Consumption of non-caloric artificial sweeteners (NAS), commonly found in diet sodas, had a deleterious impact on postprandial glycemic response in healthy subjects, a new double-blind randomized trial found .
Artificially sweetened beverages (ASBs) are thought to be healthier than sugar sweetened beverages because they contain little or no sugar. However, an increasing number of large-scale epidemiological studies have reported an unfavorable association between the consumption of ASBs and increased risks of type 2 diabetes, metabolic syndrome, obesity, cardiovascular disease, and even neurocognitive disorders (click here for additional info). The mechanisms via which NAS increase disease risks are not fully understood, but it has been shown in animal models that NAS can induce glucose intolerance .
A group of researchers led by Dr. Richard Young from the University of Adelaide (Adelaide, Australia) conducted a clinical trial to investigate whether NAS affected glucose response in humans. They recruited 27 healthy adults and randomized them to dietary supplementation with a NAS combination (92 mg sucralose and 52 mg acesulfame-K per day) or placebo for 2 weeks. The amount of NAS consumed was equivalent to roughly 4 cans of diet soda daily. Volunteers then underwent an endoscopy incorporating a 30-minute intraduodenal glucose infusion (a technique to help assess glucose absorption and glycemic response) and biopsy collection before and immediately after the intervention.
They found that 2 weeks of dietary NAS intake increased glucose absorption by 23%, increased blood glucose by 27%, and reduced glucagon-like peptide-1 (GLP-1) levels by 35% compared to baseline. These measures were not altered in participants taking placebo. These data indicated NAS could reduce the body’s control of blood glucose levels, exaggerate postprandial glycemic response, and could potentially predispose consumers to type 2 diabetes.
The results of this study were presented as a late breaking abstract at the European Association for the Study of Diabetes (EASD) 2017 Annual Meeting in Lisbon, Portugal (September, 2017).
Why is this Clinically Relevant?
- Nearly 40% of adults and 25% of children in the U.S. consume ASBs daily 
- Most consumers still believe that ASBs are healthier alternatives for weight management and glucose control. However, increasing number of studies are indicating otherwise
- For example, data from seven randomized clinical trials found that consumption of ASBs was not beneficial for weight reduction over 6 to 24 months 
- Results from the current study provide a probable mechanistic explanation on how NAS negatively impact our health
 Young, R.L., et al., Impact of artificial sweeteners on glycaemic control in healthy humans [abstract], in European Association for the Study of Diabetes Annual Meeting 2017. Lisbon, Portugal.
 Suez, J., et al., Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 2014. 514(7521): p. 181-6.
 Sylvetsky, A.C., et al., Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. J Acad Nutr Diet, 2017. 117(3): p. 441-448 e2.
 Azad, M.B., et al., Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ, 2017. 189(28): p. E929-E939.