Added sugars are no friend to your health — especially your gut health. Eating too much sugar can trigger
inflammation, increase your risk of developing
leaky gut and cause a potentially harmful microbial imbalance known as
dysbiosis.
Due to these associated risks, swapping sugar for sugar substitutes may start to seem like an attractive option. Artificial and natural sweeteners have been marketed as healthier, lower-calorie alternatives to table sugar since the
introduction of saccharin in 1970 and are
recognized as safe by the FDA.
More people are turning to these sweeteners to replace some or all of the sugar in their diets. Annual sugar consumption in the U.S. has decreased by
25.4 pounds per person since 2000 while purchases of products that contain both traditional and alternative sweeteners
have increased.
Today,
40% of adults and
25% of children consume these sweeteners regularly in products like diet soda, but some evidence suggests that the swap could have adverse effects on gut health.
Sugar Substitutes and Gut Bacteria Health
Part of the reason sugar substitutes are so attractive is that they offer a sweet flavor with a fraction of the calories of regular sugar. These sweeteners are
divided into two categories based on calorie content:
- Non-nutritive sweeteners marketed as "zero calorie," such as aspartame (NutraSweet, Equal), saccharin (Sweet'N Low), sucralose (Splenda) and stevia
- Nutritive sweeteners containing minimal calories per serving, such as xylitol, sorbitol and mannitol
Up to
75% of the compounds in both type of sweeteners travel to your colon during digestion and may affect your gut microbiome.
Artificial sweeteners and gut health
Artificial sweeteners are sugar alternatives
created synthetically in a lab. The
FDA currently authorizes six of them: aspartame, acesulfame-K, saccharin, sucralose, neotame and advantame.
Despite their
continued popularity in the food and beverage market, artificial sweeteners have been under scrutiny for their potentially harmful effects since 1968, when studies
linked a sweetener called cyclamate to cancer. Since then, further research has suggested similar effects from
other artificial sweeteners, but results from studies of their impact on gut health are mixed.
Some research suggests that consuming these sweeteners can lead to problems similar to those associated with sugar. In studies on rodents and humans, each sweetener has shown different potential effects:
- Aspartame may increase populations of pro-inflammatory or pathogenic bacteria, decrease beneficial microbes and affect the variety of species within the microbiome.
- Saccharin may cause significant microbiome changes, including increased pro-inflammatory bacteria, even at low doses. It may also reduce populations of microbes that help regulate blood sugar and inflammation.
- Sucralose can alter the population of many different microbes, increase pro-inflammatory compounds or damage the intestinal barrier. The effects may be more significant with long-term use.
Sometimes, though, study results don't show any effects on the microbiome, inflammation or metabolism, even at levels much higher than is possible to consume in your diet. In some studies, saccharin and sucralose have even been shown to
increase the production of beneficial short-chain fatty acids (SCFAs).
The gut effects of natural sweeteners and sugar alcohols
Other sugar alternatives like stevia are seen as healthier and more natural than artificial sweeteners. However, these alternatives may actually be either natural or artificial because they can either be made from sources like fruit or plant roots or produced synthetically.
Regardless of which method is used, "natural" sweeteners may not work out better for your gut microbiome. Stevia, which comes from the leaves of the
Stevia rebaudiana plant, appears to have some potentially beneficial properties. However, an extract of the sweetener called Rebaudioside A (Reb A) can reduce healthy bacteria in your gut and increase the production of
compounds associated with body fat and obesity. Long-term stevia consumption may promote pro-inflammatory responses in your gut and
liver.
Monk fruit is a newer addition to the family of alternative sweeteners. It's made from the
fruit of a plant called lo huan go and was
approved by the FDA in 2010. Research on its effects on the gut is limited, but a study using microbes cultured in petri dishes showed that mogroside V, the main compound responsible for monk fruit's sweetness, may increase both
beneficial bacteria and short-chain fatty acids (SCFAs). In theory, these effects could support gut health and help maintain healthy blood sugar responses.
Sugar alcohols, which include sweeteners like xylitol, sorbitol and mannitol,
may have some beneficial effects, including increased production of anti-inflammatory SCFAs and and overall increase in populations of beneficial bacteria. But using large amounts of these sweeteners
may give you diarrhea because they aren't fully broken down before reaching the colon.
Effects and side effects of sugar substitutes
The changes that sugar substitutes can cause in your microbiome may
impact systems throughout your body and lead to other health effects, including:
- Slowing the movement of food in your digestive tract
- Affecting your body's ability to use insulin
- Increasing your fasting blood sugar levels
- Interfering with some metabolic functions, which may lead to weight gain
- Changing how your body metabolizes carbohydrates and absorbs nutrients
- Increasing inflammation in and outside of the gut
- Altering the process your cells use to make energy, known as the Krebs cycle
- Increasing the expression of genes associated with bacterial toxins
In some people, artificial sweeteners may trigger more immediate symptoms like
headaches, fatigue and dizziness. One particular sugar alcohol, erythritol, has been
linked to cardiovascular problems like heart attack and stroke. This may be due to its potential to
increase the risk of blood clots, so the scientists who discovered the link recommended that more research should be done to evaluate the sweetener's safety.
Better sugar alternatives for a healthy gut
If you want to cut back on sugar but don't want to wait for scientists to determine which sugar substitutes are safest, you have several options that could potentially support gut health without causing side effects:
- Dates have a flavor similar to caramel and are available whole and in the form of unrefined sugar or syrup. Unlike sugar and other alternative sweeteners, dates provide fiber along with a range of nutrients and antioxidants.
- Sweet potatoes add moisture and sweetness to baked goods like cake and quick beads and can actually feed your microbiome thanks to the 6 grams of fiber you get from one large potato.
- Yacon syrup, made from the roots of the yacon plant, contains fructooligosaccharides, a type of fiber that may benefit you microbiome and improve digestion.
But don't stop at switching up your sweeteners if you want better gut health! Other
healthy dietary changes, such as increasing your intake of high-fiber fruits, vegetables, whole grains, and legumes, are also important for maintaining a healthy microbiome. Emphasizing these foods can improve the quality of your diet and lower your overall fat intake, two factors that appear to influence
how your microbiome responds to sugar substitutes. So whether you choose to use alternative sweeteners or not, keeping your microbiome well-fed can help maintain a healthy gut even as you enjoy the occasional sweet treat.
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