In more recent times, the US Food and Drug Administration has approved six synthetic nonnutritive sweeteners as being "generally recognized as safe": saccharin, aspartame, sucralose, neotame, acesulfame-K, and stevia. Several sugar alcohols (types of carbohydrates derived from fruit and vegetables) and naturally occurring low-calorie sweeteners extracted from monk fruit, licorice root, and other sources have saturated the market further.
As rates of obesity, type 2 diabetes, and metabolic syndrome have steadily grown, consumers have increasingly turned to artificial sweeteners as seemingly healthier alternatives to sugar, but ongoing research suggests that some of these products may not be as safe as initially suspected.
Microbiome-Altering Sugar Substitutes
Investigators have begun to elucidate the pathways by which diet, among other factors, can negatively affect gut microbiota and cause chronic inflammation. Certain research has linked widespread use of sugar substitutes with this process, which can eventually result in the development of several proinflammatory disease states.
Although some sugar substitutes have no perceived concerns, others have been shown to promote gut dysbiosis, causing chronic low-grade inflammation and contributing to insulin resistance and increased intestinal permeability. Other results have linked their use with increased mutations of Escherichia coli and increased rates of antibiotic resistance.
One study found that noncaloric artificial sweeteners, including saccharin and sucralose, contributed to intestinal dysbiosis and poor glycemic control even in short-term trials with healthy participants who didn't normally use such sweeteners. This is of particular concern, given that these products are often used by consumers seeking to decrease their sugar intake to improve glycemic control.
Sucralose is commercially available and more commonly known as Splenda. Splenda contains sucralose and maltodextrin which, together, have been linked to a significant decrease in beneficial microbes in the intestines of rats. Sucralose alone has been shown to decrease the presence of intestinal bacteria and amino acid synthesis and to increase inflammation in animals.
