Artificial Sweeteners Cause Metabolic Disorders

For the diabetics, obese and weight conscious individuals artificial sweeteners (AS) are considered safe choice to help regulate the blood glucose level and manage body weight. Use of AS considered good choice to sweeten the drinks and deserts as opposed to the common table sugar mostly due to low amount or lack of calorie in them.  Because of the same reason many food and beverage companies market their “calorie free” “Lite” and “diet” drinks and food items to cater the need of various “calorie conscious” customers.

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Food and drug administration (FDA) of USA identifies some of these sweeteners as “high-intensity sweeteners” and regulates them as food additive, meaning that they must undergo premarket review and approval by FDA before it can be used in food.  Accordingly nearly six artificial sweeteners have been approved by FDA as food additives in the USA. These are saccharin, aspartame, acesulfame potassium (Ace-K), sucralose, neotame, and advantame. The agency considers these FDA approved AS safe for the general population in certain conditions of use¹.  

The use of AS has become more common in general population due to reported ill effects of common sugar including sudden increase in blood sugar, tooth decay, weight gain, obesity, and an array of life style diseases such as hypertension, cardiovascular diseases, type 2 diabetes and dementia among others. The increased use of AS has propelled the scientists to examine the long-term effects of AS on humans.

In a recent study scientists have observed that use of AS may lead to the development of glucose intolerance (GI). GI is a hyperglycaemic state that is linked to insulin resistance and generally occurs in pre-diabetic individuals. AS induced glucose intolerance, scientists observed, develops due to alteration in the composition and function of the microorganism or microbiota that live in our intestine.

The group of scientists led by Jotham Suez² found that when mice were fed AS, they showed altered GI and also their intestinal microbiota composition changed from that of normal mice not fed AS. Further, when the intestinal microbiota from AS consuming mice was transferred to germ- free mice they also showed altered GI and other metabolic defects. These defective metabolisms were abrogated by the use of antibiotics which is known to kill the intestinal bacteria suggesting that the effects were caused due to the changed intestinal microbiota. 

When scientists compared the bacterial population from glucose-fed verses AS-fed mice by genetic analysis, they found that not only the composition, but the functions of the bacteria also had changed in AS-fed mice. The bacteria from AS-fed mice intestine showed increased carbohydrate degrading mechanisms. This means that they can degrade even complex carbohydrates easily leading to elevated glucose levels that may contribute to GI.

The scientists also examined and compared the intestinal microbiota of AS consuming individuals with those who did not consume AS and found that AS consuming people had different bacterial population in their intestine which correlated with markers of obesity and GI. When they fed AS to the volunteers, they showed increased blood glucose levels as well as altered intestinal bacteria in just four days.

These scientific evidences clearly indicate that consumption of AS is associated with increased GI, risk of obesity related metabolic disorders and these changes are not direct but by altering the bacterial community in the intestine. Thus, a caution regarding the excessive use of AS as food additive needs reassessment and in-depth study before being approved for use by general population

References:

1. http://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397716.htm

2. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, Israeli D, Zmora N, Gilad S, Weinberger A, Kuperman Y, Harmelin A, Kolodkin-Gal I, Shapiro H, Halpern Z, Segal E, Elinav E. Nature. 2014 Sep 17. doi: 10.1038/nature13793

Diabetes - Prevention and Management by Awareness - Part 2

Continuing from the part-1 of this series where we learned the types of diabetes, how they develop and what are the risk factors (link below). In this part, 2nd and last in this series, we will learn how diabetes harms us, is it just the increased glucose or it means something else as well.

http://simplefiedscience.blogspot.in/2014/01/diabetes-prevention-and-management-by.html

Come to think of it, how diabetes harms our body is yet another area where general population is found misinformed and misguided. There is much more than sugar in the urine, sweating, trembling of hands and legs, and usual anxiety in diabetes. The increased glucose level in the blood creates havoc for the cells in our body. It deregulates the normal metabolism and function of the organs including liver, heart, kidney, eyes, brain, lungs, blood capillaries and their cells.

Even though our cells are being severely affected and damaged by increased sugar in the blood, we do not realize this until it is too late. Initially, in type 2 diabetes, with little increase in the blood sugar our body tries to adjust by increasing the insulin level. Slowly, it reaches a point where even several fold increase in insulin, hyper-insulinemia, is also not effective to down regulate glucose level. And because insulin also helps in increased fatty acid synthesis, cell growth and many other physiological role, the enhanced levels of insulin may expose the body to many other pathological conditions such as metabolic deregulation, obesity, heart diseases, cancer and so on.

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After a while insulin level tapers down leading to full-blown diabetes where there is no regulation of blood glucose, whatsoever. At this stage gluco-meter readings come more than 400mg/dL.

The vessels that carry the blood get affected first leading to macro- and micro-angiopathy including endothelial dysfunction, arteriosclerosis and angiogenesis, neuropathy leading to loss in sensation and nerve conduction, nephropathy leading to kidney failure, occulopathy such as diabetic retinopathy, glaucoma and cataract development in eye lens. Besides these, the frequent glucose up-regulation (hyperglycemia) and down-regulation (hypoglycemia) creates problem to the brain functioning leading to hallucinations, disorientation, depression and other problems.

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Although early diagnosis would lead to better management of the diabetes, being older or newer disease is not as important as how well or poorly it has been managed. Even if diabetes is diagnosed early, if not managed well with proper diet, exercise and healthy lifestyle, the patients suffer more mortality and morbidity.

To be a diabetes free society it is as much an individual problem as a social problem. Many epidemiological studies indicate that society plays greater role in how and which disease spreads in its people.

Image curtesy: (Diabetics Friends Society) http://youngleaders.idf.org/

 

If a society has good attitude towards healthy eating and living, and educational and awareness programs to educate its people, the individuals could benefit and protect themselves from many diseases, including diabetes.

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What is good eating and living attitude? To recognize how much calorie one needs to stay active and fit, to know which food has roughly how much calories, to be aware that in the comfort and luxury seeking society physical activity is equally or rather highly important factor to stay well and free of diseases. Individual eating and living approach will have better effect on overall behavior of the society towards how it protects its people and tackles the lifestyle diseases such as obesity and diabetes.

 

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Thus, next time when you see someone reacting to high glucose level in a random blood test in disbelief, anguish, anxiety, worry and other emotional expressions, you know what we must do as an individual and as a society!