Artificial sweeteners and brain health: critical evaluation of aspartame impact on neurovascular and cognitive consequences

Purpose This review critically evaluates the impact of aspartame (APM) on neurovascular and cognitive health. While regulatory bodies maintain that current acceptable daily intake (ADI) levels are safe, this study aims to investigate potential neurological risks that may be underestimated in standard safety assessments. Design/methodology/approach A comprehensive synthesis of in vitro, animal and human studies was conducted. The analysis focused on three mechanistic pathways: neurotransmitter disruption, excitotoxicity and oxidative stress, specifically regarding their role in the disruption of the neurovascular unit (NVU). The methodology included a critical appraisal of existing data and the creation of a targeted evidence map. Findings Evidence suggests that APM doses within the ADI can exacerbate neuroinflammation and cognitive decline, particularly during critical developmental windows or in the presence of comorbidities like obesity. This review identifies systemic limitations in current human trials, including short follow-up periods and restrictive sample sizes, which likely mask cumulative deleterious effects in susceptible populations. Originality/value This work offers a novel integration of biochemical evidence linking APM to the functional breakdown of the NVU. It challenges the “one-size-fits-all” ADI approach by highlighting how developmental stages and metabolic health influence neurotoxicity. The evaluation provides a new, population-sensitive framework for safety assessments, emphasizing the urgent need for long-term research on vulnerable demographics.