March 3, 2020

expert reaction to study looking at an artificial sweetener and carbohydrate consumption

Research, published in the journal Cell Metabolismi, reports on the relationship between an artificial sweetener and carbohydrate consumption. 

Dr Sarah Berry, Senior Lecturer, Nutritional Sciences, King’s College London, said:

“With the increasing awareness of the negative impact of sugar on health, the consumption of artificial sweeteners has increased dramatically in recent years and looks set to increase further.

“However, there is very limited research in humans on the effect of sweeteners on health outcomes, and many of the studies report conflicting results. This is partly because of the complex interacting mechanisms whereby sweeteners may impact health. Additionally, there are many sweeteners on the market which have varying properties, are metabolised differently and impact different possible pathways involved in their effects on health.

“The study included a well-defined appropriate control arm and addressed important questions regarding the short term (immediate hours post-consumption) and long term (after 2 weeks of regular consumption) effect of sweeteners, allowing the acute and chronic effects of sweeteners to be addressed. This is relevant because the short and long term effects of sweeteners are likely to be mediated by different mechanisms. However, whilst the study design was robust and the results are interesting, it is noteworthy that the study only investigated one type of sweetener and the study was terminated early for ethical reasons resulting in a small sample size.

“From a public health perspective, this research is relevant in the context that we typically consume sweeteners alongside carbohydrate containing foods. For example, sweeteners are found in many refined low calorie and low sugar foods in conjunction with other carbohydrates. What is interesting is that when the sweeteners were consumed in isolation, as is often the case for sweetened ‘diet’ drinks, they did not induce the same negative effect on glucose metabolism compared to when they were consumed together with carbohydrates.

“A note of caution; these results cannot be generalised to all sweeteners because the main types of different sweeteners commonly incorporated into our foods and drinks (including sucralose, aspartame, saccharin and Ace-K) are metabolised differently and therefore will have different health effects.

“As with all foods and drinks, occasional consumption of diet drinks or foods containing sweeteners is not going to be harmful to health. However, this research supports previous findings to suggest that we should not see diet drinks as a healthy alternative to sugar sweetened drinks. The results from this study do not support the suggestion that we would be better off swopping diet coke for full sugar coke, partly because diet coke does not contain the specific sweetener – sucralose – that this study looks at. Taken together with the evidence to support a detrimental effect of sugar on health, we should avoid excessive consumption of both sugar rich and artificial sweetened drinks and foods. Therefore, we should not be swopping diet drinks for full sugar drinks, but should be encouraging the consumption of water.”

‘Short-term consumption of sucralose with, but not without, carbohydrate impairs neural and metabolic sensitivity to sugar’ by Dalenberg et al. was published in Cell Metabolism at 16:00 UK time on Tuesday 3^rd March.

DOI: 10.1016/j.celrep.2020.02.019

Declared interests

Dr Sarah Berry: “I am consultant to Zoe Global Ltd.”