Amidst an obesity pandemic, much attention is focused on the massive rise in sugar intake. The American Heart Association recommends no more than 5 teaspoons (20 g) of added sugar per day. In 1970, we averaged 3.5 teaspoons per day, but this has now risen to a deadly 50 teaspoons every day, equivalent to over one wheelbarrow full of sugar each year! Total sugar intake ranges from 15-26% of daily energy consumption, with children often consuming higher proportions than adults. There is no doubt that our natural love of sweetness, is leading us into terrible trouble!
Figure 1. A 16-ounce (494ml) bottle of coke contains 13 teaspoons or 52g of sugar.
The deleterious effects of sugar on our metabolism, weight and health are indisputable. The World Health Organisation recommends limiting sugar consumption to no more than 5-10% of daily energy consumption, whilst our governments still fail to grasp the gravity of this situation.
The food and drinks industry’s response has been to increase the use of artificial sweeteners; think diet cola for example. Artificial sweeteners are used in ‘diet food and drinks’, reducing the sugar load, whilst maintaining the sweetness. Until recently, sweeteners were limited to diet drinks, and packets for tea and coffee. Now truly ubiquitous, sweeteners are added to fruit juices, tinned foods, dairy products, baked goods and low-calorie foods. The food industry even adds sweeteners to foods that are not traditionally sweet, such as bread!
Worldwide, the sweetener industry is worth $7.2 billion and is predicted to show an annual growth of over 5% over the next 5 years. More than 40% of all Americans consume artificial sweeteners, a pattern repeated across the world as more people adopt the Western Pattern Diet (typical US type fast food diet rich in high GI carbs, sugar, and refined foods in packets).
WHAT ARE SWEETENERS?
There are two groups of sweeteners: nutritive and non-nutritive. Nutritive sweeteners, contain carbs and provide calories, such as polyols or sugar alcohols, honey, and syrups. Non-nutritive sweeteners are food additives with high sweetening power but provide little or no energy. The term artificial sweetener is used interchangeably with non-nutritive sweetener, non-caloric sweetener and low-calorie sweetener.
ARTIFICIAL SWEETENERS AND SAFETY
Artificial sweeteners, like other food additives are subject to safety control and ‘acceptable daily intakes’ have been established for each of these chemicals.
Introduced to avoid the adverse metabolic toll of sugar and to improve our health, there are many studies which do not support the concept of artificial sweeteners achieving this goal. Paradoxically, studies describe an association of artificial sweeteners with weight gain, a range of metabolic diseases and cancer. 1 Such is the level of concern, that food safety agencies, including the European Food Safety Authority are currently re-evaluating the safety of artificial sweeteners.
The safety concerns of artificial sweeteners are centred on their effects on insulin resistance, weight gain, metabolic diseases, cancer and gut bugs.
EFFECT OF ARTIFICIAL SWEETENERS ON WEIGHT
Since the introduction of artificial sweeteners, the obesity pandemic has remained untouched and increased usage of these food additives has not slowed the rise in weight gain. Despite this, the relationship between consumption of artificial sweeteners and the effect on weight remains the subject of controversy. Studies of artificial sweeteners and weight have shown weight gain, other studies weight loss and some studies, no change in weight. 1 2 So, what is going on?
We are gradually finding answers to this conundrum by studying the actions of these chemicals. We are learning how these chemicals may cause weight gain and how they may hinder weight loss.
One of the key factors is the food that accompanies the artificial sweetener. Researchers have shown that we react differently to artificial sweeteners when they are eaten with or without high GI carbs (sugar). 3
This study found that when artificial sweeteners were consumed with high GI carbs (e.g., chips and diet cola, tea and biscuits, fruit juice and snack bar), glucose metabolism was altered with the development of insulin resistance. Worryingly, that insulin resistance developed after only 10 days! If carbs (sugar) are not eaten at the same time as artificial sweeteners, the alteration in glucose metabolism did not occur.
The researchers postulate a reduction in the sensitivity of the brain’s sweet receptors (not the mouth’s) as the cause of insulin resistance. 3
This helps us to understand the discrepancies in the scientific literature. It is the addition of carbohydrate to the artificial sweetened food or drink that causes the metabolic problems. So, consuming diet drinks with a (carb) meal alters sugar metabolism, leading to insulin resistance and weight gain.
Figure 2. Consuming artificial sweeteners with sugars promotes insulin resistance, leading to metabolic disease and obesity.
That’s how that quick lunch, with diet soda, a burger laced with high GI carbs and sugar, turns into your own personal metabolic storm. Do this for just 10 days, and insulin resistance is knocking at the door. You have been warned!
Conclusion: Artificial sweeteners, while providing no calories have been shown to cause insulin resistance, metabolic disease and weight gain.
ARTIFICIAL SWEETENERS AND METABOLIC DISEASES
Population studies of artificial sweetener users have shown increased risk of developing metabolic diseases such as hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular disease. 1 And the higher the usage, the greater the risk.
