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Non-Caloric Artificial Sweeteners May Induce Glucose Intolerance

Consumption of non-caloric artificial sweeteners seems to induce glucose intolerance in mice and humans by altering gut microbiota….

 

Non-caloric artificial sweeteners (NAS) have been used to provide sweet taste to food without high caloric sugars. NAS are getting popular due to their use for weight loss, and regulation of blood sugar for patients with diabetes. Many studies has showed positive response to NAS, whereas some have shown connections between NAS consumption and weight gain, and increased risk of type 2 diabetes. FDA has approved six NAS products for use in U.S.

In this 10-week study, mouse groups who received water, glucose, or sucrose showed comparable glucose tolerance curves compared to all mice consuming NAS products which showed glucose intolerance (P<0.001). Also to correlate findings in obese patients, mice were fed high fat diet while giving them NAS or pure sucrose as a control. This also showed that mice developed glucose intolerance that were on commercial saccharides (P<0.03).

Gut microbiota may mediate NAS-induced glucose intolerance. Fecal transplantation was performed to test this theory, where transferring the microbiota configuration from mice on normal-chow diet drinking commercial saccharin or glucose as a control into normal-chow-consuming germ-free mice. Mice consuming commercial saccharin that received microbiota exhibited impaired glucose intolerance compared to mice consuming glucose after 6 days of fecal transplantation (P<0.03).

This study also looked at correlation between long-term NAS consumption and metabolic risk in humans. In an ongoing clinical nutritional study, it looked at 381 people who did not have diabetes. “We found significant positive correlations between NAS consumption and several metabolic-syndrome-related clinical parameters, including increased weight and waist-to-hip ratio, higher fasting blood glucose, glycosylated HbA1c [percentage] and glucose tolerance test (GTT, measures of impaired glucose tolerance), and elevated serum alanine aminotransferase,” the researchers wrote. Levels of A1c were significantly increased in subgroup of peope getting NAS compared to control consumers. The increase in A1c was significant even with adjusted body mass index (p<0.015).

Researchers also looked at short-term, 7 days, effect of NAS on glucose tolerance in seven healthy volunteers. This also showed that four of these volunteers demonstrated poor glycemic response after NAS consumption compared to regular sugar consumption.

Overall, results from short and long-term human NAS consumer cohorts suggest that individual have personalized response to NAS depending on differences in their microbiota function. NAS consumptions seems to increase in the obesity and glucose intolerance.

Practice Pearls:

  • Non-caloric artificial sweeteners (NAS) are introduced into our diets with the intention of reducing caloric intake and controlling blood glucose levels.
  • This study looked at long and short-term effect of NAS on glucose intolerance in mice and in human, and also effect of microbiota on NAS-induced glucose intolerance.
  • Mice consuming commercial saccharin that received microbiota exhibited impaired glucose intolerance compared to mice consuming glucose after 6 days of fecal transplantation.
  • Also, both long and short-term results demonstrated that group receiving NAS products showed glucose intolerance compared to control group.

Suez J, et al “Artificial sweeteners induce glucose intolerance by altering the gut microbiota” Nature 2014; DOI: 10.1038/nature13793.

Comment from Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S., FCCWS, author of Diabetes Solution: “They used brand name powdered sweeteners that were all 96% sugars but were labeled zero calories. At least 1 brand (Sweet and Low) used glucose. So they were testing sugars rather than artificial sweeteners.”