mmmmA sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy. Some sugar substitutes are produced by nature, and others produced synthetically. Those that are not produced by nature are, in general, called artificial sweeteners.

Artificial low-calorie sweeteners include:

  • Saccharin (Sweet'N Low, Sugar Twin). You can use it in both hot and cold foods. Avoid this sweetener if you are pregnant or breastfeeding.
  • Aspartame (NutraSweet, Equal). You can use it in both cold and warm foods. It may lose some sweetness at high temperatures. People who have a condition called phenylketonuria should avoid this sweetener.
  • Acesulfame potassium or ace-K (Sweet One, Swiss Sweet, Sunett). You can use it in both cold and hot foods, including in baking and cooking.
  • Sucralose (Splenda). You can use it in hot and cold foods, including in baking and cooking. Processed foods often contain it.
  • Advantame can be used in baked goods, soft drinks and other non-alcoholic beverages, chewing gum, candies, frostings, frozen desserts, gelatins and puddings, jams and jellies, processed fruits and fruit juices, toppings and syrups.
  • Neotame (Newtame).

Artificial, or nonnutritive sweeteners have no calories and are often used as diet aids. But while some well-designed trials have found that those randomly assigned to drink artificially sweetened beverages gained less weight than those given sugar-sweetened drinks, large population studies suggest that frequent consumption of artificial sweeteners may be linked with unanticipated consequences, including weight gain, diabetes, and other related metabolic diseases.

This fascinating and controversial study in mice and humans suggests artificial sweeteners, particularly saccharin, could lead to glucose intolerance by having an effect on gut bacteria. The fact that both the animal and human experiments seem to support this adds some weight to the findings.

A large study that followed a diverse group of 6,814 Americans ages 45 to 84 for at least five years found that those who drank diet soda at least once a day were at 67 percent greater risk of developing Type 2 diabetes than those who didn’t consume diet drinks, regardless of whether they gained weight or not, and at 36 percent greater risk of metabolic syndrome, which can be a precursor to heart disease, stroke and diabetes.

Another large study that followed thousands of residents of San Antonio for 10 years found those who drank more than 21 servings of diet drinks a week were at twice the risk of becoming overweight or obese, and the more diet soda people drank, the greater the risk.

These large observational trials do not prove cause and effect, however, and may reflect the fact that people who are gaining weight may be most likely to drink a lot of diet soda.

Dr. John Fernstrom, a University of Pittsburgh professor who is also a paid consultant to Ajinomoto, a maker of aspartame, reviewed the evidence on nonnutritive sweeteners and concluded that the evidence linking them to metabolic problems was “not convincing.”

But other scientists urge caution, saying more research is needed. They point to animal studies such as those showing that nonnutritive sweeteners alter responses to blood sugar in rats by disturbing the gut microbiome after which certain bacteria thrived.

This was proven in experiments with rats where rats with disturbed microbiome (after use of artificial sweetener) were given antibiotic that kills thrived bacteria and after antibiotic use altered microbiome of rats returned to its normal composition.  Also fecal transplant from mice with thrived bacteria to germe-free mice showed that the last ones developed signs of obesity and  diabetes, confirming that transferred feces(or stool) that contained altered microbiome (dysbiotic intestinal flora) was responsible for appearing of signs of overweight and other related disorders. May be the same trials will be done in humans, but it is very difficult to translate all the results achieved from mice to human due to many differences in genetic makeup and microbiome.

Others speculate that artificial sweeteners may disrupt the body’s ability to regulate blood sugar by stimulating sweet taste receptors throughout the digestive system or disrupting hormonal and neurobehavioral pathways that control hunger and satiety. Especially hormonal changes have been noticed after the use of aspartame. Aspartame is made of aspartic acid and phenylalanine, both of which increase level of leptin and insuline which are responsible for weight gain and diabetes. But other researchers have controversial attitudes by claiming that aspartame decreases insulin sensitivity causing insulin resistance.

Also it is possible that gut microbiome either as a third brain or second genome may compensate any dietetic loss of glucose or caloric restriction of fat through causing a change in hormonal, enzymatic and genetic balance in a such way that all this stuff results with elevated levels of glucose and increased fat storage. Our body always cares for our health by being adapted to any new condition in life through switching on any possible compensatory mechanism.

We should not forget that saccharin is found to inhibit cancer growth by inhibition of protein called carbonic anhydrase IX. This protein is found in some aggressive cancers and plays a role in the proliferation of these cancers in the brain, breast, kidneys, liver, lungs and pancreas.

Also aspartame was found to be linked with Alzheimer’s development due to its aminoacid composition that may help form aggregates that are hallmark of dementia related diseases.

Also other members of artificial sweeteners are being studied for other beneficial effects other than dietetic ones with the hope that they will yield promising results as a drug.

The best choice would be if we consume nonnutritive sweeteners in moderation and drink as much water as we can in order to avoid any harmful effect of artificial sweeteners.