Artificial Sweeteners

In this episode of the podcast/newsletter, we decided to take on a beast of a topic, artificial sweeteners. Everybody has an opinion on this issue, and it can often be quite a charged opinion. Part of the problem is there is so much research on these compounds (which is a good thing) that it can often become confusing. Then when you mix in click-bait headlines designed to elicit emotion, it is a perfect recipe for misunderstanding. Our hope in this episode is to give people a good sense of where the research generally points us and give them information to make their own decisions.

We begin by looking at artificial sweeteners (AS) as it relates to appetite and energy intake (does it make you eat more?). There was some early evidence that ingesting AS in compounds that have little or no calories, like water or gum, increased appetite, although other studies did not find this effect. More research done on AS within calorie-containing foods and beverages have shown no effect on appetite. The biggest question when looking at this is does ingesting AS actually make you eat more. The data collectively shows that the majority of both long and short term trials shows that AS decreases energy intake, whereas sweeteners with calories (sugar) increases energy intake. Put another way, the data shows that AS decreases the amount of calories consumed whereas sweeteners with calories (sugar) increases the amount of calories consumed.

Next we discuss how AS relates to weight loss. Overall, the literature seems to support the use of AS for weight loss. In a trial of 163 women where one group was encouraged to eat aspartame-sweetened foods and the other group was not, the aspartame group lost significantly more weight and also regained less weight over the course of a few years. Another study saw body weight and body fat decrease in the AS group, and increase in the sucrose (regular sugar) group. The National Weight Control Registry has shown that people who have lost roughly 30 lbs and maintained for greater than a year, 53% of those people regularly consume AS beverages, and 78% of them report that this helps them control their total caloric intake. A meta-analysis looking at 15 randomized controlled trials has shown that substituting AS instead of regular calorie foods and beverages resulted in significant decreases in body weight, body fat, and waist circumference.

The next topic we looked into is AS and it’s role in glucose intolerance and possible alterations of the gut microbiome. We discuss a small study where a large dose of saccharin was given to 7 people and 4 of them developed significant impairments in glycemic response. The study also investigated how saccharin affects mice and seem to negatively affect their glucose tolerance and their intestinal microbiota. This study received a lot of press. What did not receive a lot of press was the fact that similar studies of mice and saccharin have shown the opposite effect. We also discuss many studies in humans where AS have shown no effect on glycemic responses, glucose tolerance, lipid profiles, or insulin action in Type 2 diabetes. We also looked at 2 studies where AS either did not change the gut microbiota, or did change some aspects but we are not sure if this is good, bad, or neutral. There is some evidence that ingestion of AS produced favorable changes in the gut microbiota.

Finally we look at the biggie, AS as it relates to cancer. We discuss a study that concluded higher consumers of AS had a higher overall risk of cancer. We discuss our thoughts on this study, but mainly how it conflicts with a body of evidence on the safety of AS. We discuss multiple meta-analyses finding no overall association of AS to cancer. We ultimately make the point (as we do throughout the podcast) that one study doesn’t overturn a body of evidence to the contrary.

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Simplified Takeaways…

1. AS intake in place of calorie containing foods and beverages has resulted in significant decreases in weight, body fat, and waist circumference.

2. Several studies have shown that intake of AS has had no detrimental effect on glycemic control, blood lipids, glucose tolerance, or insulin action.

3. AS intake as it relates to the gut microbiome is an area that is getting more and more research which is great. At this point, it really is hard to tell if AS affects the gut positively, negatively, or is neutral. There are studies where you could argue that AS affected the gut positively.

4. There are many studies showing AS has no association to cancer.

5. With all of these points, you can find studies that conclude the opposite. However, we make the point to try and consider where most of the research tends to point instead of basing everything on one study.

Further Reading…

1.  Study showing AS reducing body weight, body fat, and waist circumference.

2.   Study showing no adverse effects when consuming AS

3.   Study showing no overall association with AS intake and cancer

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