The effect of the artificial sweeteners on glucose metabolism in healthy adults: a randomized double-blinded crossover clinical trial

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Author(s): Ahmad SY, Friel JK, MacKay DS.
Publication name: Appl Physiol Nutr Metab. 2020 Jun;45(6):606-612. doi: 10.1139/apnm-2019-0359. Epub 2019 Nov 7.
Publication year: 2019

Abstract

This study aimed to determine the effect of pure forms of sucralose and aspartame, in doses reflective of common consumption, on glucose metabolism. Healthy participants consumed pure forms of a non-nutritive sweetener (NNS) that were mixed with water and standardized to doses of 14% (0.425 g) of the acceptable daily intake (ADI) for aspartame and 20% (0.136 g) of the ADI for sucralose every day for 2 weeks. Blood samples were collected and analyzed for glucose, insulin, active glucagon-like peptide-1 (GLP-1), and leptin. Seventeen participants (10 females and 7 males; age, 24 ± 6.8 years; body mass index, 22.9 ± 2.5 kg/m2) participated in the study. The total area under the curve values of glucose, insulin, active GLP-1 and leptin were similar for the aspartame and sucralose treatment groups compared with the baseline values in healthy participants. There was no change in insulin sensitivity after NNS treatment compared with the baseline values. These findings suggest that daily repeated consumption of pure sucralose or aspartame for 2 weeks had no effect on glucose metabolism among normoglycaemic adults. However, these results need to be tested in studies with longer durations. Novelty Daily consumption of pure aspartame or sucralose for 2 weeks had no effect on glucose metabolism. Daily consumption of pure aspartame or sucralose for 2 weeks had no effect on insulin sensitivity among healthy adults.

Summary

The current randomised controlled trial that tested the effects of the daily ingestion of pure aspartame- and sucralose-based beverages on glycaemia found that 2-week consumption of the low/no calorie sweetened beverages had no effect on glucose metabolism, insulin sensitivity active GLP-1 or leptin concentrations in healthy adults.

Indexes of insulin resistance, such as HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), were also unaffected by aspartame and sucralose ingestion, suggesting that the daily consumption of low/no calorie sweeteners does not impact glucose control or insulin resistance at doses reflective of common consumption (approx. 3 cans per day).

These results are in line with findings of previously published human studies that have also shown lack of effects of low/no calorie sweeteners on glucose metabolism (Bonnet et al. 2018; Engel et al, 2017; Grotz et al. 2017; Higgins et al. 2018; Thomson et al, 2019).

Ahmad and colleagues published on a second scientific paper the results of their analysis examining the impact of the consumption of the pure form of sucralose and aspartame on the gut microbiome using samples from this trial (Ahmad et al, 2020). This additional analysis found that daily repeated consumption of pure aspartame or sucralose in doses reflective of typical high consumption have minimal effect on gut microbiota composition or on short-chain fatty acids production.

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