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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Wednesday, October 8, 2014

ARTIFICIAL SWEETENERS MAY IMPACT BLOOD SUGAR CONTROL


A set of intriguing but preliminary studies on mice and humans suggests that consumption of artificial sweeteners may impair the body's ability to regulate blood sugar.  The studies also suggest that this disruption of blood sugar control is due to changes in intestinal bacteria caused by artificial sweeteners. Artificial sweeteners have typically been recommended to persons with diabetes and excess weight because, unlike sugar and other natural sweeteners, they contain no calories or carbohydrates.  However, if the results of these studies hold true in future investigations, than artificial sweeteners may actually cause metabolic changes that increase the risk for diabetes. 
 
First, the researchers added three artificial sweeteners, either sucralose (Splenda), aspartame (Equal), or saccharin (Sweet n' Low), to the water of three groups of mice. Three other control groups of mice were given normal water or water with added sucrose or glucose. 11 weeks later, the mice consuming artificial sweeteners exhibited glucose intolerance (a condition in which there are greater blood sugar increases and a reduced capacity to lower blood sugar after a meal).  

The researchers then tested whether gut bacteria changes might be responsible for the metabolic changes of the mice fed the artificial sweeteners.  When they gave the artificial sweetener fed mice antibiotics that eliminated the bacteria living in their intestines, they found that the metabolic problems went away. Researchers also found they could glucose intolerance in healthy mice never exposed to artificial sweeteners by transplanting gut bacteria from the mice who had been fed saccharine.  Researchers hypothesize that when gut bacteria come into contact with artificial sweeteners, they produce substances that increase bodily inflammation and glucose intolerance.  Notably, the changes researchers observed in the gut bacteria of the mice consuming artificial sweeteners resembled the patterns of microbiota that are observed in mice with obesity and diabetes.  A previous study found similar changes in the microbiota of rats given sucralose (Splenda).

The researchers then evaluated a group of nearly 400 people who were long-term users of artificial sweeteners.   The researchers found that they were more likely to have glucose intolerance compared with people who don't normally use such sweeteners.  In a small follow-up experiment, the researchers tested blood sugar levels of seven people who don't normally consume artificial sweeteners. The researchers found that four of these people had higher fasting blood sugar levels and greater glucose intolerance after consuming the U.S Food and Drug Administration's maximum recommended daily amount of saccharine (equivalent to 8.5 packets of Sweet n' Low) for six days straight .

Previous studies on the health effects of artificial sweeteners have yielded conflicting findings. Some have found the sweeteners were associated with weight loss while others have found the exact opposite, that people who drank diet soda actually weighed more and had higher rates of excess weight and diabetes, but this may be due to the fact that persons using artificial sweeteners are doing so because they are overweight.  A recent observational study involving more than 300,000 people showed no association between consumption of artificially sweetened drinks and the development of diabetes. 

What to do:  Certainly much larger studies on humans need to be conducted before definitive conclusions about the effect of artificial sweeteners on gut bacteria and glucose intolerance can be made.  Meantime, a single 20-ounce regular soda has nearly 20 teaspoons of sugar and there is ample evidence that consumption of sugary drinks is strongly linked to excess weight which drives the development of diabetes.  So, diet drinks are likely a better alternative to regular sweet drinks if you must consume them.  But, your best bet is to drop the sweet tasting drink habit and go for water.  For added taste appeal, try flavoring water or seltzer with lemon, oranges, mint, a splash of juice, cucumbers, or herbal tea.

Sources:
Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota.  Nature.  2014;514;181-186. DOI: 10.1038/nature13793 

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, et al.  Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.  Journal of Toxicology & Environmental Health. 2008;71(21):1415-29. DOI: 10.1080/15287390802328630

Adapted from articles available at:

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