Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements

Abstract

The negative impact of consuming sugar-sweetened beverages on weight and other health outcomes has been increasingly recognized; therefore, many people have turned to high-intensity sweeteners like aspartame, sucralose, and saccharin as a way to reduce the risk of these consequences. However, accumulating evidence suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease. This paper discusses these findings and considers the hypothesis that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis. Because of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic derangements.

Keywords: diabetes; obesity; sweeteners.

Figure 1

Beverage consumption and the prevalence of obesity. Line graph illustrates changes in per capita consumption of artificially sweetened beverages (ASB; red squares), sugar-sweetened beverages (SSB; black triangles), and the prevalence of obesity (blue circles) in the USA since 1962. For obesity data, years reported represent the final year of the data collection period (e.g., National Health and Nutrition Examination Survey (NHANES) II 1976–1980 shown with soda consumption data from 1980). Inset bar graph illustrates per capita consumption of ASB (red bar) and SSB (black bar) in the year 2000. Obesity data adapted from National Center for Health Statistics Health E-stats, September 2012: http://www.cdc.gov/nchs/data/hestat/obesity_adult_09_10/obesity_adult_09_10.pdf, accessed 28 May, 2013. Beverage data adapted from Beverages Worksheet. USDA Economic Research Service: http://www.ers.usda.gov/datafiles/Food_Availabily_Per_Capita_Data_System/Food_Availability/beverage.xls, accessed 28 May, 2013.