Sweeteners can also raise blood sugar

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Although two artificial sweeteners, saccharin and sucralose, are not thought to increase blood sugar levels, they may induce changes in blood sugar levels by altering the human gut microbiome. The paper was published in Cell on August 19.

These sweeteners are sugar substitutes for people who suffer from metabolic diseases such as diabetes or who wish to lose weight. They are more than 200 times sweeter than sugar and have few or even zero calories.

Jotham Suez of Johns Hopkins University in the United States and colleagues tested the effects of 4 sugar substitutes on blood sugar in 120 adults in Israel with no underlying health conditions. Participants said they did not consume low-calorie sweeteners in the 6 months prior to the study.

Participants were divided into 6 groups. Over a two-week period, four of the participants consumed two packets of water-soluble aspartame, sucralose, saccharin, or stevia three times a day. All sweetener packs contain at least 96% glucose. The total daily intake of each sweetener is below the acceptable level set by the U.S. Food and Drug Administration. Group 5 consumed the same amount of glucose powder at the same time. Group 6 was not ingested.

Throughout the study and for one week before and after, all participants wore continuous blood glucose monitors. In phase 9 of the study, participants completed a glucose tolerance test. The trial measured the effectiveness of controlling blood glucose levels after glucose intake in humans.

The researchers found that, on average, people who consumed saccharin and sucralose had significantly higher blood sugar levels after the sugar tolerance test. Suez said blood sugar remained stable or even slightly lower in other groups of participants, even those who consumed glucose on a daily basis. This suggests that it is not the glucose in the sweetener pack that raises blood sugar levels.

The team also analyzed the participants’ daily stool and saliva samples and found that all 4 sweeteners significantly changed the number, activity, and type of bacteria in the gut and mouth. They took weekly blood samples and found corresponding changes in metabolites or molecules, which are byproducts of digestion.

Some changes in blood metabolites in the saccharin and sucralose groups are also present in patients with diabetes mellitus or vascular disease. Some of these are known to play a role in sugar breakdown.

The researchers transplanted stool samples from saccharin, sucralose, glucose, and people without supplementation intake into the digestive tract of the mice and found that feces transplanted from the saccharin and sucralose groups caused postprandial blood sugar in the mice to rise.

This suggests that changes in the microbiome are responsible for this result. “Sweeteners by themselves don’t raise blood sugar.” But it appears that microbial-mediated mechanisms weaken the body’s ability to control blood sugar levels after eating, Suez said.

The health effects of these microbial and metabolic changes remain unknown, and the team hopes that future research will help clarify these relationships. (Source: China Science Daily Wang Fang)

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