Scientists suggest the query could be misdirected.
An increasing body of research suggests that artificial sweeteners might increase the risk of heart disease and other conditions.
Though some of the world’s top scientists have called for better-designed clinical studies to examine the long-term health impacts of sugar replacements, scientists believe the results are far from conclusive.
For this reason, scientists are currently trying to learn more about how artificial sweeteners impact gut microbiota health, blood glucose levels, and cardiovascular function via independent experiments. While some research aim to find out how the alternatives effect the body in comparison to sugar, others are starting to test the alternatives against each other.
Customers now have a hard time figuring out which sugar substitute has the least health hazards. The majority of the study is observational, which means cause and effect cannot be established. In many instances, scientists observed correlations between the use of non-sugar sweeteners and the occurrence of certain health hazards, such as diabetes or heart attacks.
The FDA has authorized all of the commonly used substitutes, including erythritol, saccharin, aspartame, sucralose, stevia, and xylitol. Numerous commodities, such as energy bars, cereals, drinks, sweets, baked goods, sports drinks, yogurts, and syrups, contain them.
Professor of nutrition science and policy at Tufts University and cardiologist Dr. Dariush Mozaffarian said that despite FDA clearance, “they’re all potentially worrisome and all understudied.”
Dr. Stanley Hazen, a cardiologist at the Cleveland Clinic, discovered in a recent study that high levels of the sugar alcohol sweeteners erythritol and xylitol may make blood platelets stickier and more prone to clotting, which might increase the risk of heart attack and stroke. According to Hazen, the effect is comparable to what occurs with elevated cholesterol. Large enough clots have the potential to obstruct vital veins and arteries and stop blood flow.
Better research is needed, according to some experts, to ascertain if replacing sugar with a non-sugar sweetener is beneficial in the first place, rather than attempting to identify the safest alternative.
Hazen and his colleagues carried out the first head-to-head human experiment evaluating the effects of ingesting erythritol vs sugar on the blood platelets that govern clotting after releasing data linking erythritol to an increased risk of heart attack and stroke. Publication of the study’s findings is still awaiting.
Meanwhile, Vasanti Malik, an assistant professor of nutritional sciences at the University of Toronto, is examining the health consequences of consuming water, noncaloric sweeteners, and sugar-sweetened drinks in a research involving over 500 participants. Malik and her colleagues want to monitor heart health and obesity throughout time.
Registered dietician Valisa Hedrick of Virginia Tech is collaborating with the National Institutes of Health on a separate research that compares the effects of sugar and four different artificial sweeteners on gut flora health and blood glucose levels. Participants in the controlled feeding experiment, which focuses on individuals with prediabetes, are limited to consuming the meals that NIH offers them.
According to Hedrick, this is significant since there is rising worry about non-sugar sweeteners and how they may manipulate the brain to make people want sugar more. This might lead to an increase in sugar consumption throughout the day, which would raise blood sugar levels.
Researchers can determine if sweeteners directly elevate blood glucose levels via controlled studies, as opposed to the sugar that patients may consume later.
The restrictions on sweetener research
Reverse causality is a kind of study bias that may make it difficult to draw firm conclusions from earlier investigations, according to Malik.
After individuals begin to gain weight or get diabetes, people often alter their diets, according to Malik. These are often the ones who are most prone to go from sugar to artificial sweeteners. This is the point at which reverse causation becomes relevant.
“There is a false correlation found between the use of non-sugar sweeteners and the risk of developing diabetes,” the speaker said. In other words, the evidence ultimately points to the possibility that artificial sweeteners are exacerbating pre-existing health issues.
Additionally, reporting whether or not one has ingested non-sugar replacements is a requirement for many research, which might be problematic. Words like xylitol may be lost in a lengthy ingredient list.
While certain studies, such as those on erythritol and xylitol by Hazen, may concentrate specifically on the physiological reactions that occur in the body after the use of these sweeteners, they often only recruit a small number of participants and follow them for a brief period of time.
