Excessive sugar intake has been linked to a range of maladies including type 2 diabetes, cardiovascular disease, accelerated aging, metabolic syndrome and obesity. Its no wonder people are often looking for a “healthier” option to satisfy his or her sweet tooth. Currently there are 6 approved artificial sweeteners by the FDA; some of which are thousands of times sweeter than table sugar. Many are readily available, placed right next to the sugar packets on restaurant tables waiting to be sprinkled into coffee or tea, while others are incorporated into the processed “reduced sugar” and “diet” snacks foods that line the supermarket shelves.
Even though some people are hesitant to make the switch from sugar to artificial sweeteners due to other health concerns such as cancer and seizures, many people happily consume them on a daily basis. Artificial sweeteners sound great in theory- drinking diet soda, or eating “diet” snacks allows people to experience the sweet taste that he or she craves without the excess calories that come along with typical sugar laden foods. Even though they provide no calories or nutrients when ingested, there is mounting evidence linking artificial sweeteners to list of adverse effects when consuming them- including alterations in gut microflora, cognitive changes, as well as metabolic and endocrine disturbances- making them a less healthy alternative than originally thought.
While some studies have shown that they are helpful as a weight loss tool, the research is still mixed. In one study, people lost more weight and reported feeling less hungry when consuming artificial sweeteners compared to participants that did not. (1) Conversely, observational research shows that people who consume artificial sweeteners are more likely to be overweight or obese. (2) Making many question the utility of them as a diet aid in the first place (however, it is important to note that cause and effect cannot be determined in this type of study).
Logically, a food or beverage that provides no calories or nutrition should not have a physiological impact, however that does not seem to be the case. For one, the quantity needed to provide the perception of sweet taste is at a lower concentration than sugar. Therefore, repeated use may alter perception of sweet taste in some individuals, and the amount needed of dessert, like apple pie or a chocolate brownie is increased in order to get the same satisfaction. In addition, artificial sweeteners have been shown to alter levels of hormones that impact blood sugar control, similar to the effects observed after sugar ingestion.
Newer evidence also shows that artificial sweeteners can cross the blood brain barrier and may trick parts of the brain that control feelings of hunger and satiety. In one study, artificial sweeteners negatively impacted cognition and were associated with a poor future snack choice. This can sabotage weight loss goals and make dieting seem impossible when high calorie snacks are in sight.(3) (4)
Another area of interest is the affects it exerts over the microbiome. Although still in the early stages of research, the microbiome is emerging as a significant component of health. The bacterial stains that populate our intestine can be altered by a variety of factors, including comorbidities, weight status (some strains are more common in obese individuals versus lean) and what we eat- including artificial sweeteners. In one study, it took only 7 days for people consuming the upper acceptable limit of saccharin (set by the FDA) to show significant changes in gut flora. The bacterial strains found in their gut were strains that are associated with type 2-diabetes. Moreover, there was a decrease in glucose control (5)- having the opposite effect of what artificial sweeteners are intended to have.
Although more substantial research is needed and a “one size fits all” recommendation cannot be made, it’s becoming more apparent that artificial sweeteners may be contributing to the same problems that they were originally intended to alleviate, and more thought should be given to their use.
1. Peters JC, Wyatt HR, Foster GD, Pan Z, Wojtanowski AC, Vander Veur SS, Herring SJ, Brill C, Hill JO. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity. 2014 Jun;22:1415-21.
2. Bleich SN, Wolfson JA, Vine S, Wang YC. Diet-beverage consumption and caloric intake among US adults, overall and by body weight. Am J Public Health. 2014 Mar;104:e72-8.
3. Burke MV, Small DM. Physiological mechanisms by which non-nutritive sweeteners may impact body weight and metabolism. Physiol Behav. 2015 Jun 3
4. Hill SE, Prokosch ML, Morin A, Rodeheffer CD. The effect of non-caloric sweeteners on cognition, choice, and post-consumption satisfaction. Appetite. 2014 12/1/;83:82-8.
5. Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, Israeli D, Zmora N, Gilad S, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct 9;514:181-6.
Appreciation is extended to Kristen Criscitelli for drafting this post.
Dr. Nicole Avena is a research neuroscientist, author and expert in the fields of nutrition, diet and addiction. She received a Ph.D. in Neuroscience and Psychology from Princeton University, followed by a postdoctoral fellowship in molecular biology at The Rockefeller University in New York City. She has published over 70 scholarly journal articles, as well as several book chapters and books, on topics related to food, addiction, obesityand eating disorders. She also edited the books, Animal Models of Eating Disorders (2012) and Hedonic Eating (2015), coauthored the popular book of food and addiction called Why Diets Fail (Ten Speed Press), and recently finished her new book, What to Eat When You're Pregnant. Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, the National Institute on Drug Abuse, and her research has been funded by the National Institutes of Health (NIH) and National Eating Disorders Association.