Background: The effects of the regular intake of beverages containing high-intensity sweeteners on insulin sensitivity in healthy individuals remain controversial.
Objective: This trial compared the effects of the consumption of a carbonated beverage containing aspartame and acesulfame K (high-intensity sweeteners beverage—HISB) with those of an unsweetened, no-calorie carbonated beverage (UB) on insulin sensitivity and secretion in nondiabetic adults.
Methods: SEDULC was a randomized, double-blind, crossover study. Nondiabetic adults [mean age 31 y, 44% men, body mass index (BMI; kg/m2) 19?29] who did not consume high-intensity sweeteners were randomized 1:1 to drink 1 of the 2 carbonated beverages, 2 cans (330 mL each)/d, for 12 wk. After a 4-wk washout period, participants were switched to the opposite beverage for 12 wk. The primary outcome tested was the change in insulin sensitivity as assessed by the Matsuda Insulin Sensitivity Index (MISI) after an oral glucose load. Secondary outcomes were indexes of insulin secretion.
Results: Sixty individuals were enrolled and 50 completed the study (28 non overweight and 22 overweight participants). The change in MISI from baseline did not significantly differ between beverages and noninferiority was demonstrated (difference = –0.23; 95% CI: –1.31, 0.85; P < 0.0001). The change in insulinogenic (means ± SEMs: 0.23 ± 0.14 for HISB compared with 0.08 ± 0.1 for UB) and disposition indexes (2.70 ± 0.99 for HISB compared with 1.62 ± 0.90 for UB) did not differ, and no differences in insulin secretion estimates were confirmed by the Stumvoll indexes. Consuming the high-intensity sweeteners did not affect body weight, self-reported dietary consumption, or self-reported physical activity.
Conclusions: These findings suggest that the daily consumption of 2 cans of a beverage containing aspartame and acesulfame K over 12 wk has no significant effect on insulin sensitivity and secretion in nondiabetic adults.
The key finding of this randomised controlled trial in 50 adults is that the daily consumption of 2 cans (330 mL each) of a carbonated beverage containing aspartame and acesulfame-K for 12 weeks did not affect insulin sensitivity or insulin secretion in healthy, non-diabetic, normal- and overweight individuals, when compared to an unsweetened control beverage. Furthermore, the daily consumption of the low calorie sweetened drinks for 3 months did not affect differently energy intake, body weight or waist circumference compared to the control drink, in line with other findings.
Overall, this new study adds further evidence to previous findings supporting that the consumption of low calorie sweeteners in drinks does not negatively affect insulin sensitivity and secretion or overall glucose control, when compared to water or to an unsweetened control drink. When compared to sugar, which causes a spike in blood glucose post-prandially, low calorie sweeteners have the benefit of not affecting nor increasing blood glucose and insulin levels after consumption, as shown consistently also in a recent systematic review and meta-analysis.