UCLA Study Shows That Artificial Sweeteners Like Stevia, Saccharin And Sucralose Causes Glycemic Response Impairment Via Gut Microbiome

A new study led by Dr Kathleen A. Page, a Professor at the Division of Endocrinology, Department of Internal Medicine, Keck School of Medicine of the University of Southern California,-Los Angeles, has found that using artificial sweeteners like stevia, saccharin and sucralose can also cause glycemic response impairment via the gut microbiome and also cause more long term health issues.


 
Natural sugars when used in moderation are healthy but unfortunately many tend to overconsume sugars plus the fact that many processed foods and even ordinary food tend to be overladen with sugars.
 
Sugars are among the most commonly consumed flavoring agents, as their addictive sweetness enhances the taste of almost every other flavor. Sugar is found in a wide variety of foods, natural and otherwise.
 
Importantly, sugar provides instant energy and nourishes a wide range of commensal and symbiotic organisms in the human microbiome.
 
Non-nutritive sweeteners (NNS) are increasingly consumed to satisfy cravings for sweet taste without the associated calories.
 
Paradoxically, non-nutritive sweeteners have been linked to metabolic risks, but the underlying mechanisms have not been clearly understood.
 
The study team from UCLA pinpoint changes in the gut microbiome as a mechanism for non-nutritive sweetener-induced glycemic impairments in healthy adults.
 
The study findings were published in the peer reviewed journal: Cell.
https://www.cell.com/cell/fulltext/S0092-8674(22)00994-1
 
This is the first study to describe the effects of non-nutritive sweeteners (NNS), frequently used to avoid increasing calorie intake while satisfying the desire for something sweet, on the gut microbiome.
 
Many of these NNS, including stevia, saccharin and sucralose are often consumed by ignorant health-conscious individuals who want to restrict their caloric intake despite many previous studies showing the adverse metabolic effects due to the intake of these products.
 
The UCLA study findings summarizes available evidence on how the activity of the gut microbiome mediates this effect following exposure to these sweeteners.
 
Alarmingly, it is estimated that almost half of adults and 25% of children in the United States depend on NNS for their sweetness cravings. The initial surge in the consumption of these alternative sweeteners was due to their metabolic inertness.
 
In Thailand, we have a certain stupid female endocrinologist working at both a public and private hospital promoting the use of Stevia and having her distant family members promote the use Stevia sweetened herb drinks as a healthy beverage alternative. Many stupid Thais also think that consuming NNS or products only containing NNS like stevia and sucralose shows that they are very health conscious!
 
The actual mechanism of action of these sweeteners on the human gut, as well as their potential to affect human metabolic activity, remains debated.
 
This new UCLA study findings presents novel insights on how exposure to NNS affects glycemic control in humans through its effects on the gut microbiome.
 
Though previous studies have examined this aspect in rodents, limited studies are ava ilable on their impact on humans.
 
The human gut microbiome consists of trillions of microorganisms that are key to human health.
 
Interestingly when NNS are ingested, they are not digested and, as a result, become available to gut microbes. This subsequently leads to the production of intermediates and byproducts that alter host metabolism.
 
In the UCLA, four types of commercially available NNS were used to understand how they affected the gut microbiome in 120 healthy adults who had no earlier exposure to these compounds.
 
This randomized clinical trial (RCT) study included two arms, one of which involved adults who ingested one of these sweeteners daily for two weeks, with another group ingesting glucose or no sweetener. The dosage was below the acceptable limit.
 
The trial study findings reported specific effects on the microbiome and plasma metabolite profile following ingestion of each type of NNS.
 
All the NNS were reported to impair glycemic responses but saccharin and sucralose even led to even poorer glycemic responses.
 
Continuous glucose monitoring devices were used to measure glucose tolerance allowing the study team to understand how glycemic responses varied over the two weeks of the trial in a free-living setting.
 
The study findings also showed that the response to sucralose depended on the microbiome profile at baseline.
 
Dr Page told Thailand Medical News, “The study findings support the notion that differential human responses to non-nutritive sweetener exposure may be driven by unique host and microbiome features.”
 
The exact changes in gut microbiome composition and function were examined using fecal microbiota transplants from trial subjects who showed the most significant response in germ-free mice with sterile guts.
 
These identified individuals were classified as responders, indicating that they exhibited poor glycemic responses following NNS ingestion compared to baseline. Conversely, non-responders did not exhibit any change in the glycemic response.
 
Importantly when mice were transplanted with stool samples from responders, they developed impaired glycemic responses. This was unlike those that received fecal samples from non-responders. This indicates that alterations in the gut microbiome underlie the inability to normalize glucose levels when challenged with a glucose load. This condition would otherwise be referred to as glucose intolerance.
 
The study team utilized shotgun metagenomic sequencing and metabolic pathway analysis to examine different species' structural and functional aspects of the gut microbiome.
Importantly the presence of natural sugars also influenced glycemic responses. Earlier research showed a rapid increase in insulin resistance when sucralose was used with natural carbohydrates.
 
The study team plans to measure potential differences in glycemic responses following NNS intake in individuals with obesity, diabetes, and other metabolic dysregulatory diseases in future studies.
 
The study findings will heavily impact current advice to substitute NNS for natural sweeteners in such conditions, both for weight loss and to stabilize blood sugar levels.
 
More detailed studies will be warranted to correlate the results with insulin and incretin responses alongside glucose levels in response to NNS intake. This will add important information on the hormonal regulation of glucose homeostasis in this situation. In addition, a combination of NNS with natural sweeteners must be used to understand how NNS affects the metabolism of glucose and other natural sugars through the microbiome.
 
The study team added, “Unraveling mechanisms underlying metabolic consequences of non-nutritive sweetener consumption in humans may enable personalized approaches to nutritional recommendations to improve metabolic health.”
 
The study team highly recommends that people stop using NNS and instead focus on proper healthy eating and exercise to reduce calorie intakes or to manage conditions like diabetes or obesity.
 
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