Effect of nutritive and non-nutritive sweeteners on hemodynamic responses to acute stress: a randomized crossover trial in healthy women.

Nutrition & diabetes. 2020;10(1):1

Plain language summary

Stress may play a role in the development of non-communicable diseases such as insulin resistance and heart disease, possibly due to changed metabolism and hormone related eating behaviours. Consumption of sweet foods has been shown to decrease levels of stress hormones, but the effect of sweeteners remains controversial. This randomised control trial of 12 healthy women aimed to determine the effect of sweeteners and sugar on physiological measures related to stress. The results showed that following induced stress, there were no differences to blood pressure, heart rate, and amount of blood pumped by the heart. when consuming sugary or artificially sweetened beverages. It was concluded that the consumption of sugar and sweeteners does not affect physiological stress measures during a period of stress. However, this study does not rule out the possibility that sweeteners and sugar may contribute to non-communicable diseases in other ways. This study can be used by health care professionals to understand that certain aspects of physiological stress remain unaffected by the consumption of sugar and sweeteners.


BACKGROUND The mechanisms by which chronic stress increases the risk of non-communicable diseases remain poorly understood. On one hand, chronic stress may increase systemic vascular resistance (SVR) and blood pressure, which may lead to blood vessels injury and altered myocardial perfusion. On the other hand, chronic stress may promote the overconsumption of sugar-containing foods and favor obesity. There is indeed evidence that sweet foods are preferentially consumed to alleviate stress responses. The effects of nutritive and non-nutritive sweeteners (NNS) on hemodynamic stress responses remain however largely unknown. OBJECTIVE/DESIGN This study aimed at comparing the effects of sucrose-containing and NNS-containing drinks, as compared to unsweetened water, on hemodynamic responses to acute stress in twelve healthy female subjects. Acute stress responses were elicited by a 30-min mental stress (5-min Stroop's test alternated with 5-min mental arithmetic) and a 3-min cold pressure test (CPT), each preceded by a resting baseline period. Hemodynamic stress responses were investigated by the repeated measurement of mean arterial pressure and the continuous monitoring of cardiac output by thoracic electrical bioimpedance measurement. SVR was selected as a primary outcome because it is a sensitive measure of hemodynamic responses to acute stress procedures. RESULTS With all three drinks, SVR were not changed with mental stress (P = 0.437), but were increased with CPT (P = 0.045). Both mental stress and CPT increased mean arterial pressure and heart rate (all P < 0.001). Cardiac output increased with mental stress (P < 0.001) and remained unchanged with CPT (P = 0.252). No significant differences in hemodynamic responses were observed between water, sucrose and NNS (stress × condition, all P > 0.05). CONCLUSIONS These results demonstrate that sucrose and NNS do not alter hemodynamic responses to two different standardized acute stress protocols.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal ; Structural
Patient Centred Factors : Triggers/Sugar sweetened beverages
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : 2
Allocation concealment : No