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How Artificial Sweeteners Be bad for your Brain?


How Be Artificial Sweeteners bad for your Brain?

Artificial Sweeteners

Sugar-Sweetened and Artificially Sweetened Beverages about Stroke and Dementia

  • A sweetened beverage is any beverage with added sugar. It has been described as “liquid candy.
  • Consumption of sweetened beverages has been linked to weight gain, obesity, and associated health risks.
  • According to the CDC, sweetened beverages are associated with unhealthy behaviours like smoking and not getting enough sleep and exercise. In addition to eating fast food often and not enough fruits regularly.
  • A sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy.
  • Some sugar substitutes are produced by nature, and others are produced synthetically.
  • Those that are not produced by nature are, in general, called artificial sweeteners. 
  • In 2017, sucralose was the most common sugar substitute in manufacturing foods and beverages.

Non-nutritive sweeteners

  • Non-nutritive sweeteners(NNSs) have been introduced into the market in non-caloric drinks such as diet sodas.
  • These artificial sweeteners are popular due to the growing demand for alternatives to SSBs.
  • Consumption of artificially sweetened beverages (ASBs) with low-caloric NNSs has risen worldwide in recent years
  • Artificial sweeteners are synthetic sugar substitutes.
  • On the other hand, it may be derived from naturally occurring substances, including herbs or sugar. Artificial sweeteners are also known as intense sweeteners. This is because they are many times sweeter than regular sugar.
  • Sweeteners as artificial sweeteners such as stevia, sucralose, aspartame, sugar substitutes, and stevia sugar.

FDA Approve artificial sweeteners

  • The FDA approved five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved one natural low-calorie sweetener, stevia. How the human body and brain respond to these sweeteners is very complex.
Artificial Sweeteners
  • One concern is that people who use artificial sweeteners may replace the lost calories through other sources. Therefore, possibly offsetting weight loss or health benefits, says Dr Ludwig. This can happen because we like to fool ourselves: “I’m drinking diet soda, so it’s okay to have cake.” The AHA and ADA also added this caveat to their recommendation.

The Artificial Sweeteners in the Soft Drinks?

  • A soft drink is a drink that typically contains carbonated water, a sweetener, and a natural or artificial flavouring.
  • The sweetener may be sugar, high-fructose corn syrup, fruit juice, sugar substitutes (in the case of diet drinks), or some combination.
  • Soft drinks may also contain caffeine, colourings, preservatives, and other ingredients. (1)
  • As measured by the recommendation of the 2015 World Health Organization “WHO” Guideline on the intake of free sugars, a single can of sugar-sweetened soda contains about the upper limit of the recommended 25 to 50 g per day. (2) 

The risk associated with sugar-sweetened soft drinks and Artificial Sweeteners

Artificial Sweeteners

  • Both Cancer Research UK and the US National Cancer Institute have said sweeteners don’t cause cancer.
  • “Large studies looking at people have now provided strong evidence that artificial sweeteners are safe for humans,” states Cancer Research UK. This is for cancer risk. What about the vascular and metabolic risks?

What about the other metabolic risks?

  • The interpretation of the association between ASB consumption and vascular outcomes is more controversial. Is there a direct or indirect causal pathway, or is there any association
  • As there is an increase of bias from reverse causation? People are at increased risk of vascular events. This is because preexisting vascular risk factors may switch from regular to diet soft drinks to control weight and insulin resistance.
  • It is possible that the intake of ASB starts after the cardiovascular risk is increased and, therefore, is a marker of a high-risk profile rather than being a causal risk factor for stroke or dementia.
  • The data interpreted in favour of this hypothesis: compared with people with a high intake of SSBs, participants regularly consuming ASB showed a higher prevalence of hypertension, diabetes mellitus, and cardiovascular disease.
  • Whether the observed associations between ASBs and vascular outcomes reflect reverse causation bias is difficult to elucidate.
  • In the epidemiological literature, adjustment for vascular risk factors has typically attenuated many of the effects of ASBs. This can be interpreted as either a reduction in bias because of confounding or blocking potential indirect causal pathways through which ASB consumption may impact cerebrovascular health.
  • ASB consumption may occur because of weight gain but could also exacerbate these conditions.
  • The regular consumption of sugar-sweetened soft drinks is associated with weight gain, metabolic syndrome, and type 2 diabetes mellitus (3)

The Meta-Analysis from American Diabetic Association?

Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes “Meta-Analysis from ADA”

Artificial Sweeteners

  • The ADA meta-analysis aims to address the relation between the consumption of sugar-sweetened beverages (SSBs). That includes soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks that have risen across the globe.
  • Regular consumption of SSBs associated with weight gain and risk of overweight and obesity.
  • Furthermore, the role of SSBs in the development of related chronic metabolic diseases.
  • Examples of these risks, such as metabolic syndrome and type 2 diabetes, are not quantitatively reviewed. For these reasons, they did this meta-analysis.
  • The conclusion Findings from their meta-analyses show a clear link between SSB consumption and risk of metabolic syndrome and type 2 diabetes. 
  • Short-term experimental studies suggest that fructose.
  • This is a constituent of sucrose and high-fructose corn syrup in relatively equal parts.

Artificial Sweeteners Adverse Effects

  • Therefore, it may exert particularly adverse metabolic effects compared with glucose.
  • Fructose is preferentially metabolised to lipids in the liver, leading to increased hepatic de novo lipogenesis, the development of high triglycerides, low HDL cholesterol, small, dense LDL, atherogenic dyslipidemia, and insulin resistance.
  • In summary, this meta-analysis demonstrated that higher consumption of SSBs.
  • Artificial sweeteners relation to the development of metabolic syndrome and type 2 diabetes.
  • It further supports limiting the consumption of these beverages in place of healthy alternatives such as water to reduce obesity-related chronic disease risk.
  • Furthermore, higher sugar-sweetened beverages are associated with increased hypertension and coronary heart disease risks. In addition to stroke, adverse changes in lipid levels and inflammatory markers. (4)
  • Others associated sugar-sweetened beverages with cardio-metabolic diseases, which may increase the risk of stroke and dementia.
  • This is because such beverages provide a high dose of added sugar.
  • Moreover, it leads to a rapid spike in blood glucose and insulin. This is providinprovidesg a plausible mechanism to link consumption to the development of stroke and dementia.(5)

The outcome of recent studies on Artificial Sweeteners

Artificial Sweeteners

  • According to recent studies, more than 50.000 cardiometabolic deaths in US adults can be attributed to high sugar-sweetened beverage consumption. Moreover, making them the leading factor associated with cardiometabolic mortality in young and middle-aged adults. (6)
  • For healthier alternatives, some consume diet drinks which contain sugar substitutes. A sugar substitute is a food additive that provides a sweet taste like sugar. This is because of containing significantly less food energy.
  • Some sugar substitutes are produced by nature. In addition to synthetically substitutes. Those produced by nature are, in general, called artificial sweeteners. (7)

Artificial Sweeteners Beverages

Artificial Sweeteners

  • Artificially sweetened beverages sweetened with non-nutritive sweeteners, such as saccharin, acesulfame, aspartame, neotame, sucralose or stevia.
  • These synthetic substances are much more potent than sucrose, with only trace amounts needed to generate the sensation of sweetness (5).
  • Artificially sweetened beverages marketed as healthier alternatives to sugar-sweetened beverages. Therefore, their consumption is rising worldwide, particularly among children (8).
  • However, The American Heart Association “AHA” and the American Diabetes Association “ADA” have been cautious not to use artificial sweeteners in place of sugar to combat obesity.
  • In addition to metabolic syndrome and diabetes mellitus. But there is still uncertainty about the benefits and healthfulness of artificial sweeteners(9).
  • Although conflicting findings have been reported,  several large observational studies, including the Atherosclerosis Risk in Communities Study,(10)
  • In addition, the Framingham Heart Study (11)and the Multi-Ethnic Study of Atherosclerosis(12) reported meaningful outcomes. The outcome is the positive association between diet soda consumption, increased risks of metabolic syndrome, and type 2 diabetes mellitus.
  • Moreover, the results from the Northern Manhattan Study indicated that diet soda consumption was associated with an increased risk of stroke, myocardial infarction, and vascular death. (13)

The relation between consumption of Artificial Sweeteners and stroke

Artificial Sweeteners

  • In this issue, Paseetal, in their study, analysed the relationship between long-term consumption of sugar-sweetened beverages and artificially sweetened beverages. Furthermore, the risks of incident stroke and dementia.
  • The authors found that during a follow-up of 10 years, higher recent and cumulative intake of artificially sweetened soft drinks was associated with an increased risk of ischemic stroke. In addition to dementia and Alzheimer’s dementia.
  • Even though some longitudinal studies have not confirmed the association between the intake of artificially sweetened beverages and cardiovascular disease risk. Others assumed that sugar-sweetened and artificially sweetened soft drinks might harm the brain and cardiovascular system(14).

Back to natural sugar

  • Back to natural sugar may be an exciting option. “Sugar-containing foods in their natural form, whole fruit, for example, tend to be highly nutritious—nutrient-dense, high in fibre, and low in glycemic load.
  • On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels increase triglycerides. In addition to inflammatory mediators and oxygen radicals. Moreover, the risk for diabetes, cardiovascular disease, and other chronic illnesses.
  • While artificial sweeteners and sugar substitutes may help with weight management, they aren’t a magic bullet. Now, used only in moderation. If you use sugar substitutes to save calories, be careful not to eat higher-calorie foods as a reward for the calories you saved.
  • Just because a food is marketed as sugar-free doesn’t mean it’s free of calories. Eating too many sugar-free foods can still gain weight if they contain other ingredients that have calories.
  • Remember that processed foods, which often contain sugar substitutes, generally don’t offer the same health benefits as whole foods, such as fruits and vegetables.

