Artificial Sweeteners and Gut Health

Dr. David Wiss

July 8, 2021

Gut Health

The “calorie model” of viewing nutrition generates the assumption that excess calories are the primary driver of weight gain. We now know that the calorie model is incomplete. Fortunately, there are now other explanatory models of understanding nutrition and weight science, including those focusing on gut health. We are huge proponents of increasing fiber for gut health, particularly soluble fibers. This can one way to reverse the negative associations between artificial sweeteners and the gut microbiome. 

The rise in ultra-processed food consumption since 1980 has led to excess calorie consumption and is one factor in the “obesity epidemic.” The food industry responded to the obesity and type-2 diabetes epidemics by providing non-caloric sweeteners (better known as artificial sweeteners) as “healthy” alternatives to refined sugars. It turns out these products may not be health-promoting after all. Are you surprised? The link between artificial sweeteners and gut bacteria is one example of how ultra-processed foods can be considered a public health issue. 

In this article, we review some of the latest science linking gut bacteria and artificial sweeteners. The original problems associated with artificial sweeteners are related to cancer, leading to many products losing popularity. Not surprisingly, there are always new characters on the scene, such as stevia and monk fruit. 

Sucralose (better known as Splenda) was widely accepted due to clever marketing campaigns (i.e., “made from real sugar”). Meanwhile, at the population level, Sucralose consumption was associated with rises in gut-related issues (e.g., inflammatory bowel disease) [1]. Then came stevia. It is safe to predict that scientists will eventually report adverse consequences with all artificial sweeteners. For example, it has recently been shown that stevia has the same negative impact on gut microbiota as saccharin [2]. Are you surprised? Many people ask about monk fruit. In our prediction, monk fruit will follow a similar pattern with other artificial sweeteners and gut health: reduced bacterial diversity

Artificial sweeteners designed to stave off chronic diseases may be contributing to the problem due to microbial alterations. Imbalance in gut bacteria is often described as “dysbiosis” and can result in gas, bloating, or increased inflammation. There is now sufficient evidence to show that artificial sweeteners negatively impact our gut, for example, by reducing bacterial diversity which can increase intestinal permeability. 

Animal studies have shown that one consequence of these microbial shifts is weight gain [3]. Using the calorie model, one would assume non-caloric sweeteners would lead to weight loss, but this is not the case, according to a recent systematic review [4]. A systematic review of studies on the link between artificially sweetened beverages and weight concluded that review sponsorship and authors’ financial conflicts of interest introduced bias that affected the reviews’ outcomes [5]. In other words, industry-sponsored papers report artificial sweeteners as beneficial, whereas independent articles do not. 

In an elegant study of both animals and humans, artificial sweeteners induced glucose intolerance (aberrations in blood sugar levels), leading to metabolic derangements by altering gut microbiota [6]. It has been shown that artificial sweetener consumption during pregnancy can program reward pathways in the offspring [7] and modify infant gut microbiota and metabolism [8]. A recent review concluded that saccharin, sucralose, and stevia can unfavorably change gut microbiota composition [9]. Now that we know artificial sweeteners can wreak havoc on our gut, impact our blood sugar over the long run, and perpetuate sweet dependence, can we justify still using them?  Some people say yes.         

At Wise Mind Nutrition, our goal is to help people reduce artificial sweeteners and aim to get sweetness from natural sources, including fruit, honey, and other plant foods. When you stop consuming artificial sweeteners, unsweetened food becomes more enjoyable! You might even bite into an apple or yellow bell pepper and be pleasantly surprised! Remember: there are no biochemical free rides, and there is no such thing as “getting over” – it does not exist!

Do you have experience with artificial sweeteners and gut health? Join the conversation on Instagram and share your thoughts! If you have not yet tried to reduce sugar substitute intakes and increase fiber intake, give it a shot! A high-fiber diet does work much better than taking fiber supplements. Our program can show you how to get there!

 References

1. Qin X. When and How Was the New Round of Increase in Inflammatory Bowel Disease in the United States Started? J Clin Gastroenterol. 2014;48(6):564–5.

2. Becker SL, Chiang E, Plantinga A, Carey HV, Suen G, Swoap SJ. Effect of stevia on the gut microbiota and glucose tolerance in a murine model of diet-induced obesity. Fems Microbiol Ecol. 2020;

3. Bian X, Chi L, Gao B, Tu P, Ru H, Lu K. The artificial sweetener acesulfame potassium affects the gut microbiome and body weight gain in CD-1 mice. Plos One. 2017;12(6):e0178426.

4. Toews I, Lohner S, Gaudry DK de, Sommer H, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. Bmj. 2018;364:k4718.

5. Mandrioli D, Kearns CE, Bero LA. Relationship between Research Outcomes and Risk of Bias, Study Sponsorship, and Author Financial Conflicts of Interest in Reviews of the Effects of Artificially Sweetened Beverages on Weight Outcomes: A Systematic Review of Reviews. Plos One. 2016;11(9):e0162198.

6. Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514(7521):181–6.

7. Wiss DA, Criscitelli K, Gold M, Avena N. Preclinical evidence for the addiction potential of highly palatable foods: Current developments related to maternal influence. Appetite. 2017;115:19–27.

8. Laforest-Lapointe I, Becker AB, Mandhane PJ, Turvey SE, Moraes TJ, Sears MR, et al. Maternal consumption of artificially sweetened beverages during pregnancy is associated with infant gut microbiota and metabolic modifications and increased infant body mass index. Gut Microbes. 2020;13(1):1–15.

9. Ruiz-Ojeda FJ, Plaza-Díaz J, Sáez-Lara MJ, Gil A. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials. Adv Nutr. 2019;10(suppl_1):S31–48.