Artificial Sweeteners - Not That Sweet

Spoon with falling sugar and Rasperry on it.

Written by:
Vedanshi Mehta, Sciences - Specialization in Biology

 

When I go grocery shopping, chances are I will come across a product that has “0g sugar/low sugar” labelled on it. The increasing number of cases of diabetes worldwide provides corporations with the perfect opportunity to create products aimed at the management of diabetes. With an abundance of products committed to ditching “good ol’ sugar”, companies tend to use artificial sweeteners as a substitute to maintain a level of sweetness in their products. Even though having little to no sugar in processed foods may be beneficial for a diabetic individual, the unfortunate truth is that artificial sweeteners have the potential to cause harmful long-term effects.

I was surprised to learn that several health risks may be increased through artificial sweeteners. These include, for example, stroke, dementia, type 2 diabetes, and glucose intolerance (Pase et al., 2017; Nettleton et al., 2009). Diet drinks have been the subject of some robust research on the subject. A study examined the diet of 3,000 adults over the span of 10 years and recorded the incidence of stroke and dementia that occurred in that time frame (Pase et al., 2017). The findings were highly concerning. It turns out that adults that consumed diet drinks experienced 3 times more strokes and were 3 times more likely to be diagnosed with dementia in comparison to adults that did not consume diet drinks (Pase et al., 2017). These findings demonstrate that the consumption of a sugar-free product (e.g., diet coke) may be linked to life-threatening consequences.

Consumption of artificial sweeteners has also shown a correlation with the development of type 2 diabetes and glucose intolerance. A review study found that regular consumption of diet soda led to a 67% greater risk of developing type 2 diabetes in comparison to people who did not consume diet soda regularly (Nettleton et al., 2009). Furthermore, a study which involved injecting mice with an artificial sweetener (Saccharin) for 11 weeks found that the mice developed glucose intolerance (Suez et al., 2014). Glucose intolerance is a metabolic condition that leads to increased blood glucose levels, resulting in individuals becoming prediabetic or diabetic (Goyal et al, 2022). These studies suggest that replacing sugars with artificial sweeteners may be ineffective in avoiding diseases like diabetes.

With the rise of diabetes and having family members that are diabetic, it's tricky to watch out for my loved ones. I would want them to consume the healthier alternative, though if the healthier alternative increases glucose intolerance and may potentially make their diabetes worse, then is the diet soda worth it? It seems that developing diabetes is a hard bullet to dodge, as foods that claim to be sugar-free may have the opposite effects of what I hope for my body to experience.

Additionally, one of the neurological consequences of consuming foods with artificial sweeteners is the risk of developing an addiction for them. A study conducted on rats showed that rats may prefer saccharin over highly addictive substances such as cocaine (Lenoir et al., 2007). Their preference for artificial sweeteners demonstrates the potential for people to be addicted to food that contains these products. Dr. Ludwig (an obesity and weight loss specialist) states that people who are addicted to artificial sweeteners find healthy foods such as fruits and vegetables ‘unappealing’ or ‘unpalatable’ (Strawbridge, 2012). This can be alarming because not only does being addicted to artificial sweeteners increase the risk of developing disease, but it also deters people away from consuming nutritional foods essential for the maintenance of optimal health and well-being.

When I think of addiction, it’s often drugs and alcohol that pop into my mind. And I’m sure many other people have a similar thought process. We often think that substances that have legal consequences are correlated to being addictive. Who would think that the white crystal-like substances available on grocery store shelves across the country would have addiction effects that are similar to drugs?

Sugar makes our lives sweeter, both metaphorically and literally. It’s the dessert that we look forward to eating all day and baking cookies with our loved ones that add some delight to our lives. It’s tough to make a substance that we enjoy and indirectly brings people together a culprit for addiction. Something that we think may have positive effects on our lives, both individually and socially, may pose a serious risk for being something that we can’t live without.

Despite the evidence that many artificial sweeteners can be harmful, there are FDA-approved sweeteners that can be a healthy alternative to sugar. Stevia is a popular natural sweetener extracted from the plant Stevia rebaudiana. It can be up to 350 times sweeter than sugar, yet Stevioside, a compound found in Stevia rebaudiana, is linked to lower blood pressure and controlled blood sugar levels (Samuel et al., 2018). Monk fruit sweetener is another sweetener which is extracted from the monk fruit plant and is deemed to be a safe and healthy alternative to sugar and acts as an antioxidant (Xu et al., 2013). Sugar alcohol (xylitol), which is extracted from corn and birch wood, does not raise blood or insulin levels and is actually linked to an improvement in dental and bone health (Salli et al., 2019). Similarly, the sugar alcohol erythritol is a substitute that tastes very similar to sugar and does not raise glucose or insulin levels (Regnat, Mach, Mach-Aigner., 2018). However, the long-term effects of the sugar alcohols xylitol and erythritol remain inconclusive with more research needed. That being said, well-known sweeteners such as honey, maple syrup, coconut sugars, and molasses are also great alternatives to white sugar and can be incorporated in many different ways into one’s diet.

It is tough to win in this situation, regardless of whether someone has diabetes or not. We are advised to avoid food with sugar, but also not to have sugar-free food as it may be artificially sweetened. The best way to go about this situation is to consume foods (with or without artificial sweeteners) in moderation.

 

References:

  1.  Goyal R, Nguyen M, Jialal I. Glucose Intolerance. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499910/
  2. Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007). Intense sweetness surpasses cocaine reward. PloS one, 2(8), e698.
  3. Nettleton, J. A., Lutsey, P. L., Wang, Y., Lima, J. A., Michos, E. D., & Jacobs, D. R. (2009). Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes care, 32(4), 688-694.
  4. Pase, M. P., Himali, J. J., Beiser, A. S., Aparicio, H. J., Satizabal, C. L., Vasan, R. S., ... & Jacques, P. F. (2017). Sugar-and artificially sweetened beverages and the risks of incident stroke and dementia: a prospective cohort study. Stroke, 48(5), 1139-1146.
  5. Regnat, K., Mach, R. L., & Mach-Aigner, A. R. (2018). Erythritol as sweetener-wherefrom and whereto?. Applied microbiology and biotechnology, 102(2), 587–595. https://doi.org/10.1007/s00253-017-8654-1
  6. Salli, K., Lehtinen, M. J., Tiihonen, K., & Ouwehand, A. C. (2019). Xylitol's Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients, 11(8), 1813. https://doi.org/10.3390/nu11081813
  7. Samuel, P., Ayoob, K. T., Magnuson, B. A., Wölwer-Rieck, U., Jeppesen, P. B., Rogers, P. J., Rowland, I., & Mathews, R. (2018). Stevia Leaf to Stevia Sweetener: Exploring Its Science, Benefits, and Future Potential. The Journal of nutrition, 148(7), 1186S–1205S. https://doi.org/10.1093/jn/nxy102
  8. Sharma, A., Amarnath, S., Thulasimani, M., & Ramaswamy, S. (2016). Artificial sweeteners as a sugar substitute: Are they really safe?. Indian journal of pharmacology, 48(3), 237.
  9. Strawbridge, H. (2012). Artificial sweeteners: sugar-free, but at what cost?. Harvard Health Blog.
  10. Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., ... & Kuperman, Y. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181-186.
  11. Xu, Q., Chen, S. Y., Deng, L. D., Feng, L. P., Huang, L. Z., & Yu, R. R. (2013). Antioxidant effect of mogrosides against oxidative stress induced by palmitic acid in mouse insulinoma NIT-1 cells.
  12. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 46(11), 949–955. https://doi.org/10.1590/1414-431X20133163

 

 

 

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