3 Not-So-Sweet Insulin Effects of Artificial Sweeteners

By November 11, 2016Blog

POST SUMMARY: What this means for you…

We all enjoy eating sweets. Thankfully, there are many good treats available sweetened with stevia, xylitol, erythritol, and others that have no effect on your insulin levels. Start slowly though—some sweeteners take some time getting used (they can give you gas or diarrhea at first). Even still, consider these treats, even those that won’t increase your insulin as much as the ‘real’ thing, as things to be enjoyed intermittently. Make an effort to create a structure that is challenging but achievable for you, i.e. one treat every three days, or one treat per week, etc.

Sweeteners are a broad class of non-nutritive compounds—things that taste like sugar but provide little or no calories and no nutrition. The evidence on specific sweeteners and insulin resistance (or many other things) is sparse, though there is enough to mention.

The overall conclusion that artificial sweeteners increase the risk of insulin resistance is supported; people who drink an artificially sweetened (diet) soda daily have a 36% greater chance of developing the metabolic syndrome (remember that it used to be called “insulin resistance syndrome”) and a whopping 67% increased risk of type 2 diabetes [1]. How can this be when diet soda has no calories? Well, there’s no clear answer; just a few theories.

Theory 1: Our Body’s Expectations

Artificial sweeteners may make us want “real” food [2]. In other words, when your body tastes something sweet, it expects a corresponding load of energy—something, anything, that will fuel the body. However, when that energy doesn’t come (remember, the sweetener doesn’t provide anything real), the body craves something that will provide energy. Thus, the person starts out avoiding food by consuming the fake sweetener, then, in the end, ends up eating it anyway.

Theory 2: We Eat More

Artificial sweeteners may make us think we can eat more [3]. In this case, a person purchases a food item that is artificially sweetened and, in so doing, believes they can be more liberal with other foods. Something like, “I’m sure glad this Diet Coke is going to balance out all these fries! Awesome!” Thus, the person eats more than they otherwise would.

Theory 3: Something Called “CPIR”

Third, and my favorite… Some sweeteners elicit an insulin response [4]. This phenomenon is known as the cephalic phase insulin response (CPIR), and we believe that it helps prepare the body for the inevitable carbohydrate load that comes with it. Because it should! In nature, anything sweet would be a carbohydrate. The CPIR is simply the body’s way of “priming the pump” by releasing a little insulin in anticipation of a carbohydrate load, which will cause a subsequent greater insulin release. There are countless sweeteners, but the main ones may cause a CPIR, including aspartame [5] and saccharin [6].

In a slight twist, one interesting study explored the effects of various sweeteners on altering the insulin release from a meal (i.e., drinking a sweetened drink while eating) [7]. Drinking sucrose (sugar) with the meal had the highest effect, but, interestingly, aspartame consumption with the meal was almost identical to sugar. Stevia, however, had no effect.

References:

  1. Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR, Jr.: Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2009, 32:688-694.
  2. Blundell JE, Hill AJ: Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet 1986, 31:1092-1093.
  3. Swithers SE, Davidson TL: A role for sweet taste: calorie predictive relations in energy regulation by rats. Behavioral Neuroscience 2008, 122:161-173.
  4. Tonosaki K, Hori Y, Shimizu Y, Tonosaki K: Relationships between insulin release and taste. Biomed Res 2007, 28:79-83.
  5. Ferland A, Brassard P, Poirier P: Is aspartame really safer in reducing the risk of hypoglycemia during exercise in patients with type 2 diabetes?. Diabetes Care 2007, 30:e59.
  6. Just T, Pau HW, Engel U, Hummel T: Cephalic phase insulin release in healthy humans after taste stimulation? Appetite 2008, 51:622-627.
  7. Anton SD, Martin CK, Han H, Coulon S, Cefalu WT, Geiselman P, Williamson DA: Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite 2010, 55:37-43.

This blog post (and all other posts and content on this website) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

About Benjamin Bikman, Ph.D. – Ben earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand chronic modern-day diseases, with special emphasis on the origins and consequences of obesity and diabetes. He frequently publishes his research in peer-reviewed journals and presents at international science meetings.

4 Comments

  • Colleen Handley says:

    Interesting! I have a question if you don’t mind. My daughter is in her 30s. She is healthy, exercises, is normally weighted, great blood pressure, normal blood sugar, good cholesterol numbers, definitely not insulin resistant. She understands a healthy diet and feeds her family a balanced diet. Her question to me is this: “I use dates and figs and such as sweeteners in the things I bake. Since everyone should be concerned about the over consumption of sugar, should I be using something like monk fruit sugar instead? I’m not insulin resistant yet…but shouldn’t I be trying to prevent that?” I don’t have the answer for her. What is your opinion please. Thank you!

    • Ben Bikman says:

      Hi Colleen. No, I would not recommend using dates or figs, as those use fructose as the sweetener (and fructose is metabolized only in the liver, with much of it turning into fat). Monk fruit is fine.

  • Dr Peter says:

    I have read conflicting studies and information about Stevia as well as sugar alcohols about causing blood insulin spikes, even if they don’t spike blood sugar. As Dr Fung and others cogently argue – it is high insulin leading to insulin resistance that leads to obesity and metabolic syndrome/ type II diabetes. In our household we have been focusing on using Stevia and erythritol in recent years, while moving to a low carb/higher fat diet. Some family members have an extreme sweet tooth (i.e. they’ve become sugar addicted over decades) and desire the Stevia/Erythritol substitute to cope with coming off sugar and refined carbs. We have been wondering if this ongoing need for sweet snack has been making the progress on lchf very slow?

    So although Dr Bilkman, you say “Stevia, however has no effect” – are you certain the evidence is robust that it causes neither blood sugar rises, nor insulin rises and insulin resistance over time? What is the consensus of the evidence? Would love a review article on the topic.

    Thank you.

    • Ben Bikman says:

      Hi Peter. These are relevant questions. Yes, based on the evidence, I’m quite confident that stevia has no effect on insulin. I suspect you’ll come to the same conclusions by following and reading the citations listed in the post.

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