (one packet) of artificial sweetener is 4g sucrose equivalent.)" Cohort 2 - Aspartame Naïve Participants: Consumes less than or equal to 2 cans of diet soda per week Screening Visit #2 OGTT Outcome: 0-h plasma glucose < 110 mg/dl AND 2-h plasma glucose < 140 mg/dl Abnormal OGTT during the screening phase of the study (area under curve on the high end of distribution) Must be able to comply with a metabolic Prudent diet Willing to fast 10 hours before each OGTT and BodPod Current level of exercise (aerobic and/or resistance training) must be able to be sustained while an in-patient Exclusion Criteria: Any evidence of US National Cholesterol Education Program Adult Treatment Panel III Clinical Identification of the Metabolic Syndrome (must have 3 or more of the following risk factors): Abdominal Obesity, given as a waist circumference: Men >102 cm (>40 in) Women > 88 cm (>35 in) Triglycerides >150 mg/dl HDL Cholesterol: Men < 40 mg/dl Women <50 mg/dl Blood Pressure >130/ >85 mm Hg Fasting Glucose > 110 mg/dl Average systolic blood pressure (SBP) > 150 mmHg and / or diastolic blood pressure (DBP) > 90 mmHG (based on 3 BPs taken at screening visit #1), LDL-C > 240mg/dl Triglycerides > 400 mg/dl Evidence of a liver disorder (ALT > three fold of the ULN) Evidence of any renal disease Currently on a weight-loss diet Diabetes Self-reported history of thyroid dysfunction Sugar sweetened beverage consumption (> 84 ounces per week) Hemoglobin <13.0 g/dl for males and 12.0 g/dl for females Current, prior (within 2 months), or anticipated use of any of the following medications: antihyperlipidemic, hyperglycemic medications, Antineoplastics, Antiretrovirals, Selective Serotonin Reuptake Inhibitors, Diuretics, Antihypertensives, Anticonvulsants, Hormone therapy, Birth control Self-reported antibiotic use within the previous 3 months Currently pregnant or lactating History of cardiac disease Active illegal drug user (self-reported) History of GI surgery (gastric bypass, bariatric, Roux-en-Y, colon resection, etc.) Habitual ingestion of > 2 alcoholic beverages/day Ever diagnosed with an eating disorder (self-reported) Use of steroids or beta agonists (orally, intranasal or inhaled) within a week of any OGTT Positive Hepatitis Serology (Hep. B surface Antibody; Hep. B surface antigen; Hep. C surface antibody) HIV Positive Tobacco use within the past 3 months Any medical or social condition that, in the opinion of the Investigator, might pose additional risk to the participant or confound the results of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas Huber, MD PhD
Organizational Affiliation
Rockefeller University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Rockefeller University
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of the Reversibility of Glucose Intolerance Caused by Chronic Aspartame Consumption

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