Not So Sweet After All

 

The news has spread far and wide that sugar has detrimental effects on our health. In an effort to reduce the amount of sugar consumed many are turning away from their favourite sugar-sweetened beverages (SSB) to low or zero-calorie alternatives. But, it’s not that simple. Research has shown that artificially sweetened beverages (ASB) are associated with the same health consequences as SSBs, in particular, weight gain, metabolic syndrome, type 2 diabetes and cardiovascular disease.

Approximately 25% of children and 41% of adults consume ASB. They comprise about one quarter of the global sweetened beverages market. However, they are not taxed or regulated to the same extent as SSBs. This is likely due to their perceived harmlessness, according to some researchers.

Weight Loss or Gain?

It was originally surmised that switching from sugar-filled drinks to 0 calories drinks would lead to weight loss. However, there is a paucity of independent research showing that that is indeed the case. There are, however, a number of studies showing the opposite. A 3-can a day habit can double one’s risk of obesity in adults that started at a healthy body weight. Further, a review of 18 separate studies showed that consuming either SSB or ASB led to weight gain in children and teens.

Metabolic Mess

It has been shown that non-nutritive sweeteners like aspartame, sucralose and saccharin disrupt the balance and diversity of our gut microbiota. Rich, diverse gut bacteria is associated with a reduced adiposity (body fat), improved insulin sensitivity and triglyceride levels, as well as, decrease in inflammation. Less diverse microbiota results in the opposite, that is, weight gain, inflammation, increased triglycerides and “bad” cholesterol.

The disruption in balance of the microbiome also results in impaired glucose tolerance which is a well-known risk factor for the development of type 2 diabetes and cardiovascular disease.

A number of studies have shown an increased risk in developing metabolic syndrome in those who consume ASB compared to those who do not. Metabolic syndrome is a term used to describe a cluster of risk factors that increase your risk for heart disease, diabetes and stroke. This may be due to the fact that a breakdown product of aspartame inhibits a gut enzyme (intestinal alkaline phosphatase) that is known to protect against metabolic syndrome.

One study showed that consuming just one ASB or one SSB a day increases the risk of developing type 2 diabetes even in participants who maintained a healthy body weight.

Physiological Confusion

Some researchers believe there may be a disconnect between the brain and the gut when we taste something sweet but no calories arrive. Sweetness should evoke numerous physiological responses that help prepare our body to metabolize the sugars into energy for immediate use or to store as glycogen or fat. Consuming sweet drinks or food should also trigger a cascade that ends up signalling to our brain when we are full. However, research on mice has shown that consuming artificial sweeteners may impair the body’s ability to respond and regulate our intake of sweet foods that contain energy (calories). In other words, if one regularly consumes artificial sweeteners and then has a piece of cake with real sugar, he may not metabolize the sugars effectively and, further, he is unlikely to feel satiated which, in turn, could lead to over-eating.

Keep Away from Kids

Artificial sweeteners may have an even more deleterious effect on children. They range from 200-700 times sweeter than regular sucrose (table sugar). When children are exposed to hyper-sweet foods they can develop a preference for them. This preference is hard to dial back and can stay with them through to adulthood. The level of sweetness they then crave cannot be satisfied by a ripe strawberry, a mango or perhaps not even by regular sugar.

What’s the answer?

Non-caloric sweeteners are not the panacea big food companies and sugar-lovers all hoped. They mess up our metabolism, lead to the same health risks as consuming regular sugar-sweetened beverages and reduce diversity in our gut which we only recently realized was an important thing to have.

The only real answer is to train your taste buds to crave less sweet things. Drink water for thirst. Reduce sugar and artificial sweeteners as much as you possibly can. A 3- month weaning process is achievable and may be more successful than cold-turkey attempts.

After all:

References:

Brown, R.J., et al. Artificial Sweeteners: A systematic review of metabolic effects in youth. International Journal of Pediatric Obesity, 2010; 00: 1–8

Gul SS. et al. Inhibition of the gut enzyme intestinal alkaline phosphatase may explain how aspartame promotes glucose intolerance and obesity in mice. Appl Physiol Nutr Metab. 2017 Jan;42(1):77-83. doi: 10.1139/apnm-2016-0346

Fowler SP1, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.  Obesity (Silver Spring). 2008 Aug;16(8):1894-900. doi: 10.1038/oby.2008.284. Epub 2008 Jun 5.

Nettleton JE1, Reimer RA2, Shearer J3. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016 Oct 1;164(Pt B):488-93. doi: 10.1016/j.physbeh.2016.04.029. Epub 2016 Apr 15.

Suez J1 et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct 9;514(7521):181-6. doi: 10.1038/nature13793. Epub 2014 Sep 17.

Susan E. Swithers Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab. 2013 Sep; 24(9): 431–441. Published online 2013 Jul 10. doi:  10.1016/j.tem.2013.05.005 

Sylvetsky AC, Jin Y, Clark EJ, Welsh JA, Rother KI, Talegawkar SA. Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. J Acad Nutr Diet. 2017 Mar;117(3):441-448.e2. doi: 10.1016/j.jand.2016.11.004. Epub 2017 Jan 10.

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