Over the last decade, artificial sweetener consumption has dramatically increased. With the rise of chronic health conditions such as Type 2 Diabetes, many people are investigating options to reduce their blood sugar while still being able to indulge in their food preferences. Unfortunately, the use of these artificial sweeteners does not seem as promising as we once thought they were. The WHO has recently taken the job of looking into non-nutritive sweeteners and areas of health. This article, the topic is focused on how artificial sweeteners can negatively impact gut health and provides insight into how to regain optimal health.  

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What are Artificial Sweeteners?

Sugar substitutes, also called artificial sweeteners, or low-calorie sweeteners, are often used to reduce the intake of traditional sugar. While these alternatives have no calories, they have an intensely sweet taste compared to table sugar and juice sweeteners, with some sources stating they are 200 to 700 times sweeter. There are six FDA-approved artificial sweeteners, which are: Aspartame, Advantame, Acesulfame potassium, Sucralose, Saccharin, and Neotamme. These food additives were created with the intention of providing low glycemic options for blood sugar control and weight management. Over the years, research has been inconclusive on the overall safety of the overuse of artificial sweeteners. One area there is emerging scientific evidence is the effects that these non-nutritive sugar substitutes have on gut health.

How Do Artificial Sweeteners Affect Gut Health?

Artificial sweeteners can affect gut health through the following mechanism:

Microbiome Disruption

Recent studies have found a correlation between non-caloric artificial sweeteners (NAS) and alterations in intestinal microbiota. One nutrition survey looked at 381 participants and the impact of NAS consumption on gut flora. The results revealed that in addition to clinical changes in blood pressure, BMI, and HbA1C, there was also an increase in three gut-pathogenic bacterial species: Clostridial species, Enterobacterials, and Actinobacteria. In a randomized controlled trial (RCT) of 120 healthy adults, multiple sugar substitutes were trialed- sucralose, aspartame, saccharin, or stevia. Microbial content was altered in samples of stool, oral microbiome, and plasma regardless of the artificial sweetener administration the participants received. While these recent studies do show a correlation between alternative sweeteners and gut microbiome, much of the research is in animal studies or in vitro investigations. More human trials would be beneficial in this area to evaluate the full impact that NAS can have on the intestinal microbiome and human health outcomes.

Glucose Intolerance

The microbiome changes can cause dysbiosis, an imbalanced microbial flora, which leads to glucose intolerance. Artificial sweeteners were created to combat diabetes and metabolic dysfunction, but studies are showing they can have the opposite effect. One pathway in which glucose homeostasis is disrupted by intense sweetener intake is through alteration in glucagon-like peptide 1 (GLP-1). The role of this peptide is to activate the release of insulin from the pancreas when glucose enters the body, so glucose can be properly taken up by the cells. GLP-1 also helps regulate hunger and appetite. Two randomized studies revealed that artificially sweetened beverages can increase GLP-1 secretion in comparison to water alone. The intense sweetener sucralose has been studied for its effect on metabolism, showing that when given to participants that do not normally consume NAS, there is an increase in blood glucose, insulin secretion, and a decrease in insulin clearance time following the ingestion of the NAS. This evidence suggests that the impact of non-nutritive sweeteners can negatively disrupt blood sugar regulation, thus leading to the opposite effect they are intended to prevent.

Common Names of Artificial Sweeteners To Look Out For?

Each of the FDA-approved artificial sweeteners has a chemical (scientific) name, and most of them have a common (or brand) name. It's important to read the labels and identify non-nutritive sweeteners by both their scientific and brand names. Here are the common names for each of the six approved artificial sweeteners.

Functional Medicine Labs to Test for Gut Health

The following functional medicine labs can be used to evaluate gut health:

Microbiome Assessment

Doctor's Data has a comprehensive stool test called GI360 Microbiome that will assess the abundance and diversity of gut microflora. Clostridial species, Enterobacterials, and Actinobacteria, that was part of the above-mentioned study, can be evaluated through this microbiome test along with other pathogenic microbes. This test is a great way to evaluate gut dysbiosis, which will provide you and your holistic practitioner insight that will direct targeted treatment options.

Blood Sugar Regulation Markers

A comprehensive metabolic panel (CMP) will measure key markers involved in blood sugar regulation, such as glucose and kidney function. This test should be done following a minimum of an 8-hour fast for the most accurate depiction. Additional labs that provide insight into blood sugar homeostasis include Insulin and Hemoglobin A1C (HbA1C), which is a marker indicating the average blood sugar levels from the previous 2-3 months.

Best Nutrition To Focus on Gut Health

Cultivating a healthy gut starts with nutrition. Eliminating microbiome-disrupting foods is the first step to re-establishing a healthy gut. Avoiding processed foods, food additives, and artificial sweeteners can help reduce inflammation, play a role in healing the lining of the gut, and eliminate causative factors that disrupt the microbial balance. The impact that artificial sweeteners have on glucose intolerance is an impactful reason to also change your diet for better gut functionality. Implementing a Mediterranean Diet is an effective way to support both gut health and blood sugar regulation. This complete nutrition-based diet emphasizes whole foods that are rich in fibrous vegetables, fruits, lean proteins like fish and chicken, and healthy fats, including olive oil and nuts.

Natural Sweeteners That Are Better for Gut Health

There are a few natural sweeteners that have beneficial effects on gut health. Inulin is a substance found in fruits, vegetables, and grains that have prebiotic fiber. Inulin is present in bananas, chicory root, and artichokes. One of the most common ways to utilize inulin as a natural sweetener is in powder form, added to beverages or food. This soluble fiber is great for bowel motility, blood sugar regulation, and gut microbiome diversity. Honey is another great option for natural sweetness, as it holds more nutritional value than table sugar and has fewer questionable impacts than artificial sweeteners. Intake of honey can also aid in gut microbiome balance by providing prebiotic nutrition to probiotic strains of the intestinal tract. An additional whole-food sweetener that is packed full of nutrients is dates. While these may be higher in calories, they're a great source of insoluble fiber and can curb a sweet tooth when needed. Dates have also been shown to improve bowel movements and reduce gut inflammation. Swapping these natural sweeteners, when applicable, can help reduce the use of table sugar and artificial sweeteners that are not benefiting your health and wellness from a nutrition-based aspect.

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Summary

When it comes to artificial sweeteners, there is an unfortunate impact of these no-calorie food additives. While there was hope that these six FDA-approved sweeteners would benefit diabetic and pre-diabetic individuals, there is emerging evidence of gut health dysfunction and blood glucose regulation. Recognizing how your diet influences all areas of your health, removing the obstacles to obtaining vibrant health and restoring your gut flora with beneficial natural sweeteners can all contribute to optimal health and wellness.