Could Artificial Sweeteners Raise Your Blood Sugar
Editor’s note: This story was updated on Sept. 18, 2014.
Sept. 17, 2014 — If youre one of the millions of Americans for whom diet sodas and artificially sweetened desserts play leading roles in efforts to shed pounds and help prevent long-term diseases like diabetes, new research might give you pause.
The work, done with mice and humans, suggests that artificial sweeteners could raise your blood sugar levels more than if you indulged in sugar-sweetened sodas and desserts.
Blame it on the bugs in your gut, scientists say. They found that saccharin , sucralose and aspartame raised blood sugar levels by dramatically changing the makeup of the gut microorganisms, mainly bacteria, that are in the intestines and help with nutrition and the immune system. There are trillions of them — many times more than the cells of the body — and they account for roughly 4 pounds of your body weight.
Scientists in recent years have focused more and more on the link between the gut microorganisms and health.
In the latest research, what we are seeing in humans and also in mice is this previously unappreciated correlation between artificial sweetener use and microorganisms in the gut, said Eran Elinav, MD, one of the scientists involved in the new study. Elinav and a collaborator, Eran Segal, PhD, spoke at a press conference held by Nature, the journal that published their teams findings. Both of the scientists are on the faculty of the Weizmann Institute of Science in Israel.
What Amount Of Sweetener Is Safe To Eat
As part of the approval process for each non-nutritive sweetener, an Acceptable Daily Intake level is set. The ADI is the estimated amount per kilogram of body weight that a person can consume, on average, every day, over a lifetime without risk. ADIs are set 100 times less than the smallest amount that may cause health concerns, so its extremely difficult for most people to reach the ADI. With these checks, the current levels of intake of artificial sweeteners in the UK are safe, although people with phenylketonuria are advised to avoid sweeteners containing aspartame.
How Do Artificial Sweeteners Affect Our Bodies
Now thats a million-dollar question!
There are so many ideas out there to try to explain it, but the reality is we dont know for sure plus, it might play out differently in different people.
- Is it because people feel that they can eat cake because theyve switched to diet soda?
- Perhaps its because the sweeteners change the taste preferences so that fruit starts to taste worse, and veggies taste terrible?
- Maybe artificial sweeteners increase our cravings for more sweets?
- It can be that the sweet taste of these sweeteners signals to our body to release insulin to lower our blood sugar but, because we didnt actually ingest sugar, our blood sugar levels get too low, to the point where we get sugar cravings.
- Some even say that saccharin may inspire addictive tendencies toward it.
- Maybe there is even a more complex response that involves our gut microbes and how they help to regulate our blood sugar levels.
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Do Artificial Sweeteners Cause Insulin Release
May 5, 2014
Do Artificial Sweeteners Cause Insulin Release Why Do People Care So Much?
The search for the answer has reached almost mythical status, and is most commonly asked by those following a low carbohydrate diet, such as the Atkins diet. Lets briefly look at the theory behind the Atkins diet, which is outlined but vastly oversimplified on the Atkins webpage. Very simply put, eating carbohydrates leads to increased sugar in the blood stream that triggers insulin to be released and allow the sugar to be taken in to cells. Some of this sugar is used for energy, but the rest is stored in cells or converted into fat. On a low carb diet, there are no carbohydrates to turn in to sugar so there is no insulin response. The body still needs fuel though, and so one of the things it does to compensate is that it turns to breaking down eaten and stored fats for energy thereby promoting fat loss. Whether this is exactly as it seems or not and the validity behind all the claims is the subject of great debate, and for the purposes of the current article Im going to steer clear of that and stick to the title question.
Sweetening a Low Carb Diet, Is It OK?
The Pancreas and Insulin Release A Little More Detail
Some Laboratory Experiments Suggested That Artificial Sweeteners Cause Insulin Release
Experimental Settings Arent Human Settings!
Human studies of the older artificial sweeteners Saccharin, Aspartame and Acesulfame
Is There A Connection Between Artificial Sweeteners And Diabetes
Because artificial sweeteners aren’t digested, they pass through the gastrointestinal tract and come into direct contact with the bacteria that normally reside there. Investigators studied the effect that three artificial sweeteners have on these intestinal bacteria. Since changes in the intestinal microenvironment have been linked to diabetes and metabolic syndrome, the researchers wanted to learn whether or not the artificial sweeteners caused changes that could lead to impairment in glucose metabolism. They conducted experiments in which mice drank either normal water or water supplemented with three different kinds of artificial sweeteners . The mice in all three of the groups consuming artificial sweeteners developed glucose intolerance, with higher blood glucose levels than the mice drinking water alone. Further, the effect was also observed in mice that were fed a high-fat diet, indicating that the sweeteners had the effect in both the lean state and the high-fat state . They went on to conduct experiments that proved that the elevated glucose levels in the sweetener-consuming mice were directly related to changes in the intestinal bacterial composition.
