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Artificial sweeteners: a wolf in sheep’s clothing?

In use for over a century now, artificial sweeteners are commonly used in a variety of foods, processed sodas, and other products that we routinely see on the shelf and ingest perhaps every day. Artificial sweeteners are frequently recommended to patients with prediabetes, diabetes, and obesity because they are noncaloric and don’t have an absorbable sugar.

Are they really good for us? The data on glycemic (blood sugar) control in patients with diabetes or obesity are quite mixed. What I want to share with you is why some of these artificial sweeteners are really not good and, in fact, may be bad for you.

Studies found that exposure to noncaloric artificial sweeteners, resulted in increases in hemoglobin A1c, more prediabetes, reduced glucose tolerance, impaired fasting glucose, and increased body weight and waist-to-hip ratios. So, there was this central obesity pattern seen in metabolic syndrome. These changes were all related to this exposure to noncaloric artificial sweeteners, and there seemed to be a dose-related effect. In other words, those people who used more of these noncaloric artificial sweeteners had even more pronounced effects.

Artificial sweeteners are frequently used around the world to try to decrease glucose exposure, increase glycemic control, and decrease the tendency for overweight. In fact, what we are seeing is that these artificial sweeteners actually have a profound effect on the metabolic consequences. Through a number of different pathways this can possibly increase risk of developing diabetes or exacerbation of glycemic control in patients with diabetes, and the same for obesity.

As we strive to try to improve these disease states, we actually may be making them worse. To conclude, be careful if you have diabetes or obesity. These artificial sweeteners certainly may be a part, if not the crux, of the problem, and you should discuss using these sweeteners with your physician.

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