Sucralose does not disrupt the gut microbiota nor cause metabolic changes linked to diabetes

Share on facebook
Share on twitter
Share on linkedin
Share on email

ISA statement in response to study by Méndez-García et al.

Brussels, 14th April 2022: The International Sweeteners Association (ISA) responds to the study by Méndez-García et al1 and points to the confirmed safety of sucralose, contrary to claims in this study that this low/no calorie sweetener could cause disorders like diabetes.

Recognised authorities have repeatedly confirmed the safety of all approved low/no calorie sweeteners, including sucralose.2,3,4 Before being approved for use on the market, all low/no calorie sweeteners have undergone a thorough safety assessment by the competent regulatory authority, such as the Joint Food and Agriculture Organisation (FAO) /World Health Organization (WHO) Expert Committee on Food Additives (JECFA), the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA).

Actually, in the study by Méndez-García et al several limitations need to be highlighted as these might have a direct impact on the study results. Firstly, the lack of habitual diet control in this study could largely affect the reported results. When conducting dietary intervention studies to assess the effects on the gut microbiome of ingredients that are added to the diet in small amounts, such as low/no calorie sweeteners, it is critical that the habitual diet of the subjects is well-characterised and the intervention diets are carefully controlled.5 In the current study, habitual diet is neither controlled nor well-characterised. Therefore, any reported changes in the gut microbiota could very likely be due to other unreported dietary differences, and not necessarily linked to low/no calorie sweeteners’ consumption.

The small sample size, the parallel study design and the lack of gut microbiota sample collection at more points of time during the intervention are additional limitations of this study.

Importantly, previous controlled clinical trials, testing higher doses of sucralose, reported no effects of sucralose on the relative abundance of intestinal bacteria.6,7 Similarly, larger clinical studies have confirmed no adverse effect of sucralose on glucose control and insulin secretion in both healthy adults and in people with diabetes.8,9

At a time when obesity and non-communicable diseases including diabetes and dental diseases remain major global health challenges, and in light of current public health recommendations to reduce overall sugar intake, all low/no calorie sweeteners can be helpful in creating healthier food environments. They provide people with a wide choice of sweet-tasting options with low or no calories, and thus can be a useful tool, when used in place of sugar and as part of a balanced diet, in helping reduce overall sugar and calorie intake10, as well as in managing blood glucose levels.11 Low/no calorie sweeteners are also not fermentable by oral bacteria, which means that they do not contribute to tooth demineralisation, which is one of the reasons for tooth decay.12

  1. Méndez-García LA, Bueno-Hernández N, Cid-Soto MA, De León KL, Mendoza-Martínez VM, Espinosa-Flores AJ, Carrero-Aguirre M, Esquivel-Velázquez M, León-Hernández M, Viurcos-Sanabria R, Ruíz-Barranco A, Cota-Arce JM, Álvarez-Lee A, De León-Nava MA, Meléndez G, Escobedo G. Ten-Week Sucralose Consumption Induces Gut Dysbiosis and Altered Glucose and Insulin Levels in Healthy Young Adults. Microorganisms. 2022; 10(2):434. https://doi.org/10.3390/microorganisms10020434
  2. http://www.fao.org/food/food-safety-quality/scientific-advice/jecfa/en/
  3. https://www.fda.gov/food/food-additives-petitions/high-intensity-sweeteners
  4. http://www.efsa.europa.eu/en/topics/topic/sweeteners
  5. Lobach AR, Roberts A, & Rowland IR.. Assessing the in vivo data on low/no-calorie sweeteners and the gut microbiota. Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association, 2019;124:385–399.
  6. Ahmad SY, Friel JK, MacKay DS. The effect of the artificial sweeteners on glucose metabolism in health adults: a randomized, double-blinded, crossover clinical trial. Appl Physiol Nutr Metab 2020;45(6):606-612
  7. Thomson P, Santibañez R, Aguirre C, Galgani J, & Garrido D. Short-term impact of sucralose consumption on the metabolic response and gut microbiome of healthy adults. British Journal of Nutrition, 2019;122(8):856-862.
  8. Grotz VL, Pi-Sunyer X, Porte D, Roberts A, & Richard Trout J. A 12-week randomized clinical trial investigating the potential for sucralose to affect glucose homeostasis. Regulatory toxicology and pharmacology 2017; 88: 22–33.
  9. Greyling A, Appleton KM, Raben A, Mela DJ. Acute glycemic and insulinemic effects of low-energy sweeteners: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2020; 112(4):1002-1014
  10. Rogers PJ and Appleton KM. The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies. Int J Obes (Lond) 2021;45(3):464-478.
  11. Diabetes UK. The use of low or no calorie sweeteners. Position Statement (Updated December 2018). Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/use-of-low-or-no-calorie-sweetners
  12. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076.