Artificial Sweetener Unknowns

 by Elaine Beulick

Artificial sweeteners, also called non-nutritive sweeteners, low-calorie, noncaloric, or high-intensity sweeteners, and sugar substitutes are increasingly being consumed in the United States and around the world (Sylvetsky et al., 2017). Currently, there are seven artificial sweeteners approved for use in the United States. These include acesulfame K, aspartame, luo han guo fruit extract, neotame, saccharin, stevia, and sucralose (Fitch & Keim, 2012). Some examples of common names of these artificial sweeteners include Splenda (sucralose), Sweet N Low (saccharin), and Equal (aspartame and acesulfame potassium). Despite their approval by the Food and Drug Administration (FDA), do we really know how safe they are? This blog post explores evidence-based research that may make you second-guess using artificial sweeteners.

(https://riverview.org/blog/uncategorized/artificial-sweeteners-are-they-safe/)

Many people use artificial sweeteners with the intended benefit of weight management. However, research challenges this benefit. Studies suggest a link between artificial sweetener use and increased weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular events (Azad et al., 2017). Hypothesized ways artificial sweeteners cause these outcomes are by altering metabolic hormones, the gut microbiome, adipose tissue, bone tissue, thyroid function, and sweet taste receptor activation (Rother et al., 2018a).

(Rother et al., 2018a).

Additionally, there is evidence of artificial sweetener use linked to earlier puberty and increased risk for premature delivery (Rother et al., 2018a). In relation to delivery, artificial sweeteners were found in cord blood, therefore the babies’ blood, and amniotic fluid, indicating babies have direct gastrointestinal/lung exposure (Halasa et al., 2020). Additionally, artificial sweeteners are transferred in breast milk (Rother et al., 2018b).

Further research is needed to truly determine the safety of artificial sweeteners. Unintended artificial sweetener exposure begins in utero and continues in infants who are breastfed. Additionally, diabetics often use artificial sweeteners to reduce sugar intake. Given all the potentially harmful metabolic outcomes among various age groups, artificial sweetener intake recommendations for every age, including throughout pregnancy and lactation, need to be questioned. 

My Opinion: After working in a research lab studying artificial sweeteners, and given the many unknowns, artificial sweeteners should be avoided when possible until the potentially harmful outcomes have been proved one way or another. 

References:

Azad, M. B., Abou-Setta, A. M., Chauhan, B. F., Rabbani, R., Lys, J., Copstein, L., Mann, A., Jeyaraman, M. M., Reid, A. E., Fiander, M., MacKay, D. S., McGavock, J., Wicklow, B., & Zarychanski, R. (2017). Nonnutritive sweeteners and cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ, 189(28), E929–E939. https://doi.org/10.1503/cmaj.161390

Fitch, C., & Keim, K. S. (2012). Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweeteners. Journal of the Academy of Nutrition and Dietetics, 112(5), 739–758. https://doi.org/10.1016/j.jand.2012.03.009

Halasa, B. C., Sylvetsky, A., Conway, E. M., Walter, P. J., Cai, H., Walter, M. F., ... & Rother, K. I. (2020). SUN-055 Prenatal Exposure to Artificial Sweeteners. Journal of the Endocrine Society, 4(Supplement_1), SUN-055.

Rother, K. I., Conway, E. M., & Sylvetsky, A. C. (2018a). How Non-nutritive Sweeteners Influence Hormones and Health. Trends in Endocrinology & Metabolism, 29(7), 455–467. https://doi.org/10.1016/j.tem.2018.04.010

Rother, K. I., Sylvetsky, A. C., Walter, P. J., Garraffo, H. M., & Fields, D. A. (2018b). Pharmacokinetics of Sucralose and Acesulfame-Potassium in Breast Milk Following Ingestion of Diet Soda. Journal of Pediatric Gastroenterology and Nutrition, 66(3), 466–470. https://doi.org/10.1097/MPG.0000000000001817

Sylvetsky, A. C., Jin, Y., Clark, E. J., Welsh, J. A., Rother, K. I., & Talegawkar, S. A. (2017). Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. Journal of the Academy of Nutrition and Dietetics, 117(3), 441-448.e2. https://doi.org/10.1016/j.jand.2016.11.004