Cardiovascular health

Artificial sweeteners better than sugar?


People who use artificial sweeteners are generally health conscious and believe they are having a healthier choice by taking artificial sweeteners. Recent evidence shows this might not be the case.

More than 40% of adult americans report that they use artificial sweeteners, and the actual percentage is even higher because of the unknowing intake of artificial sweeteners in prepared foods and beverages. While there is one previous report that artificial sweeteners intake is observed to be related to higher BMI (body mass index) and diabetes, the correlation doesn’t convincingly show the causative effect. Also the scientific and experimental evidence was missed.

I have kept  my interest on this topic because from my observation of the limited numbers of cases in my practice, I indeed saw such a trend in my patients: giving up sugar with artificial sweeteners (Sucralose, Saccharin, Cyclamate, Acesulfame potassium, Neotame, Stevia, Aspartame and Advantame) seems slightly associate with some weight gain. But I couldn’t explain the mechanism, so I haven’t been sure about this.

How does sweetener cause obesity?

Now at the European Association for the Study of Diabetes (EASD) Annual Meeting September 14, 2017, Lisbon, Portugal, a poster seems to be able to explain some of the mechanisms. Sweeteners disrupts the regular glucose uptake at the intestine by increasing glucose absorption.  Sweeteners may also disrupt the normal gut microbiome and lead to the selection of a more obesogenic microbiome. Even though some claims that sweeteners cause insulin intolerance, there is still no final scientific conclusions regarding the use of artificial sweeteners. It seems that most of the time natural or just nothing is better than the modern artificial replacements.