Artificial Sweeteners, Insulin, and Other Concerns

Authored by Robert Chen • 
November 20, 2016

Many people consume food and drinks that have no sugar, but are packed with artificial sweeteners. The notion of whether or not these artificial sweeteners are "good" or "bad" for you, has been debated for years.

All over the media, people constantly harp on the notion that you should do low calorie, low fat diets, and eat foods with artificial sweeteners rather than sugary foods, in order to lose weight. But a major misconception regarding obesity and related complications, is that it is a hormonal problem, a central piece of which is insulin.

Artificial sweetener usage and consumption is rising at a near-alarming rate. In 1965, about 3% of the population was consuming artificial sweeteners. In 2005, it was 15%.1

artificial_sweetener_usage_bmi

Artificial sweetener usage and consumption are going up, and obesity rates are rising at alarming rates.

In this article we cover recent research on artificial sweeteners and their effect on changes in insulin levels, glucose tolerance and other concerns. In general, the evidence on the effect of artificial sweeteners on insulin spikes, is still ambiguous. However, apart from changes in insulin signaling, artificial sweeteners carry with them other potential causes for concern including increased cancer risk, and disruption of gut microbiota.

Commonly Used Artificial Sweeteners

Recently, the most commonly used sweeteners are aspartame, saccharin, sucralose, and stevia.

Even in just the last 5 years, usage of these sweeteners in food has been growing each yearh. In fact, there has been a 50% per year increase in stevia usage in foods and beverages since 2010!2

artificial_sweetener_food_bev_2010_2015

Artificial sweeteners are used religiously in consumer foods. Growth per year ranges from low single digits (aspartame, saccharin) to 50% per year (stevia).

Current Research on Metabolic Changes Due to Artificial Sweeteners

One of the most interesting questions regarding artificial sweeteners is whether or not increased consumption of them would lead to unwanted insulin spikes. This has been debated at large and currently the evidence is ambiguous, however, most studies suggest that artificial sweeteners typically do not cause a rise in insulin in the same way that caloric sweeteners (e.g., table sugars) do.3

However, insulin is only part of the story, as there are a multitude of factors involved with maintaining a favorable metabolic state. What is interesting is that artificial sweetener consumption, is actually liked with higher levels of diabetic biomarkers! While the physiological basis of this is not rigorously understood, this is quite alarming. A study on 276 adults, showed that adults who consumed high amounts of artificial sweeteners, exhibited over 10% higher levels of hemoglobin A1c (P<0.002).4

artificial_sweetener_hbA1c

Artificial sweetener consumption is linked to significantly higher levels of hemoglobin A1c, a diabetes biomarker.

Artificial Sweeteners and Gut Bacteria

A recent study in mice and humans showed that consumption of artificial sweeteners is linked to disruption of gut microbiota. In a study on 4 mice, the evidence suggests that, consuming high amounts of artificial sweeteners (saccharin, in particular), may lead to large increases in gut expression of enzymes that break down good gut microbiota, in some cases, by increasing expression of these destructive enzymes by over 4-fold, in as little an amount of time as 11 weeks!4

artificial_sweetener_gut_microbiota_destruction

In a study in mice, artificial sweetener consumption, was linked to destruction of microbiota. Red values indicate higher expression (i.e., greater destruction of gut microbiota).

Association of Artificial Sweeteners with Obesity

Now that artificial sweeteners have been used in food for several decades, it's interesting to observe correlations between consumption of foods stacked with artificial sweeteners, the reason people eat these foods in the first place -- reductions in obesity!

Studies have shown that consumption of artificial sweeteners have been associated with weight gain.1For example, a 2-year long study in grade school-aged children showed that consumption of diet soft drinks were linked to significantly higher body mass index (BMI) (n=166).5Large-scale studies have shown that this trend persists in both males6and females.7

Editorial Opinion

Whether artificial sweeteners will significantly spike insulin levels has been up to debate, and still is up to debate! While many people experience weight loss (which is directly tied to insulin sensitivity) when replacing sugary foods with replacements that have artificial sweeteners, keep in mind that artificial sweetener consumption is linked to other conditions including cancers.

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