The CEO and co-founder of the Miami-based Prime Institute, Dr. Michelle Pearlman, is a gastroenterologist. She said, “A lot of these studies are really hard to interpret.” “The issue is that there aren’t any comparative studies comparing the effects of xylitol and candy bars, so I can’t make any general recommendations about which one is better.”
In the next years, Hedrick and Malik each want to present the findings of their own investigations.
“In addition to more thorough observational research, we need experimental science,” Malik said. “Trials are under progress, and I believe we’ll have more clarity on the subject in the next five years. Simply said, we’re not quite there.
Studies that connect alternative sweeteners to health hazards are based on erroneous research, according to a statement from the Calorie Control Council, an industry trade organization that represents more than two dozen sweetener producers. The group also claimed that the products are safe.
The president of the trade association, Carla Saunders, said in a statement that it is “irresponsible to amplify faulty research to those who look to alternative sweeteners to reduce overall sugar intake as well as the millions who use it as a tool to manage their health conditions, including obesity and diabetes.”
Why it’s critical to understand
The majority of low-calorie and sugar-free goods include one or more sugar substitutes, sometimes multiples. Particularly in the United States, the popularity of these items is rising. According to market research, the value of sugar alternatives might surpass $28.57 billion by 2033.
They’re all around us, according to Mozafarrian. And the reason they’re spreading is because people are so consumed with abstaining from sweets.
According to Mozaffarian, artificial sweeteners became very popular when the United States changed its nutrition labeling laws in 2016.
Manufacturers were now compelled by the regulation to disclose added sugars below total sugars on a separate line. The goal was to make it easier for customers to distinguish between goods that have sugars added in and those that have sugars present naturally, such as fruit and plain Greek yogurt.
“The food business now has a strong incentive to minimize the amount of “added sugars,” he said. “So, even though these compounds are present in everything, we still don’t know enough about them.”
Depending on whether they are chemically manufactured or taken from natural sources, certain items are labelled as “natural sweeteners” or “artificial sweeteners”.
According to University of Miami cardiologist Dr. Maria Carolina Delgado-Lelievre, even natural sweeteners undergo extensive chemical processing.
For instance, the FDA states that sucralose is a chemically changed form of sugar that is around 600 times sweeter than stevia, while monk fruit sweetener is derived by processing a molecule in a gourd-like fruit cultivated in China.
Human fusions of chemicals and amino acids produced aspartame and saccharin.
According to Hazen of the Cleveland Clinic, several of these sweeteners are so powerful in little amounts that they are combined with erythritol or xylitol to make them more substantial and fit inside a packet.
Hedrick noted that researchers are increasingly referring to these substances as “nonsugar sweeteners” due to this label confusion.
The dangers of adding sugars on your health
Of course, one of the most important public health issues facing the nation is sugar. Excess sugar, particularly in soda and juice, contributes to diabetes, cancer, liver disease, heart disease, and the current obesity pandemic.
But, according to Miami gastroenterologist Pearlman, there’s a significant distinction between naturally occurring sugars found in fruits and produced, concentrated sugars like high-fructose corn syrup. Sugars processed are quite addicting.
According to her, “anything containing high-fructose corn syrup activates the same brain reward centers as heroin and cocaine.” “The body responds to natural sugars from fruit differently.”
Experts concur that sugar’s poor reputation has far more to do with how much individuals eat than its inherent negative qualities.
“Sugar is added in subtle ways,” Mozaffarian said. “The industry misleads consumers into believing that foods are ‘not good,’ when it attempts to simplify that very real nuance.”
He explained that it’s normally OK to have a little amount of added sugar in otherwise healthful meals, including whole-grain cereals that have been moderately sweetened.
He said that “the harms of small amounts of added sugar have been overemphasized and the harms of these various nonsugar sweeteners have been greatly underemphasized.”
