Abstract
There is an association between the consumption of artificial sweeteners and Type 2 diabetes in cohort studies, but intervention studies do not show a clear elevation of blood glucose after the use of artificial sweeteners. The objective of this study was to examine whether two commonly used artificial sweeteners had an adverse effect on glucose control in normal-weight subjects, and in overweight and obese subjects when consumed for 2 weeks. In the study, 39 healthy subjects (body-mass index, kg/m2) (18–45) without Type 2 diabetes with an age of 18–75 years were randomly assigned to 0.6 L/day of an artificially sweetened soft drink containing acesulfame K (950) and aspartame (951) or 0.6 L/day of mineral water for 2 weeks each in a crossover study. There was a 4 week washout period with no drinks consumed. Glucose levels were read by a continuous glucose monitor (CGM) during each 2 week period. A 75 g oral glucose-tolerance test (OGTT) was performed at the beginning and end of each intervention period. Blood samples were collected at baseline, and 1 and 2 h for glucose and insulin. A 2 week intake of artificially sweetened beverage (ASB) did not alter concentrations of fasting glucose and fasting insulin, the area under the curve (AUC) for OGTT glucose and insulin, the incremental area under the curve (iAUC) for OGTT glucose and insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), and the Matsuda index compared with the baseline and with the changes after a 2 week intake of mineral water. Continuous 2 week glucose concentrations were not significantly different after a 2 week intake of ASB compared with a 2 week intake of mineral water. This study found no harmful effect of the artificially sweetened soft drink containing acesulfame K (950) and aspartame (951) on glucose control when consumed for 2 weeks by people without Type 2 diabetes.
Summary
This randomised controlled trial found that the consumption of a low/no calorie sweetened soft drink containing acesulfame K and aspartame did not alter glucose, insulin, and insulin sensitivity during 2 weeks in healthy individuals of different body weight status without Type 2 diabetes.
In a crossover design, 39 healthy adults with normal weight, overweight or obesity were randomly assigned to two groups: participants consumed 0.6 L day of a low/no calorie sweetened beverage containing 144 mg/L of aspartame and 211 mg/L of acesulphame K, or mineral water for 2 weeks with a 4-week washout period to allow for any changes to the microbiome to revert to normal. Glucose levels were read by a continuous glucose monitor (CGM). A 75 g oral glucose-tolerance test (OGTT) was performed at the beginning and end of each intervention period. There were no significant effects of the 2-week period consumption of diet beverages on fasting glucose and fasting insulin, the area under the curve (AUC) for glucose and insulin, the incremental area under the curve (iAUC) for glucose and insulin, as well as on insulin sensitivity, in comparison with baseline values and with any changes seen with mineral water. Also, the results did not differ among normal, overweight, and participants living with obesity.
Overall, this study adds further evidence to the global literature supporting that low/no calorie sweeteners do not affect glycaemic and insulinaemic control and that they do not promote insulin sensitivity.