The Good, The Bad and the Ugly about Artificial Sweeteners

sweetness

Three of my favorite artificially sweetened beverages

 

For decades Americans have been concerned consuming about too many calories. Now we hear either that calories don’t really matter or that some calories are more equal than others. There is so much confusing information about what we should or should not eat everywhere we look, it is hard to know what to believe. Why can’t nutritionists make up their mind? I contend that it is not nutrition that we should blame but pop-nutrition. Nutritionists and dietitians have a reasonable set of guidelines for us to maintain health. Pop-nutritionists decry conventional nutrition as nutritionism1 and spout new theories of healthy eating that may or may not be based in science. Conventional nutrition holds that the biggest problem with sugar is that it contributes too many calories and too many of them empty calories. Big Food offers a solution to too many sugar calories by replacing sugar with artificial sweeteners, allowing us to have our sweets and eat them too. Pop-nutrition says sugar is bad and artificial sweeteners are worse 2

The Good. For anyone worried about gaining weight, artificial sweeteners offer the sweetness without the calories. Sweet treats bring joy and happiness to social gatherings. If we are to meet the more stringent guidelines of the amount of added sugar in our diet, artificial sweeteners provide an alternative. Diabetics can consume artificially flavored foods and beverages without worrying about sugar spikes and sugar crashes.

The Bad. Use of artificial sweeteners does not offer a free ride, however. Most people who try an artificially flavored item will tell you that the sweet taste is not exactly what you get from table sugar. Also, these sweeteners must not be all that effective as more fat people consume such products than skinny people. There is always the case of someone who orders a diet soda at a fast-food restaurant and then extra fries to make up for the missing calories in the soda.

The Ugly. The most ardent anti-sugar crusaders also tend to be the biggest critics of artificial sweeteners. They point out that artificial sweeteners are chemicals and that it has to be better to consume sugar than a chemical. There is growing evidence that the microbes in our gut control much more of our body activities than previously believed.3 These added sweeteners could be poisoning the microbes we need to prevent obesity and many other of the diseases afflicting Americans. A widely publicized study showed that artificial sweeteners may decrease our ability to process sugars.4

Single studies. Pop nutrition relies on oversimplification of conclusions from individual scientific studies. Before the information from one study can sink in, the hype starts on another one. When contradictions abound, consumers throw up their hands and say that nothing is reliable. Science moves slowly, never really reaching ultimate truth but moving inexorably closer to it. The single study4 that related artificial sweeteners to microbes in the gut and to elevated blood glucose was based on rats, a survey and seven humans. In the survey they found that obese people and diabetics were more likely to have consumed artificial sweeteners than those who did not. It was not clear if the sweeteners caused these conditions or those who had these conditions were more likely to consume low-calorie sweeteners. Of the seven humans fed high levels of artificial sweeteners for a week, four of them were less able to control glucose levels in their blood and three were unaffected. Intriguing results, but not enough to change policy on consumption of such sweeteners. Other studies have shown interesting results on how diet can affect microbes in our gut5, but there are no consistent patterns to help authorities develop meaningful recommendations.6

Personal experience. I was diagnosed with chemical diabetes, also known as prediabetes, in 1985. I went to a dietitian, and the two of us designed a diet that greatly reduced my sugar consumption, replacing it with products containing artificial sweeteners. In the intervening 30 years I have been able to control my fasted blood sugar and A1C (an indicator of how well the diabetes has been controlled in recent months) through diet alone for more than 30 years. I abandoned my 5-6 sugar-sweetened sodas a day for a more modest 3-4 artificially sweetened beverages. My consumption of artificially sweetened foods is part of a concerted plan to balance my calories consumed with those I burn to maintain my weight at or below a BMI of 25.

BOTTOM LINE: It is important that in our efforts to maintain a healthy lifestyle we not be swayed by fads, single studies or even personal testimonials like the one I provided in the previous paragraph. Research on intestinal microbes suggests that the greater the diversity of organisms present in our gut the better off we are. I am wary, however, of sweeping dietary generalizations emerging from the infant science of gut microbiology when such recommendations directly conflict with established guidelines from the much more mature field of nutrition. Such times are ripe for entrepreneurs eager to siphon money from the accounts of health-seeking eaters. Small distributors use the internet to prey on unsuspecting victims. When a customer base is developed, a small company takes over to supply the market. When that market becomes large enough, Big Food rushes in to either buy the smaller company or produce a competitive product. The superior marketing and distribution systems of large food companies bring the product to the masses until the thrill is gone and another entrepreneur introduces the next super-food or super-ingredient. We need to be cautious not to succumb to the glamour of pop-nutrition.

BTW, not only are the artificial sweeteners acesulfame potassium (Ace K), aspartame (NutraSweet), saccharin (Sweet’n Low) and sucralose (Splenda) all chemicals, so are the common sugars: fructose, glucose, maltose and sucrose. Everything we put into our mouths is chemical including water.

Next week: 100 Million Years of Food

1 Pollan, M., 2008, In Defense of Food: An Eater’s Manifesto, New York: Penguin Books.

2 Hari, V., 2015, The Food Babe Way: Break Free from the Hidden Toxins in Your Food and Lose Weight, Look Years Younger and Get Healthy in Just 21 Days, New York: Little, Brown and Company.

3 Blaser, M.J., 2014, Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues,  New York: Henry Holt and Company.

4 Suez, J., T. Korem, D. Zeevi, G. Zilberman-Schapira, C.A. Thaiss, O. Maza, D. Israeli, N. Zmora, S. Gilad, A. Weinberger, Y. Kuperman, A. Harmelin, I. Kolodkin-Gal, H. Shapiro, Z. Halpern, E. Segal and E. Elinav, 2014, Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 514:181-186.

5 Griffin, N.W., P.P. Ahern, J. Cheng, A.C. Heath, O. ILkayeva, C.B. Newgard, L. Fontana and J.I. Gordon, 2017, Prior dietary practices and connections to a human gut microbial metacommunity alter responses to diet interventions. Cell Host & Microbe 21:1-13.

6 Nettleton, J.E., R.A. Reimer and J. Shearer, 2016, Reshaping the gut microbiota: Impact of low-calorie sweeteners and the link to insulin resistance? Physiology & Behavior 164:488-293.

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