254 - Do Artificial Sweeteners Really Help People With Diabetes?
MEDSCAPE Marilynn Larkin June 20, 2024, Click here for full report
Splenda, which produces sucralose and other non-sugar sweeteners (NSS), is a sponsor of the American Diabetes Association (ADA) Diabetes Food Hub. Earlier this year, the ADA settled a lawsuit regarding its former director of nutrition's refusal to approve recipes containing sucralose (Splenda), which she believed "flew in the face of the ADA's mission." Susan Swithers, PhD, professor, Department of Psychological Sciences and associate dean for Faculty Affairs at Purdue University, told Medscape Medical News.
Swithers authored an article several years ago cautioning that consuming nonnutritive sweeteners in beverages not only fails to prevent disease but also is associated with an increase in risks for the same health outcomes associated with sugar-sweetened beverages, including T2D, cardiovascular disease, hypertension, and stroke.
"At this point, we have pretty good evidence that these chemicals that were once touted as being completely inert are, in fact, not inert," she said. "We know that they're unlikely to be toxic in the short term, but they are not benign, and they have consequences. Right now, we have little understanding of the outcomes of consumption of these products chronically."
The "common" NSS named by WHO included sucralose, as well as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, stevia, and stevia derivatives.
Similarly, Jotham Suez, PhD, an assistant professor in the Department of Molecular Microbiology and Immunology at Johns Hopkins Bloomberg School of Public Health in Baltimore, told Medscape Medical News that his group "showed for the first time in 2014 that disruption of the microbiome by artificial sweeteners is causally linked to disrupted glycemic control."
Recently, the team studied the impact of sucralose, aspartame, saccharin, and stevia in healthy adults and "were surprised to discover that all four sweeteners altered gut bacteria and the molecules they secrete," he said. However, subsequent glucose tolerance tests in healthy humans showed varying results, "suggesting that human microbiome responses to the nonnutritive sweeteners we assessed are highly personalized and may lead to glycemic alterations in some, but not all, consumers depending on their microbes and the sweeteners they consume."
Nevertheless, a recent review led by researchers in Mexico concluded that sucralose consumption "is associated with various adverse health effects. Despite being considered safe following previous studies, recent research suggests possible links to systemic inflammation, metabolic diseases, disruptions in gut microbiota, liver damage, and toxic effects at the cellular level."
Sabyasachi Sen, MD, a professor of biochemistry and molecular medicine at The George Washington School of Medicine & Health Sciences, Washington, DC, has led and coauthored preclinical and clinical studies demonstrating the potential ill effects of sucralose and other artificial sweeteners. One showed that sucralose and acesulfame potassium–containing diet soda altered microbial taxa in two pilot studies in healthy young adults; another showed a connection between artificial sweeteners and inflammation.
