Episode 36 – Artificial Sweeteners

Key Topics Covered

3 Main Types

  • Sugar alcohols – eg. Sorbitol, Mannitol, Xylitol, Erythritol, Malitol
    • Often have a few calories
  • Natural low-calorie sweeteners – eg. Stevia, Allulose, Inulin, Monk Fruit) 
  • Artificial sweeteners – eg. Sucralose, Aspartame, Saccharin

Effects On Appetite and Weight 

  • Artificial Sweeteners have been used for decades to help with weight management.
  • However, the research is mixed as to whether or not it actually helps.
    •  A 2019 systematic review included several studies that showed no association between non-sugar sweeteners and weight gain. 
    • Upon further analysis, they even found that non-sugar sweetener use by overweight or obese individuals (those not trying to lose weight) resulted in reduced body weight. 
    • No consensus has been reached on how the use of low or no-calorie sweeteners affects body weight long term.   

Change in Taste Perception

  • Many studies have shown that those who consume a high amount of sweet foods (not just artificial sweeteners) have an increased demand for sweeter foods.
    • Eg. Children who consumed a large amount of sweet foods did not enjoy fruit as much.
  • Therefore, if one were to consume a high amount of sweet food, would it change their perception to standard healthy foods? Would it cause them to lean towards calorie dense foods?
  • A study also showed that low-calorie sweeteners increases appetite and therefore increases overall caloric intake. 
    • Several human studies have also shown a link between the consumption of some non-sugar sweeteners such as aspartame and saccharin and an increased appetite and heightened motivation to eat. 
    • However, even though there is this reported increase in appetite, overall studies in humans showed a mean daily energy intake of just over 1000kj less a day in people consuming non-sugar sweeteners as opposed to sugar. 
    • So despite data showing an increase in appetite, this may not reflect itself in an increased daily caloric intake or weight gain. 

Gut Health

  • There are a few animal studies showing that artificial sweeteners influence gut health, however more further research is required.
  • A 2014 study titled “Artificial Sweeteners Induce Glucose Intolerance by Altering the Gut Microbiome” indicated modifications in the intestinal microbiota after the administration of artificial sweeteners (sucralose, saccharin and aspartame) for 11 weeks.
    • The specific changes that occurred to the gut microbiota were linked to a reduction in glucose tolerance. So this could be relevant for those with T2DM. 
  • They did food frequency questionnaires and found similar changes in the microbiome of those who had higher levels of artificial sweeteners, which is interesting. But it had a few flaws in the study.

  • A 2020 review from Greyling et al identified that there is no acute glycaemic and insulin response of non-caloric sweeteners. This is important since so many people say it spikes glucose or insulin.  
  • A 2021 RCT from titled “High-Dose Saccharin Supplementation does not induce gut microbiota changes or glucose intolerance in healthy humans and mice” found 2 weeks of saccharin consumption at the MAXIMUM acceptable dosage – it did not effect glucose tolerance.
  • Another study from 2020 titled “the effects of non-nutritive sweeteners aspartame and sucralose, on the gut microbiome in healthy adults” showed no measurable change in the microbiome as assed by faecal samples.

  • Stevia may also affect the gut microbiota composition. But more studies are needed to verify this. 
  • Sugar alcohols, namely polyols, have many studies showing their links to gut health and effects on the gut (not the same thing). 
    • People with IBS tend to have adverse gastrointestinal reactions to the consumption of polyols.
    • This is why the low fodmap diet for IBS management will temporarily remove foods high in polyols from the diet and reintroduce them to see if the individual reacts poorly.
  • On the other hand, isomalt and maltitol, may have prebiotic actions and actually encourage improved gut health. 

Cancer Risk

Saccharin

  • Worries around artificial sweeteners specifically arose in the 1970s, when saccharin was shown to cause bladder cancer in laboratory animals. 
    • Human studies however have shown no clear link to bladder cancer to date. 

Aspartame

  • Before its approval by the FDA in 1981, aspartame underwent several tests in laboratory animals to assess cancer risks. No adverse effects were found. 
    • However, a 2005 study that showed very high doses might cause lymphoma and leukaemia. 
    • Again, these research studies were done with rats. And the research was assessed by Food and Drug Administrations around the world who deemed the study unfit to provide conclusions that aspartame was unsafe for human consumption. 
  • Honestly, it is impossible to say what the long-term cancer risk is from the frequent consumption of artificial sweeteners in humans. Since they have only been consumed on a widespread basis for less than 100 years, it is difficult to assess lifelong effects on health. 

Overall

They are probably okay is moderate amounts but excessive consumption should probably be avoided for now. 

Useful Links/ Resources

Studies Mentioned

Relevant Blog Posts