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Fat Cells Treat Sucralose Just Like Sugar
In the study, led by Sabyasachi Sen, MD, associate professor of medicine at George Washington University School of Medicine and Health Sciences, in Washington, DC, the researchers first looked at human fat-derived stem cells in the lab, adding the sugar subsitute, sucralose, to some cell samples but not to others.1 “We wanted to see if adding sucralose contributed to the process of making fat,” Dr. Sen tells EndocrineWeb.
Stem cells can change into mature fat, muscle, cartilage, or bone cells. After about 12 days, ”we could actually see the sucralose-added dish had more fat accumulation compared to the ones that did not get it,” Dr. Sen says.
Why did the cells accumulate fat? In the lab samples, Dr. Sen explains that the sucralose seemed to change the expression of a gene known as the glucose transporter gene. The glucose transporter gene helps sugar or in this case, sugar substitutes enter cells better.1 However, he says, when too much gets into the cells, it gets stored as fat.
Not what youd expect. They found with the stem cell research that the low-cal sweeteners promoted additional fat accumulation within the cells, compared to cells not exposed to these sweeteners. And, the higher the concentration of sweeteners introduced to the cells, the more fat that was accumulated.1 “The cells perceive as glucose,” he says.
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Can Artificial Sweeteners Cause Other Health Problems
Even though artificial sweeteners donât cause the same huge insulin spikes that sugar does, they could cause other problems. Evidence shows that bacteria in the gut could play a big role in the development of insulin resistance and diabetes. Studies show that there are differences in the gut bacteria of people with Type 2 diabetes and people who donât have diabetes.
Do sweeteners cause harmful changes in our gut bacteria? It could very well be. Evidence shows that when mice consume high amounts of sweeteners, the mice have marked changes in their gut bacteria â namely decreased âgood bacteriaâ and increased âbad bacteria.â When these gut bacteria changes occur, the mice begin to exhibit signs of insulin resistance. This has been demonstrated with aspartame, as well as saccharin and sucralose . Acesulfame K has led to bacteria changes in mice associated with obesity.
Stevia, considered one of the safest sweeteners, has also come under question, as a study from December showed it may lead to affects bacteria communication in the gut. Stevia doesnât seem to kill bacteria, however, and itâs not clear if its effect on bacteria communication causes problems or not.
No one knows how bacteria in our intestines could contribute to insulin resistance and diabetes. Some speculate that bad bacteria in our gut might send signals to our brains and produce a sugar craving. This is, once again, an area to watch.
Facts About Blood Sugar
Blood sugar, or glucose, comes from the carbohydrates that we take in. Its level in your blood is regulated by your pancreas, liver and small intestine. Glucose provides the energy that fuels your nervous system, feeds your organs and allows your muscles to work.
When you take in too many carbohydrates, your pancreas sends out insulin, which converts the extra glucose to glycogen. If you have too little glucose in your bloodstream, your body releases glucagon, which raises your blood sugar levels. Maintaining this balance is crucial to keeping your body functioning at its healthy best.
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The Artificial Sweetener Universe
There are three categories of non-sugar sweeteners: artificial, natural and sugar alcohols. Artificial are the most familiaras many as 40% of adults consume themand the most studied. These include:
- Saccharin
- Aspartame
- Acesulfame Potassium, or Ace-K
Natural sweeteners also provide taste without calories but are derived from plants or fruit. Stevia is the most prevalent, but you may also see monk fruit or yacon syrup.
Sugar alcohols like xylitol and erythritol are found naturally as well. Unlike the others, these have some calories, but no nutritional value, so theyre more sweetener than sugar.
Bottom Line: Its Important To Cut Down On Both Sugar And Artificial Sweeteners
Evidence is emerging that some artificial sweeteners could produce an insulin response, and could be affecting our gut bacteria in negative ways however, effects are variable depending on the type of sweetener. My advice is to avoid artificial sweeteners if you can.
That all said, we know for sure that consuming actual sugars in high amounts causes insulin resistance, diabetes, obesity, heart disease and more chronic health problems. Itâs imperative that people avoid juices, sodas, and sweets as much as possible. I also recommend an overall low-carb diet and this is, of course, even more important for people who already have insulin resistance and diabetes.