In future epidemiological studies

  • The recommendation is the more significant collection of data that may help answer these questions. This includes previous weight fluctuations, dieting behaviour, and SSB/ASB consumption changes over time. For this reason, it helps in choosing ASB consumption.

Now, What do you think?

You should answer now, “I think I’ll have a glass of water and an apple.”

Artificial Sweeteners

Artificial sweeteners and heart disease

  • While artificial sweeteners may seem like a good alternative to sugar to reduce caloric intake, a study published in The BMJ Trusted Source suggests there may be a connection between such sweeteners and an increased risk for cardiovascular disease (CVD), including stroke.
  • The research, conducted by the French National Institute for Health and Medical Research, is not the first study to suggest a connection between artificial sweeteners and increased risk for heart disease, however, it is the largest to date. The study included data from more than 100,000 participants.

Is it OK to consume artificial sweeteners?

  • When people try to cut sugar out of their diets, for reasons such as trying to lose weight or trying to control their blood sugar, they may turn to artificial sweeteners.
  • Artificial sweeteners have been around for more than 100 years.
  • Saccharin, for example, which is found in the sugar substitute Sweet’N Low, was first discoveredTrusted Source in 1879.
  • Since then, researchers have discovered numerous other artificial sweeteners, including sucralose, aspartame, stevia, and xylitol.
  • There has almost always been controversy surrounding artificial sweeteners.
  • As the Harvard School of Public Health notes, concerns include the development of type 2 diabetes and weight gain but the evidence is varied and inconclusive.
  • Despite the concerns, the Food and Drug AdministrationTrusted Source considers the approved sweeteners generally safe to use, as long as people do not exceed the acceptable daily intake for each type.
  • For example, with sucralose (which is found in Splenda), a 132-pound person could consume 23 packets before going over the recommended limit.

Link Between Artificial Sweeteners and Heart Health Risks

  • Touvier and her colleagues analyzed more than 103,000 adults in France who were involved in a web-based nutrition study to investigate the association between artificial sweetener intakes and cardiovascular disease risk. Almost 80% of participants were female and the average age was 42 years old.
  • Participants completed questionnaires detailing their food consumption over the course of 24 hours. They also provided information about health, lifestyle and sociodemographic factors—including their physical activity, smoking status and personal information like education and occupation.
  • Researchers also tasked participants with completing multiple food diary assessments at the start of the study and every six months afterward. This step, Touvier said, gave researchers an estimate of how much artificial sweeteners people consumed along with their intake of other foods—such as fruits, vegetables, red meats and dairy products.
  • Overall, researchers found that 37% of participants consumed artificial sweeteners in some form. Participants who consumed around 78 milligrams of artificial sweeteners per day were considered “high consumers” and those that had around 8 milligrams per day were identified as “low consumers.” There was also a group of participants who didn’t consume any artificial sweeteners, Touvier said.
  • Individuals who consumed higher amounts of artificial sweeteners had a 9% increased risk of cardiovascular disease compared to those who didn’t consume any at all, Touvier said. This included younger individuals who had a higher body mass index (BMI), were less physically active and more likely to smoke.
  • “We observed that total artificial sweetener intake was associated with an increased risk of cardiovascular disease,” Touvier said.
  • They also studied different types of artificial sweeteners and found aspartame intake was associated with a 17% increased risk of cerebrovascular events, while acesulfame potassium and sucralose were linked with increased coronary heart disease risk.

Observational Results Should Be Interpreted With Caution

  • Although the study found an association between artificial sweetener consumption and cardiovascular disease, health experts say people should consider the results with caution, as it was an observational study with self-reported data points.
  • “We cannot definitively say that this difference was actually caused by the sweetener,” Alexander Postalian, MD, a cardiologist at Texas Heart Institute, who was not involved in the study, told Health.
  • While the authors of the study did their best to ensure the accuracy of the results, limitations and confounding issues may remain, Dr. Postalian added. For example, people that consume high amounts of artificial sweeteners may be in poorer health status than their counterparts, and perhaps also consume greater amounts of other unhealthy foods.
  • “Rather than establishing that artificial sweeteners are ‘bad’ and should be avoided at all costs, the more adequate take-home point is that we should be vigilant about the indiscriminate use of these additives and consume them in moderation while ongoing research continues,” said Dr. Postalian.
  • The study authors and other health experts noted that further research is needed to confirm or refute the current findings. Dr. Postalian, for instance, said that the links observed between artificial sweeteners and cardiovascular disease are not yet clear and more investigation is needed to better understand the connection.
  • “There are multiple theories about why artificial sweeteners may cause disease. From alteration of insulin and glucose balance to modification of the gut microbiota,” Dr. Postalian said. “However, the truth is we don’t know for certain.”
  • Another factor could be the interaction of artificial sweeteners with intestinal sweet taste receptors, which plays a part in insulin secretion and glucose absorption.
  • “Additionally, the alteration of gut microbiota by some artificial sweeteners could increase glucose intolerance and may be involved in the underlying mechanisms,” Touvier said. “Vascular dysfunction and inflammation could also be involved. But these are hypotheses that need to be confirmed.”

