Artificial Sweeteners May be Linked to Greater Diabetes Risk

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Novant Health expert says newest research is not definitive

As we await more definitive research on the subject, I believe using sugar substitutes in moderation as a part of an overall well-balanced and nutritious diet is just fine.

The American Diabetes Association touts artificial sweeteners as an option to help diabetics curb their sweet tooth, but the most recent research, published in the journal Nature this September, suggests that zero-calorie sweeteners may actually be linked to an increased risk for type 2 diabetes.

The Weizmann Institute of Science in Israel recently discovered that when they fed artificial sweeteners to mice, the mice developed glucose intolerance. They then analyzed data collected from a group of about 400 people who are enrolled in an ongoing nutrition study. They found that people who heavily consume artificial sweeteners have slightly elevated HbA1C levels, a long-term measure of blood sugar, compared with people who rarely or never consume artificial sweeteners.

Finally, the researchers found seven volunteers who were not regular consumers of artificial sweeteners and asked them to consume the equivalent of 10 to 12 packets of artificial sweetener over one week. Glucose tolerance tests following the experiment revealed that some participants’ blood glucose rose to prediabetic levels.

The researchers concluded that in both the mice and human volunteers, the introduction of artificial sweeteners to their diet can alter the mix of bacteria in the gut, leading to a glucose imbalance in some subjects. It is unclear what causes the interaction between sweeteners and the microbiome.

“The new research out about sugar substitutes and our risk for type 2 diabetes is a stepping stone toward additional research to learn and understand more,” said Novant Health registered dietician Dana Plummer. “However, as a small study with many confounding variables, it does not establish a direct cause-and-effect relationship between sugar substitutes and type 2 diabetes that would currently change my recommendations.”

Artificial sweeteners are classified as food additives and are required by law to be approved by the Food and Drug Administration before they can go on the market. There are currently five FDA-approved sweeteners on the market, including Saccharin (Sweet’N Low), Aspartame (Equal), Acesulfame potassium (Sweet One) and Sucralose (Splenda). A sixth, Advantame, was introduced in May of 2014. Two types of plant-based sweeteners, including those derived from the leaves of the Stevia rebaudiana plant, fall under the FDA's "generally regarded as safe" clause and do not require explicit approval.

Despite the FDA’s approval, dieticians and medical professionals have long debated the safety of artificial sweeteners and their usefulness to patients hoping to achieve a healthy weight.

“As we await more definitive research on the subject, I believe using sugar substitutes in moderation as a part of an overall well-balanced and nutritious diet is just fine.” Plummer said.

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Kristin Moser
Novant Health
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