Plain language summary
Artificial sweeteners gained popularity in the past decade, especially in the food industry. Up until recently, people generally considered it a better option to decrease sugar consumption and reduce obesity and Type 2 Diabetes. This randomised crossover study looked at the adverse effects of two commonly used artificial sweeteners on normal-weight subjects, overweight and obese subjects. A total of 39 healthy subjects without Type 2 Diabetes participated in this study. For two weeks, participants consumed 0.6 litres of a commercially branded soft drink containing acesulfame K and aspartame to assess the effects of the ingredients on glucose homeostasis. During the two-week treatment period, the healthy subjects did not show any significant detrimental impact of artificially sweetened beverages on glucose, insulin and insulin sensitivity. However, the study population was small, and the study was conducted only for a relatively short period. Therefore, further, longer-term robust studies are required to estimate the significance of the detrimental effect of artificially sweetened beverages on glucose homeostasis. Nevertheless, this study can help healthcare practitioners understand the short-term impact of artificial sweeteners, keeping in mind that further research is needed to investigate the effects.
Abstract
There is an association between the consumption of artificial sweeteners and Type 2 diabetes in cohort studies, but intervention studies do not show a clear elevation of blood glucose after the use of artificial sweeteners. The objective of this study was to examine whether two commonly used artificial sweeteners had an adverse effect on glucose control in normal-weight subjects, and in overweight and obese subjects when consumed for 2 weeks. In the study, 39 healthy subjects (body-mass index, kg/m2) (18-45) without Type 2 diabetes with an age of 18-75 years were randomly assigned to 0.6 L/day of an artificially sweetened soft drink containing acesulfame K (950) and aspartame (951) or 0.6 L/day of mineral water for 2 weeks each in a crossover study. There was a 4 week washout period with no drinks consumed. Glucose levels were read by a continuous glucose monitor (CGM) during each 2 week period. A 75 g oral glucose-tolerance test (OGTT) was performed at the beginning and end of each intervention period. Blood samples were collected at baseline, and 1 and 2 h for glucose and insulin. A 2 week intake of artificially sweetened beverage (ASB) did not alter concentrations of fasting glucose and fasting insulin, the area under the curve (AUC) for OGTT glucose and insulin, the incremental area under the curve (iAUC) for OGTT glucose and insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), and the Matsuda index compared with the baseline and with the changes after a 2 week intake of mineral water. Continuous 2 week glucose concentrations were not significantly different after a 2 week intake of ASB compared with a 2 week intake of mineral water. This study found no harmful effect of the artificially sweetened soft drink containing acesulfame K (950) and aspartame (951) on glucose control when consumed for 2 weeks by people without Type 2 diabetes.
Methodological quality
Jadad score
:
2
Allocation concealment
:
Yes