The sweeteners studied

  • The study began in 2009 with the launch of the NutriNet-Santé e-cohort. People interested in participating in “the world’s largest nutrition study” could sign up online.
  • More than 170,000 signed up for the study, and the researchers narrowed down their field to 103,388. The chosen participants included people 18 years of age and older, as well as people who filled out questionnaires related to “diet, health, anthropometric data, lifestyle and sociodemographic data, and physical activity.”
  • The average age of the included participants was 42 years, and the majority of the participants were females (79.8%).
  • Throughout the following years, researchers periodically gathered information from the participants such as all food and beverages consumed during a 24-hour period. To make sure the participants were being accurate with their food logs, the researchers required them to submit photos.
  • Additionally, participants also reported their artificial sweetener consumption. The researchers wanted to know the amount and sweetener brand.
  • Approximately 37% of the participants reported using artificial sweeteners, with the participants divided into non-consumers, lower consumers (artificial sweetener intake below the median), and higher consumers (artificial sweetener intake above the median).

The participants consumed an average of 42.46 mg/day. They consumed the following artificial sweetener types:

    • aspartame
    • acesulfame potassium
    • sucralose
    • cyclamates
    • saccharin
    • thaumatin
    • neohesperidine dihydrochalcone
    • steviol glycosides
    • salt of aspartame-acesulfame potassium

The researchers also collected other health information from the participants throughout the duration of the study, including information from “any new health events, medical treatments, and examinations.” Additionally, the participants provided documentation of any reports of CVD.

Higher consumption higher risk

  • At the end of the study, the researchers compared the number of cardiovascular events that people who consumed artificial sweeteners experienced to the number of events that people who did not consume these sweeteners experienced.
  • The researchers found that people who were higher consumers of artificial sweeteners had an increased risk of cardiovascular disease compared to non-consumers.
  • Participants reported 1,502 cardiovascular events during the follow-up, including 730 coronary heart disease events and 777 cerebrovascular disease events.
  • Higher consumers of artificial sweeteners experienced 346 events per 100,000 person-years and non-consumers experienced 314 events per 100,000 person-years.

3 particularly problematic sweeteners

  • “Our results indicate that these food additives, consumed daily by millions of people and present in thousands of foods and beverages, should not be considered a healthy and safe alternative to sugar, in line with the current position of several health agencies,” write the authors.
  • The authors noted that they do not believe the occasional use of artificial sweeteners is as problematic as daily use. “Occasional artificial sweetener consumption is not likely to have a strong impact on CVD risk, and so even if some consumption might have been missed, it would probably have had a low impact on the study results.”
  • Additionally, the authors noted that three artificial sweeteners in particular were associated with higher risks.
  • According to the authors, “Aspartame intake was associated with increased risk of cerebrovascular events, and acesulfame potassium and sucralose were associated with increased coronary heart disease risk.”

Conclusion

  • More research into this question, for even small causal effects would have a tremendous impact on public health due to the popularity of both ASB and SSB consumption.
  • The current body of literature is inconclusive about the causal nature of the associations between ASB consumption and the risk of stroke. In addition to dementia, diabetes mellitus, and metabolic syndrome.
  • The growing epidemiological studies show strong associations between frequent consumption of ASBs and vascular outcomes.
  • However, it suggests that it may not be reasonable to substitute or promote ASBs as healthier alternatives to SSBs. Both sugar-sweetened and artificially sweetened soft drinks may be stiff on the brain.
  • Future researchers must replicate our findings and investigate the mechanisms underlying the reported associations. The consumption of soft drinks is increasing in the community.
  • A massive study involving French citizens that spanned more than a decade evaluated their use of artificial sweeteners.
  • The observational study periodically checked the participants’ food and drink intake and had the participants regularly report on their health.
  • By the end of the study, the researchers learned that the participants who consumed higher levels of artificial sweeteners experienced cardiovascular disease events at a higher rate than participants who did not consume artificial sweeteners.

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