Artificial Sweeteners & Gut Health

Updated: Jan 6

Written by Monica Cvoro (Student Dietitian, Nutrition Coordinator)


Sweet, sweet Zero-sugar drinks and desserts - the power of artificial sweeteners to add flavour to food, minus the extra calories.

Artificial sweeteners are largely used by food manufacturers in diet products that advertise being sugar-free. They are commonly used to assist people with weight loss or to help them simply consume less sugar.


So, how do they work? And are they good or bad for gut health?

The Food and Drug Administration (FDA) of the United States ensures the protection of public health and food safety, and has approved the use of certain artificial sweeteners for use by food manufacturers. Approved sweeteners include Acesulfame Potassium (Ace-K), Advantame, Aspartame, Neotame, Saccharin, SGFE, certain high purity steviol glycosides and sucralose.


Artificial sweeteners are hundreds to thousands of times sweeter than regular table sugar, whereby a much, much smaller amount can be used to achieve the same sweetness that sugar provides. They are able to provide so few (or zero) calories since the body is unable to use them completely as a source of energy. The FDA have also set ‘Acceptable Daily Intakes’ of each approved sweetener, with acceptable values being so high that most people would find it very difficult to consume close to that amount in one day.

Flavour enhancers without the calories... Sounds sweet! But is it too good to be true?

Recent studies have shown the impact that artificial sweeteners can have on gut health, and the interpretations of such studies are mixed within the population and even among health professionals - with some claims that their potential gut health consequences can lead to insulin resistance and obesity.


Studies on the impact that artificial sweeteners have on the human gut microbiome are limited, with the majority of the studies in this area using mice as subjects. Some of these mice studies have shown that the use of particular artificial sweeteners does impact the ratios and abundance of certain gut bacteria, involving mostly bacteria that naturally reside in the gut in lower quantities. It’s important to note, however, that many of these mice studies use artificial sweeteners in extremely large quantities in comparison to the real-world day-to-day amounts for human consumption. They are also based on short-term trials in comparison to long-term use in humans.


Changes in a person’s gut microbiome do have flow on effects to other aspects of health, with some of these effects evidenced by science and many others unknown. As a result of artificial sweetener consumption, the alterations in the amounts of certain bacteria living in the gut (in mice studies) have not yet been proven to either positively, negative or neutrally affect overall human health, especially in the long-term.


It is also important to recognise that even small changes in a person’s diet (what they eat day to day) can also alter their gut microbiome composition. The gut microbiome is extremely unique to each individual and is constantly evolving in response to changes in the environment, the food someone eats, the amount of exercise someone does, how much sleep they get and even how stressed they are.


Like many other relatively new products and technologies, there isn’t any scientific evidence for the long-term effects of artificial sweeteners. In future, studies in large human population groups should be conducted to see if there are negative, positive or neutral impacts of these sweet compounds on all factors of health, including gut health.


Considerations for use of Artificial Sweeteners

Whether you choose to consume artificial sweeteners is a personal choice. Some questions to ask yourself when making a decision to consume artificial sweeteners include:


Do they leave me bloated or feeling sick?

Some people are sensitive to certain artificial sweeteners (such as sugar alcohols or polyols in FODMAP) - xylitol and sorbitol), and can lead to unpleasant gut symptoms such as bloating, gas or diarrhea when consumed. If you’ve found that artificial sweeteners are the culprit for such symptoms, it’s best to reduce your consumption of them.


What am I consuming them with?

Picture a meal with a nice cold diet coke coupled with either a salad or chips. The diet coke probably isn’t the biggest worry in the latter example. This is just one confounding factor that makes studying their effects in humans so complex, because the diet that goes with them likely has a greater impact on health than the sweeteners alone.


“I’m scared of all the chemicals in diet-products"

There is no need to be scared of “chemicals” with the name ‘artificial’ sweetener. Natural foods contain lots of different types of chemicals and It doesn’t necessarily mean its harmful.


Do they help me maintain a healthy body weight?

This is a major reason behind people choosing artificially sweetened foods and drinks. Consuming them alongside a healthy, balanced diet in moderation can be a great tool to decreasing overall energy intake.


If you need help with figuring out how to optimise your diet for better gut health, book an appointment with our experienced dietitian for a tailored nutriton plan.


References:
Bian, X., et al. (2017). "The artificial sweetener acesulfame potassium affects the gut microbiome and body weight gain in CD-1 mice." PloS one 12(6): e0178426.
 
Bokulich, Nicholas A. and Martin J. Blaser (2014). "A Bitter Aftertaste: Unintended Effects of Artificial Sweeteners on the Gut Microbiome." Cell Metabolism 20(5): 701-703.
 
Bryant, C. and J. McLaughlin (2016). "Low calorie sweeteners: Evidence remains lacking for effects on human gut function." Physiology & Behavior 164.
 
Chi, L., et al. (2018). "Effects of the Artificial Sweetener Neotame on the Gut Microbiome and Fecal Metabolites in Mice." Molecules (Basel, Switzerland) 23(2): 367. 

Suez, J., et al. (2014). "Artificial sweeteners induce glucose intolerance by altering the gut microbiota." Nature (London) 514(7521): 181-186.

Wang, Q.-P., et al. (2018). "Non-nutritive sweeteners possess a bacteriostatic effect and alter gut microbiota in mice." PloS one 13(7): e0199080-e0199080. 

FDA, U. (2018, 02/08/2018). "Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States." from https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states.