We can’t say with certainty the mechanisms for the development of metabolic diseases, but there are probably multiple factors involved. At the heart of the problem, lies insulin resistance, mediated by the effect on our sweet taste receptors, both in the gut and in the brain. Sweeteners also have an adverse effect on our gut bugs. And once insulin resistance develops, metabolic disease is not far away.
Conclusion: There is a link between metabolic disease and artificial sweeteners. There are many potential causes for this, but at the centre lies the development of insulin resistance, which directly leads to metabolic diseases, the commonest of which are obesity, type 2 diabetes, hypertension, dyslipidaemia, and heart disease.
ARTIFICIAL SWEETENERS AND CANCER
A link between artificial sweeteners and cancer has been suggested by several experimental studies, but until recently, there was no robust evidence of the association with cancer in humans. In March 2022, the NutriNet-Sante population-based study added to the evidence, linking consumption of artificial sweeteners with cancer. 4
The NutriNet-Sante study is a French population study involving over 100,000 adults, who record their diet and have been followed up for an average of 7.8 years. The group was divided into those who consumed artificial sweeteners (36.9%) and those who did not (63.1%).
Higher consumers of artificial sweeteners had a higher risk of cancer compared to non-consumers. More specifically, aspartame intake was associated with higher risks of breast cancer and obesity-related cancers. The data was adjusted for body weight and the increased risk was not explained by weight alone.
The mechanism by which artificial sweeteners predispose to the development of cancer are unclear but several factors are implicated. The possible mechanisms include damage to DNA, inflammation, and the adverse effect on gut bugs.
The NutriNet-Sante study describes an association between consumption of artificial sweeteners and increased cancer risk. To support these findings, this will need to be replicated in other future studies. This study establishes correlation between artificial sweeteners and an increased risk of cancer, but it does not establish causation.
Conclusion: The NutriNet-Sante study raises concern about the notion that these chemicals are safe.
Figure 3. Look after your gut bugs and they will look after you.
ARTIFICIAL SWEETENERS AND GUT BUGS
Your health and well-being depend on a healthy gut bug community. Your gut bugs are a complex ecosystem, composed of over 1500 different species. A more diverse gut bug composition increases your resilience and health. Gut bugs produce powerful chemicals, which in turn control, support and influence your mood, immunity, and metabolism.
Your gut bugs will change and adapt throughout life, influenced primarily by what you eat. Disrupting the balance of your gut bugs, called dysbiosis, leads to health problems. Like your DNA, your gut bug composition is unique to you. However, certain patterns and predominant species can be identified in certain conditions, including obesity. The Western Pattern Diet causes low diversity and poor resilience of gut bugs, with predictable poor metabolic health. The food that you eat, including sweeteners, are strong influencers of both the composition and activity of your gut bugs.
Artificial sweeteners were initially thought to be inert, but we now know these powerful chemicals are far from inert in the human body. 5 We know they can’t be digested by our normal digestive enzymes, and that our gut bugs play a role in their metabolism. Laboratory experiments, animal experiments and human studies have shown that artificial sweeteners not only influence, but also interact with gut bugs. In animal models, artificial sweeteners reduce effective gut bug communications, reduce healthy fermentation of fiber, and worsen gut bug diversity. 6 Critically, alteration of the function of gut bugs, drives insulin resistance, with the subsequent cascade of metabolic consequences. 7
Human studies have replicated the findings from this laboratory work. At normal dose levels, artificial sweeteners induce gut bug dysbiosis, altering the composition of gut bugs for the worse. 89 Adverse shifts in the gut bug community with a change in gut bug metabolism and an increase in ‘bad bugs’ such as Shigella have also been demonstrated. 10
Conclusion: There is evidence that artificial sweeteners adversely affect our gut bugs.
SHOULD I CONSUME ARTIFICIAL SWEETENERS?
At Whisperer HQ, our answer is: No
There is now enough evidence to raise concerns about their safety. They hinder rather than help your weight loss journey. Those who consume them risk gaining weight, developing metabolic disease, and have an increased risk of cancer. They will compromise your gut bug health, with many subsequent risks to your health.
By reducing your high GI carbs and sugars, and fat adapting your body, you will find your sweetness where you least expected it, as your ‘polluted’ taste buds recover. You will find natural sweetness in vegetables, that you had long since forgotten. Our policy at whisperer HQ, is not to substitute sugar with sweeteners, but accept the new tastes on your new journey and rejoice in them. And, for that occasional treat, sugar is by far your best bet.
For this article, we have grouped the data on all types of artificial sweeteners together, but the effect of artificial sweeteners varies depending on the type, dose and mixture of sweeteners.
- Cracks are appearing in the safety arguments, and the debate about these chemicals continues, with conflicting reports in the scientific literature.
- There is growing evidence that artificial sweeteners promote weight gain, obesity, are associated with insulin resistance and hence diabetes and other metabolic disorders and cancer.
- Artificial sweeteners damage our gut bugs.