Artificial Sweeteners

Oh, How Sweet!

Artificial sweeteners, also known as non-nutritive sweeteners, can be defined as “substances used instead of sugar to sweeten foods, beverages, and other products, such as oral care products and certain medications (C. 2019).” Artificial sweeteners are extremely sweet and depending on which is used, they can be anywhere between 200-12,000x sweeter than table sugar." For this reason, they are used in very small amounts and it makes them either a no-calorie or low-calorie alternative. The focus of this article will be on the effects of artificial sweeteners on weight gain and weight loss while touching on the gut microbiome. The FDA has approved 8 artificial sweeteners to be added to food and beverages. These include aspartame, saccharin, sucralose, advantame, neotame, and acesulfame potassium-k (ace-k), stevia, and luo han guo. Artificial sweeteners are a highly controversial topic due to different methodologies, differences in participants, and varying previous health among participants.


Below we are going to break down which artificial sweeteners are found in what foods and drinks, and what we do know about them so far.


Aspartame:

  • Commonly found as Equal or Nutrasweet. This sweetener must not be ingested by any persons who have phenylketonuria (PKU). It is a rare genetic disorder and aspartame can build up resulting in the central nervous system and brain damage.

Acesulfame Potassium-K (ace-k):

  • Commonly found as Sweet One and used in sugar-free drinks.

Saccharin:

  • Commonly found as Sweet ‘N Low and Sweet Twin. It is the oldest artificial sweetener to be discovered and is 200-700 times sweeter than table sugar.

Sucralose:

  • Commonly found as Splenda. It is 600 times sweeter than table sugar.

Advantame:

  • Not used in any products and is the most newly accepted artificial sweetener by the FDA. It is 20,000 times sweeter than table sugar.

Neotame:

  • Not commonly found on the market because it is approximately 7,000-13,000 times sweeter than table sugar.

Stevia:

  • Commonly found as Stevia in the Raw and Truvia. It comes from the leaves of the stevia plant, and is from South America! It's 200-300 times sweeter than table sugar.

Luo han guo:

  • Commonly found as Monk Fruit in the Raw. It's made from crushed monk fruit and is 10-250 times sweeter than table sugar.

(C. 2019)

Weight Loss & Weight Gain

Artificial sweeteners have been promoted by the FDA when it comes to combating obesity in the U.S., this is because they hold little to no calories and provide a pleasant taste. This holds true, however, there are studies that show a positive correlation between artificial sweeteners and both weight gain and weight loss. Let's look at why this might be.


One study showed that participants with multiple follow ups during a 5-7 year span had a higher BMI after using artificial sweeteners. The difference between the weight gained group and the control group who did not use any artificial sweeteners was less than 2 pounds. It is statistically significant but looking at the overall picture for the general population, it is a small increase. A meta analysis of observational studies among artificial sweeteners goes on to explain that when consuming foods or drinks with artificial sweeteners, they are usually low calorie or no calorie (Cavagnari, B. M. 2019). This is likely to make the person consuming these products make up for those calories elsewhere or find themselves saying they can eat or drink more now since the artificial sweeteners are generally low or no calories at all.


Contradictory to the above, there are studies that also show that using artificial sweeteners in the diet correlates positively with weight loss. The weight loss was approximately 1.8 lbs lost in the group consuming artificial sweeteners. This trend is similar findings to the weight gain studies that touched on above. Again, statistically significant but for clinical and everyday nutrition, not so much significance (Cavagnari, B. M. 2019). This is most likely due to the creation of a caloric deficit if a person is using artificially sweetened drinks or foods, as a replacement for a higher calorie food or drink. When it comes to studies on weight gain and loss, it’s hard to differentiate if the correlation is directly related to artificial sweeteners or if it is actually due to participant differences in the gut microbiome, glucose sensitivity, and/or overall diet.



Gut Microbiome


Some artificial sweeteners are not metabolized when ingested, meaning they move through the body unchanged. This can cause gas and bloating in some individuals as it passes through the large intestine. A study done by Jotham Suez and comrades showed that there was a correlation between an individual person’s gut microbiome and their susceptibility to artificial sweeteners (2015). Therefore, artificial sweeteners and their effects on the gut microbiome can be different for each individual. This is important as clinical and everyday nutrition moves forward since nutrition is not a “one size fits all” approach and nutrition may have to adhere to these intolerances. If you find yourself bloated or feeling uncomfortable gas when ingesting food or drinks with artificial sweeteners, reducing the amount, eliminating intake, or eliminating intake with a reintroduction phase may be beneficial. ( “check out our FODMAPs article on food elimination and reintroduction”)


Is it OK to Include Artificial Sweeteners in your Diet?


Definitely! A majority of clinical studies include large doses of artificial sweeteners that are nearly impossible to hit on a daily basis. No one should be consuming a case of pop a day! However, keeping with the overdone word of “moderation,” a Coke Zero or Sweet ‘N Low in your coffee a couple of days a week won’t hurt at all. It’s a way to keep within your daily calories and keep diversity within your normal diet, thus, creating better adherence.



References:


C. (Ed.). (2019, January 16). Sugar Substitutes. Retrieved August 25, 2020, from https://my.clevelandclinic.org/health/articles/15166-sugar-substitutes--non-nutritive-sweeteners


Suez, J., Korem, T., Zilberman-Schapira, G., Segal, E., & Elinav, E. (2015). Non-caloric artificial sweeteners and the microbiome: Findings and challenges. Gut Microbes,6(2), 149-155. doi:10.1080/19490976.2015.1017700


Cavagnari, B. M. (2019). NON-CALORIC SWEETENERS AND BODY WEIGHT. Retrieved August 25, 2020, from http://www.medicinabuenosaires.com/PMID/31048277.pdf

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