But if youâre addicted to sweets, like many of us are â including myself! â you likely give into a craving once in a while. In this case, youâre better off choosing sweets and drinks flavoured with artificial sweeteners over sugar. Itâs important to remember that while a jolt of a sugary beverage is definitely going to spike insulin, a single diet coke every once in a while isnât going to wipe out your good bacteria or cause insulin resistance. So far, Stevia and erythritol are considered to have the safest profile, but these are both new sweeteners so not a lot of research has been done on them.
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Brain Reactions To Real Vs Artificial Sugars
Although sometimes we cannot taste the difference between artificial and real sugars , our brains and bodies can react to the differences. Our bodies can sometimes even detect very small differences between types of sugars and respond differently to each. Artificial sweeteners are highly concentratedmeaning that for the same physical amount, they can be between 200 to 13,000 times sweeter than sugar! Even though artificial sugars are sweeter than real ones, they are nearly calorie-free. In some studies, scientists have even found that people prefer the taste of artificial sugars over real ones. However, there is also data to suggest that there is greater brain activation in response to real sugar than to saccharin , and this effect is particularly strong when people are hungry .
Using Sugar Substitutes In Cooking And Baking
Read packages carefully for specific instructions on the best way to substitute the low-calorie sweetener for sugar in recipes. Things to know when using a sugar substitute:
- Baked products may be lighter in color because of the lack of browning effect found in real sugar
- Volume may be lower in cakes, muffins and sweet breads because of the lack of bulking ability in real sugar
- The texture may be altered
- There may be an aftertaste with some of the substitutes
- Cooking time may vary
- Products may not keep as long
If you still have questions, talk to a registered dietitian or refer the American Diabetes Association at diabetes.org.
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Health Effects Of Artificial Sweeteners
Negative health effects from artificial sweeteners are cited all over the place, and while many studies show effects, others dont. Cancer? Maybe yes, maybe no. Heart disease? Maybe yes, maybe no. Not to mention that much of the research has been on animals, which may or may not translate to people.
I did want to point out one ironic thing, to do with artificial sweeteners and weight.
One study found that people who tend to drink diet sodas have double the risk of gaining weight than those who didnt.
Another study has shown an increased risk for metabolic syndrome and diabetes for those who consume diet drinks every day.
While these results dont apply equally to everyone, they do somehow seem ironic, dont they?
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Ways Diabetics Can Enjoy Sweets Without Relying On Artificial Sweeteners Or Added Sugar
With Sabyasachi Sen, MD, FRCP, FACP, FACE, and Christopher Gardner, PhD
That piece of chocolate cake is awfully tempting, but a little voice says, “not worth the sugar and calories.” But as you’re trying to walk away, a louder voice says, “go ahead. You had an aspartame-sweetened yogurt for breakfast and a diet soda with lunch so you’re ahead of the game.”
That kind of thinking is just one reason some experts are discouraging use of artificial sweeteners and sugar substitutes, especially if you have diabetes or noticed the weight creeping up. And the chorus is getting louder as the science points to reasons why you should think twice and then walk away from artificially sweetened foods.
For decades, we’ve relied on artificial sweeteners to deliver the taste without the calories or glucose rush, but it seems it’s time to reconsider.
Researchers who presented new data at ENDO 2018, the 100th annual meeting of the Endocrine Society,1 in Chicago, say artificial sweeteners can promote ”metabolic dysregulation.” If it sounds awful that because it is. Translations: just as sugar creates problems, so it seems do artificial sweeteners by messing up your body’s normal response to glucose and insulin, complicate rather than help weight loss efforts, and make you more prone to prediabetes and diabetes, especially if you are currently overweight.
How To Quit Sugar And Other Sweeteners
While sugar replacements reduce kilojoules, they don’t actually address people’s preferences for sweet foods. “I consider one of the major reasons for not going from sugar to artificial sweeteners is that they will continue to feed the desire for sweet tastes,” says Rosemary Stanton.
“One example that I often use is when people stop taking sugar in their tea , they lose the liking for sweet tea . Indeed, if you give someone a cup of sweetened tea when they no longer take sugar, they usually dislike the taste so much that they can’t drink it. However, if they had instead switched to artificial sweetener, their liking for sweet tea would not have abated in this way.”
Tips to curb your sweet addiction
Sweeteners generally replace sugar in discretionary foods which have little nutritional value. Reducing discretionary foods, regardless of what they’re sweetened with, leaves more room in your diet for nutritious foods.
If you reduce your need for sweetness, you reduce your intake of both sugar and artificial sweeteners. It’s boring advice, especially compared with fads that promise fast results, but the best approach is to stick to whole foods, as unprocessed as possible, and have everything in moderation.
Try a two-pronged approach: replace sugary foods and drinks with unsweetened substitutes, and slowly cut down on the amount of sugar you use.
Stanton suggests:
Other things to remember
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