Artificial sweeteners sound like a sweet deal–the taste of sweet without the calories or sugar. Who wouldn’t want that? These days, you can find packets of artificial sweetener in colored packets of pink, for saccharin, blue, for aspartame, and yellow, for sucralose in many restaurants to sweeten your coffee and tea. Sucralose has become the dominant artificial sweetener with saccharin and aspartame losing market share to the little yellow packets that have less of a bitter aftertaste than previous sweetener incarnations. You can sweeten something using only small amounts as there are hundreds of times sweeter than sugar – but can they cause digestive issues?
Many people wonder whether artificial sweeteners are harmful to health and whether they increase the risk of diseases such as cancer if you use them in abundance. In the 1970s, some research linked saccharin with a greater risk of bladder cancer in rats. Because of this study, saccharin carried a warning label for years. However, further research couldn’t confirm these findings in humans, so they removed the warning. In fact, there’s no strong evidence that any artificial sweetener causes cancer in the amount the average person uses. Still, there’s much we don’t know about these sugar alternatives made in a laboratory. These sweeteners are classified as GRAS for generally recognized as safe, but there’s always the chance that new evidence will emerge that shows these sweeteners aren’t so safe after all.
How do artificial sweeteners impact your gut, and can they cause digestive issues? Some people believe that using them in large amounts can trigger gas and bloating since your body doesn’t absorb these sweeteners and they stay in your digestive tract. Are artificial sweeteners harmful to your gut and can they cause digestive problems such as bloating, nausea, or excessive gas?
The Impact of Artificial Sweeteners on the Gut
Artificial sweeteners offer the sweetness of sugar without the calories or impact on blood glucose. Most artificial sweeteners cause little or no rise in blood sugar levels when you consume them. Therefore, you might think they are of benefit to diabetics trying to control their blood sugar or for people trying to lose weight. We know that sugar is a source of empty calories and consuming it causes a rise in blood glucose. In contrast, artificial sweeteners are calorie-free and don’t cause a significant rise in blood glucose. Plus, you consume fewer calories when you replace sugar with artificial sweeteners. Therefore, you might expect to lose weight. In fact, that’s one reason people use them.
Some studies show that people lose modest amounts of weight when they replace sugar with artificial sweeteners. However, some research also suggests that using these sweeteners that trick the brain into believing you’re eating something sweet can backfire on you. According to these studies, consuming artificial sweeteners tells your brain to expect calories to follow and when they don’t, you don’t feel satisfied and consume more to make up for the mismatch.
Studies also show that switching sugar-sweetened soft drinks for calorie-free drinks sweetened artificially won’t necessarily lead to weight loss and may increase the risk of developing metabolic syndrome and type 2 diabetes. Why would artificial sweeteners increase the risk of type 2 diabetes and metabolic syndrome when they don’t cause a rise in blood sugar? Some research suggests that artificial, calorie-free sweeteners alter the gut microbiome in a way that reduces insulin sensitivity. For example, saccharin, aspartame, and sucralose appear to disrupt the balance of good versus bad bacteria in the gut microbiome. In mouse studies, artificial sweeteners alter the balance of gut bacteria in a way that increases insulin resistance.
What about Digestive Problems?
Back to the initial question of whether artificial sweeteners can cause digestive problems. If they disrupt the balance of bacteria in your gut, this could lead to digestive issues indirectly. However, there is another class of low-calorie sweeteners called sugar alcohols that can cause significant digestive distress for some. Unlike artificial sweeteners, sugar alcohols come from natural sources such as fruit and vegetable matter. However, they can also be processed from other sugars.
Like artificial sweeteners, you don’t absorb these sugar substitutes from your gut, but gut bacteria can ferment these sweeteners and produce gases that cause bloating and flatulence. Some sugar alcohols are more likely to cause digestive symptoms than others. The worst are sorbitol and maltitol while more people tolerate xylitol and erythritol without digestive upset as long as they don’t consume large quantities.
People have differing tolerances to sugar alcohols. Some users can consume modest quantities without gas or bloating while others get diarrhea or become gaseous when they add only a small amount to their tea, coffee, or food. Diarrhea occurs because when sugar alcohols stay in the gut too long, they draw water into the gut and cause stools to be more liquid. People who have irritable bowel syndrome are particularly susceptible to the digestive side effects of sugar alcohols and should limit the consumption of these sweeteners.
The Bottom Line
There’s no strong evidence that artificial sweeteners cause digestive upset as sugar alcohols can. However, they may alter the composition of the gut microbiome and contribute to other issues such as insulin resistance. For this reason, it’s wise to limit how much of these sweeteners you add to your diet. Stevia, a natural sweetener, also contains no calories and doesn’t alter the gut microbiome or contribute to metabolic syndrome. Even better, learn to enjoy foods in their natural state without added sweeteners.
References:
- Mayo Clinic. “Nutrition and Healthy Eating”
- Science Daily. “Artificial sweeteners have toxic effects on gut microbes”
- com. “Could Artificial Sweeteners Cause Weight Gain?”
- Physiol Behav. 2016 Oct 1;164(Pt B):488-493. doi: 10.1016/j.physbeh.2016.04.029. Epub 2016 Apr 15.
- Mäkinen KK. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. Int J Dent. 2016;2016:5967907. doi:10.1155/2016/5967907
- Gut Microbes. 2015;6(2):149-55. doi: 10.1080/19490976.2015.1017700. Epub 2015 Apr 1.
- Spencer M, Gupta A, Dam LV, Shannon C, Menees S, Chey WD. Artificial Sweeteners: A Systematic Review and Primer for Gastroenterologists. J Neurogastroenterol Motil. 2016;22(2):168–180. doi:10.5056/jnm15206.
- com. “Sugar Alcohols: Good or Bad?”
- European Journal of Clinical Nutrition. 2007;61(3):349–354. doi: 10.1038/sj.ejcn.1602532.
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