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SDF Doc Pearls: Artificial Sweeteners and the Gut Microbiome


Whether you are trying to lose weight, help control your diabetes or actually prefer the taste of artificial sweeteners, many end up reaching for foods made with these sugar substitutes but is that the right choice? Long-story short, the tried and true of a healthy, well-balanced diet, exercise, and stress management will do more good for your body than trying to replace natural sugars with artificial sweeteners which may leave your body with undesirable effects. 

If you are not worried as much about your figure but more about the potential to rot your teeth, my suggestion would be to first cut back if you can, and at the very least, you should brush your teeth at least twice daily and maybe just rinse out your mouth with some refreshing water after you have a dessert. 

If you are trying to avoid artificial sweeteners but are unsure if what you are consuming contains artificial sweeteners, then at least be wary of foods and drinks labeled as “diet” or “sugar-free”. This is usually your first clue you are about to ingest something that contains artificial sweeteners. Advertising traps lure people in by touting the snack or food product is “low in sugar” or “contains no sugar.” They are hoping that the average consumer will make the assumption that such a claim means that these are healthy snack options and must be healthier than others. This is just not the case. 

When looking for healthy snack ideas, keep in mind your body needs and deserves natural whole foods to provide it the proper nutrients even if that means consuming the natural sugars that come along with it.

What are artificial sweeteners?

Artificial sweeteners are any additive sugar substitutes that are used in foods and drinks to make it sweeter and are not natural sugars (or sugar alcohols) and thus artificial. This seems somewhat straightforward but with names that mimic real sugars, sugar alcohols and ‘natural’ sweeteners this becomes quite confusing, especially because some labels and types of ingredients are not well regulated nor well defined. The clear artificial sweeteners are below:

What are Natural sweeteners? 

Natural sweeteners like Stevia are in their own category. Some consider them to be similar to the artificial list and some do not. Ultimately, they are likely a bit of both, a hybrid between artificial sweeteners and natural sugars. They are not part of the official artificial sweetener list because they are plant and fruit-based sweeteners that are derived from natural elements but are then of course highly processed and include:

What are natural sugar alcohols?

Natural sugar alcohols are used as sweeteners and bulking agents. They come from fruits and vegetables however the ones used in processed foods are produced artificially. Natural sugars include; sorbitol, mannitol, isomalt, lactitol, Hydrogenated starch hydrolysates (HSH), yacon syrup, fucitol, xylitol, erythritol, and maltitol. 

Are artificial sweeteners bad for you?

Of course, the answer is not black and white. Everything in moderation! While considering this, we have to keep in mind that these ingredients are literally added to our foods and drinks for the sole purpose of making them sweeter and thus tastier. While sugar substitutes may (and I mean may) help control your blood sugar level and may help contribute to weight loss efforts IF consumed correctly and in moderation, they also can exacerbate your sweet tooth as you grow accustomed to the sweeter taste of foods and lead you astray and further and further away from real, whole foods. In addition, they may carry with them unwanted side effects like bloating, gas and diarrhea. There is some evidence that long-term, daily use of artificial sweeteners and even natural sugar alcohols could be associated with a higher risk of stroke, heart disease and death overall although the evidence is not entirely convincing. In my opinion, stay as natural as you can while maintaining variety.

Do artificial sweeteners affect my gut health or the gut microbiome?

Artificial sweeteners affect gut health. Recent literature showed that these sweeteners reduced the diversity of the gut microbiome in the small intestine and directly affected elements of the immune system. Keep in mind though that diets high in sugars and saturated fats had similar ill effects on the gut microbiome. 

What is meant by my gut microbiome and how does it affect my health?

The gut microbiome refers to the bacteria (amongst other bugs) that we all have in our intestines (our gut) which largely contributes to keeping our gut safe and healthy. The true impacts of the gut microbiome on our health is still being learned and requires much more research but we know that a good microbiome is one that is diverse and has plenty of beneficial bacteria. Changing this (causing a gut dysbiosis) can affect our gut health and nutrient absorption into our body but also can affect our body as whole and perhaps especially our immune system, emotional state and brain function, endocrine function, metabolism and overall weight, etc. 

How to increase microbiome diversity?

If you are interested in the best gut health then again, eat as natural as you can and this will help improve your gut health. It makes sense that a diverse microbiome likes a diverse and plant-rich diet with seeds, nuts, whole grains, vegetables and fruits. With foods such as these you will be sure to have the dietary fiber and nutrients you need. Try to consume more foods with probiotics and prebiotics (food for the healthy bacteria) and avoid artificial sweeteners.

 

Citation:

1. Aspartame and Other Sweeteners in Food | FDA

2. Is Stevia an Artificial Sweetener? - Consumer Reports

3. Eat Any Sugar Alcohol Lately?

4. Dangers of Sugar Alcohols

3. Artificial sweeteners and other sugar substitutes - Mayo Clinic

4. https://www.medscape.com/viewarticle/artificial-sweeteners-alter-duodenal-microbiome-2024a100004g?form=fpf

5. How To Improve Gut Health Naturally (clevelandclinic.org)

 

Good articles but not used in this blog:

Influence of diet on the gut microbiome and implications for human health - PMC (nih.gov)

Sugar Alcohol - Yale New Haven Hospital (ynhh.org)