artificial sweetener

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Pharmacokinetics

  • not absorbed
  • eliminated in feces

Adverse effects

Notes

  • Artificial sweeteners are regulated by the FDA.
  • no scientific evidence that artificial sweeteners are a health risk for most people
    • not sure this is true (see adverse effects above)
    • no evidence that the regulated artificial sweeteners on the US market are related to cancer risk in humans
    • in contrast, health risks of excessive calorie consumption are well substantiated
  • no clinically-relevant benefits for most health care outcomes[7]
    • benefits of reduced calories in artificial sweeteners only realized if total calorie intake is reduced[1]
  • use of artificial sweeteners may facilitate reduction in sugar intake & thus in total calorie intake[1]
  • potential benefit in glycemic control[1]
  • artificial sweetners are not associated with reduced BMI[5]
  • artificially-sweetened beverages are aviable alternative to water as a replacement strategy in overweight or obese adults at risk for or with diabetes mellitus[10]

More general terms

More specific terms

Additional terms

References

  1. 1.0 1.1 1.2 1.3 Gardner C, Wylie-Rosett J, Gidding SS et al Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2012 Jul 24;126(4):509-19. [58 references] <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22777177 <Internet> http://circ.ahajournals.org/content/early/2012/07/09/CIR.0b013e31825c42ee (corresponding NGC guideline withdrawn Dec 2017)
  2. 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2023
  3. 3.0 3.1 Suez J et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 2014 Oct 9; 514:181 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25231862
  4. 4.0 4.1 Wersching H, Gardener H, Sacco RL Sugar-Sweetened and Artificially Sweetened Beverages in Relation to Stroke and Dementia. Are Soft Drinks Hard on the Brain? Stroke April 20, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28428347 <Internet> http://stroke.ahajournals.org/content/early/2017/04/20/STROKEAHA.117.017198
  5. 5.0 5.1 5.2 Azad MB, Abou-Setta AM, Chauhan BF et al Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ July 17, 2017 vol. 189 no. 28 E929-E939 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28716847 <Internet> http://www.cmaj.ca/content/189/28/E929
  6. 6.0 6.1 Monaco K Artificial Sweeteners Impact Metabolic Health Even on Cellular Level. Not as healthy as consumers may think, researcher says. MedPage Today. March 20, 2018 https://www.medpagetoday.com/meetingcoverage/endo/71882
    Kundu N, et al Sucralose promotes metabolic dysregulation and intracellular ROS accumulation. The Endocrine Society Annual Meeting (ENDO) 2018; Abstract SUN-071.
  7. 7.0 7.1 Toews I, Lohner S, de Gaudry DK et al Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ 2019;364:k4718 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30602577 Free full text https://www.bmj.com/content/364/bmj.k4718
    Malik VS Non-sugar sweeteners and health BMJ 2019;364:k5005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30606710 https://www.bmj.com/content/364/bmj.k5005
  8. 8.0 8.1 Mossavar-Rahmani Y, Kamensky V, Manson JE et al Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women's Health Initiative. Stroke. 2019 Mar;50(3):555-562. Published online: Feb 14, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30802187 https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023100
    Gardener H, Elkind MSV Artificial Sweeteners, Real Risks Stroke. Mar;50(3):549-551. Published online: Feb 14, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30760171 https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.024456
  9. 9.0 9.1 Chazelas E et al. Sugary drinks, artificially-sweetened beverages, and cardiovascular disease in the NutriNet-Sante cohort. J Am Coll Cardiol 2020 Nov 3; 76:2175. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33121725 https://www.sciencedirect.com/science/article/abs/pii/S0735109720365967
  10. 10.0 10.1 McGlynn ND, Khan KA, Wang L et al Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk. A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(3):e222092. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35285920 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790045
  11. 11.0 11.1 Debras C, Chazelas E, Srour B et al Artificial sweeteners and cancer risk: Results from the NutriNet-Sante population-based cohort study. PLOS Medicine. 2022. Mar 24;19(3):e1003950 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35324894 PMCID: PMC8946744 Free PMC article https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003950
  12. 12.0 12.1 Debras C, Chazelas E, Sellem L et al Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Sante cohort. BMJ 2022;378:e071204 Sept 7 Not indexed in PubMed https://www.bmj.com/content/378/bmj-2022-071204
  13. Artificial Sweeteners http://cis.nci.nih.gov/fact/3_19.htm