Artificial Sweeteners Hurt Blood Sugar
It’s a classic flip-flop that pretty well debunks the long-standing promise that switching from sugar to non-sugar sweeteners—Aspartame, Splenda, Sweet ‘n’ Lo, and the rest—can help you lose weight. This is like when fat was once wrongly blamed for all sorts of health problems—then forgiven and given its proper respect. But this time it’s about blowing away a lifetime of misconceptions about artificial sweeteners.
Worse than sweet nothings
We begin by deconstructing the false equations that link sugar with calories, and calories with weight gain. Those vastly oversimpified claims gave Big Food the perfect platform to come up with a devil’s kitchen of concoctions that tasted kind of, but not really, like sugar.
Their only “virtue” was low or no calories.
Problem solved, yes?
Not by a long shot.
Fast forward to today.
Sugar remains a problem that very much needs to be solved. But not for its caloric content—for its likely role in fueling our raging, disastrous obesity and diabetes epidemics.
The evidence is unequivocal: Sugar-filled beverages have been linked to Type 2 diabetes, stroke, heart disease, tooth decay, obesity, and, ultimately, premature death. They’re devoid of nutritional value and deliver a mega dose of calories without any accompanying satiety…or nutrition.
But a similar problem looms here. As artificial sweeteners are increasingly under the microscope, “The big controversy in this area is whether artificial sweeteners and diet beverages might be contributing to the obesity epidemic and a parallel diabetes epidemic, which is exactly what they’re supposed to help curb,” says Vasanti Malik, a Harvard researcher who has studied diet soda.
A recent study tracked users of low-calorie sweeteners in soda for 10 years along with people who don’t use artificial sugar.
The results could not be more damning.
The low-calorie sweetener users were:
- Had larger waist circumferences
- Had more abdominal obesity than the non-users
These results point to an unwanted effect on “visceral fat deposition,” which is linked to a higher risk of cardiovascular disease, and type 2 diabetes, and to breast cancer in women.
An earlier study looked at the relationship between consumption of artificially sweetened beverages and long-term weight gain in 3,682 people. Drinking diet soda was associated with an almost doubled risk of overweight or obesity.
Other research on diabetes has come to similar conclusions—as well as somewhat contradictory ones.
- A 2015 study found that regular consumption of sugary drinks was associated with diabetes—but so was consumption of diet drinks.
- A 2014 study found modest weight losses of about 1.75 pounds associated with substituting sugary drinks with low-calorie alternatives in higher quality randomized trials.
- A study published in 2012 found that people who replaced sugary soft drinks with diet beverages also lost some weight after six months. Their results were about the same as the group that gave up sugary soft drinks and drank water instead.
I’m usually of two minds in situations like this. As a physician, I love data. I require it to make good decisions.
But as a practitioner, in daily contact with people who really need help, there’s a side of me that relies on intuition, as well as data.
This is just my way of saying, yes, the jury is out and the data aren’t all in on artificial sweeteners. But I’ve got a strong, informed hunch that nothing good can come of all but two of them. Details later.
Why diet soda may promote weight gain
Several hypotheses are making their way into and through studies.
Emerging evidence from studies done on rodents suggests the chemicals in artificial sweeteners cause disturbances in the gut microflora, which are, of course, associated with metabolic disorders like diabetes and obesity.
The research community is serving up a delicious buffet of data supporting this line of inquiry and others.
- A new mice study found that the sweetener aspartame blocks an enzyme called intestinal alkaline phosphatase that has been shown to prevent obesity, diabetes, and metabolic syndrome.
- There’s also research that indicates fake sweeteners increase sugar cravings. Studies with people show that the taste of sweetness, whether real or artificial, can increase appetite and cause people to eat more. Just what we don’t need.
- Other small studiesdemonstrated that when people are given sucralose, they experience a rush of insulin that doesn’t lead to a decrease in blood glucose levels, as if the artificial sweetener is preventing the insulin from being as effective as it ought to be. This is the hallmark of insulin resistance and a harbinger of diabetes.
One idea here is that fake sugars may trigger our body’s customary responses to real sugar. When we taste something sweet, our body says “Sugar!” and releases hormones like insulin, preparing to metabolize what our body thinks is sugar.
But no sugar ever shows up. Instead, it’s an artificial sweetener.
So the next time something sweet arrives in the gut, the gut says “You’re not gonna fool me again—I’m holding back the insulin response until I figure out what’s going on.”
“The learned responses get blunted or go away,” explained Susan Swithers, a professor at Purdue University who has studied artificial sweeteners.
So fake sugar may scramble our body’s ability to metabolize real sugar, which leads in a pretty straight line to metabolic problems like diabetes and obesity.
With that as just one of several chilling possibilities, doctor’s orders are here.
Do not consume anything that contains Aspartame, which is sold as NutraSweet, Spoonful, Equal, and other trade names.
It’s technically a neurotoxin, linked to (so far):
- Cardiovascular disease
- Alzheimer’s disease
- Vision loss
- Parkinson’s disease
- Multiple sclerosis
And avoid all of these FDA-approved sweeteners as well:
- Acesulfame Potassium (Acesulfame K)
Take your honey out to eat. Pure, raw, organic honey isn’t just delicious. It’s one of nature’s most versatile and potent health givers—so rich in macronutrients, micronutrients, enzymes, probiotics, and prebiotics that we haven’t even figured out exactly how they all work.
We do know it was used by our forebears as both a sweetener and a medicinal ingredient for centuries. There are 8,000-year-old cave paintings in Spain that prove it.
That means today, our bodies are far readier to work with honey than with the chemical shocks delivered by non-natural sweeteners.
Still…moderation, my friends. A little goes a long way.
Stick with Stevia, a plant originally grown in Brazil and Paraguay, where it’s been used as a sweetener for centuries. The stevia extract we can buy is 200–300 times sweeter than white table sugar. Like honey, a little goes a long way, which is how you should use it—a little at a time.
By the way, some weight loss programs recommend stevia based on the old “no calories” claim, but that’s not the way to lose weight. Don’t go there. Get your doctor’s advice.
- Nettleton, Jennifer et al “Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)” Diabetes Care.Published April, 2009 32(4): 688-694. Last accessed January 15 2017.
- Pepino, Yanina et al “Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load” Diabetes Care. Published April, 2013. Last accessed January 15 2017.
- Chia , Chee et al. “Chronic Low-Calorie Sweetener Use and Risk of Abdominal Obesity among Older Adults: A Cohort Study” PLOS ONE. Published November 23, 2016. Last accessed January 15, 2017.
- “The science of why you might want to kick your diet soda habit” Updated Nov 28, 2016. Last accessed January 15 2017.
- Bollinger, Ty “Is Aspartame Dangerous?” with Dr. Daniel Nuzum (video) Artificial Sweeteners. Published NA. Last accessed January 15, 2017.
- Suez, Jotham et al. “Artificial sweeteners induce glucose intolerance by altering the gut microbiota” Published September 17 2014. Last accessed January 15, 2017.
Last Updated: August 16, 2018
Originally Published: February 10, 2017