Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials

Ruiz‐Ojeda, Francisco Javier; Plaza‐Díaz, Julio; Sáez-Lara, María José; Gil, Ángel

doi:10.1093/advances/nmy037

Cited by 297 publications

(307 citation statements)

References 95 publications

(133 reference statements)

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“…Recent studies on the mechanisms by which dietary mono-and disaccharides affect gut microbiota conclude that they tend to increase Bifidobacteria while decreasing Bacteroides. Human subjects' diet with several polyols, including maltitol, lactitol, and isomalt, resulted in increased relative abundance of Bifidobacteria with reduced Bacteroides [71]. In another study, the addition of lactose to the diet resulted in these same bacterial shifts while also decreasing Clostridia species.…”

Section: High Carbohydrate Intake and Intestinal Microbiotamentioning

confidence: 90%

“…Many studies reported that a high carbohydrate diet changes the intestinal microbiota, which is associated with metabolic diseases such as type 2 diabetes, cardiovascular disease, and IBD [29,71]. High sugar consumptions induced obesity, insulin resistance, inflammation, and metabolic dysfunction due to changes in the intestinal microbiota in animal studies [56,93].…”

Section: High Carbohydrate Intake and Intestinal Microbiotamentioning

confidence: 99%

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Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health

et al. 2020

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Recent studies report that microbiota in the human intestine play an important role in host health and that both long-and short-term diets influence gut microbiota. These findings have fueled interest in the potential of food to promote health by shaping the intestinal microbiota. Despite the fact that large populations in Asia consume high quantities of carbohydrates, such diets have been ignored in comparison to the attention received by Western diets containing high quantities of fat and animal protein. We gathered data that suggest an association between imbalanced high-carbohydrate intake and gut microbiota and host health. In this review, we identify not only the effect of total carbohydrates on the intestinal microbiota specifically and the health of their hosts in general, but also how specific types of carbohydrates influence both factors.

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Section: High Carbohydrate Intake and Intestinal Microbiotamentioning

confidence: 90%

Section: High Carbohydrate Intake and Intestinal Microbiotamentioning

confidence: 99%

Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health

et al. 2020

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“…It has also been proposed that these sweeteners could affect bacteria in the human gut, which are known to play an important role in metabolism, inflammation, immune function and chronic disease . A recent review of experimental studies and clinical trials on the effect of sweeteners on gut microbiota suggested that different types of artificial sweeteners might have different effects on the composition of the gut microbiome, but most of these were animal studies; the authors recommended that further research on the effect of sweeteners on human gut microbiota was needed . In a pooled analysis of the Nurses' Health and Health Professionals' Follow‐up studies, sugar‐sweetened beverage consumption was positively associated with cancer mortality (from all sites) but there was no association for artificially sweetened beverages .…”

Section: Discussionmentioning

confidence: 99%

Consumption of sugar‐sweetened and artificially sweetened soft drinks and risk of cancers not related to obesity

Bassett

Milne

English

et al. 2019

Intl Journal of Cancer

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Consumption of sugary drinks increases the risk of obesity. Previously, we reported a positive association between sugarsweetened soft drink consumption and obesity-related cancer, but this association was not fully explained by obesity; in contrast, we found no association for consumption of artificially sweetened soft drinks. Our aim was to determine whether the consumption of sugar-sweetened or artificially sweetened soft drinks was associated with cancers other than those currently identified as being related to obesity. We used data from the Melbourne Collaborative Cohort Study. Participants completed a 121-item food-frequency questionnaire at baseline including separate questions about the number of times in the past year they had consumed sugar-sweetened and artificially sweetened soft drinks. Cox regression models were fitted to estimate hazard ratios and 95% confidence intervals for the risk of cancers not related to obesity. During 19 years of follow-up, there were 35,109 eligible participants who developed 4,789 cancers not related to obesity. There was no association between frequency of consuming sugar-sweetened soft drinks and the risk of these cancers, but an unexpected positive association was observed for consumption of artificially sweetened soft drinks. Although, we did not find an association with sugar-sweetened soft drinks, we previously reported a positive association with obesity-related cancers, not fully explained by obesity. These findings leave unresolved the question of whether consumption of sugar-sweetened soft drinks influences cancer risk independently of their influence on body size.Additional Supporting Information may be found in the online version of this article.

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“…Further research is needed to confirm and characterize the potentially sex-specific biological mechanisms by which prenatal NNS exposure influences postnatal weight gain and adiposity. In addition to stimulating adipocyte differentiation, NNS may alter the maternal microbiome (33, 34), which is transmitted to the offspring during birth and postnatal interactions (35, 36), and contributes to host metabolism and weight gain (37-39). Future studies should also assess other types and sources of NNS, such as plant-derived NNS and NNS in foods.…”

Section: Discussionmentioning

confidence: 99%

Non-nutritive sweetener consumption during pregnancy affects adiposity in mouse and human offspring

Azad

Archibald

Tomczyk

et al. 2019

Preprint

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36Overweight and obesity affect over 20% of children worldwide. Emerging evidence shows that 37 nonnutritive sweeteners (NNS) could adversely influence weight gain and metabolic health, particularly 38 during critical periods of development. Thus, we aimed to investigate the impact of prenatal NNS 39 exposure on postnatal growth and adiposity. Among 2298 families participating in the CHILD cohort 40 study, children born to mothers who regularly consumed NNS during pregnancy had elevated body mass 41 index and adiposity at 3 years of age. In a complementary study designed to eliminate confounding by 42 human lifestyle factors and investigate causal mechanisms, we exposed pregnant mice and cultured 43 adipocytes to NNS (aspartame or sucralose) at doses relevant to human consumption. In mice, maternal 44 NNS exposure caused elevated body weight, adiposity and insulin resistance in offspring, especially in 45 males. Further, in 3T3-L1 pre-adipocyte cells, sucralose exposure during early stages of differentiation 46 caused increased lipid accumulation and expression of adipocyte differentiation genes (e.g. C/EBP-α, 47 FABP4, FAS). The same genes were upregulated in the adipose tissue of male mouse offspring born to 48 sucralose-fed dams. Together, these clinical and experimental findings provide evidence suggesting that 49 maternal NNS consumption induces obesity risk in the offspring through effects on adiposity and 50 adipocyte differentiation. 51Introduction 52 53 Globally, over 20% of children are overweight or obese, with rates exceeding 50% in some countries (1). 54The obesity epidemic has arisen alongside a surge in over-nutrition, which stimulates adipocytes to 55 expand and store excess calories. Mounting evidence shows that obesity originates early in life, perhaps 56 even in utero. The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that 57 prenatal and early postnatal exposures can "program" lifelong metabolism, weight gain, and other 58 endocrine pathways (reviewed in (2)). Moreover, in early life, environmental exposures can stimulate 59 adipocyte precursor cells to induce the process of adipocyte differentiation, creating a large reservoir of 60 adipocytes to support the development of obesity in response to over-nutrition later in life (3-7). 61 62 Excess energy intake from sugar, especially sugar-sweetened beverages, is strongly associated with 63 obesity (8-11); hence, sugar substitutes or "non-nutritive sweeteners" (NNS) including aspartame and 64 sucralose are marketed as healthier alternatives (12, 13). NNS are widely consumed, including by 65 pregnant women. Almost 30% of mothers in the Canadian CHILD cohort consumed NNS during 66 pregnancy (14), and similar rates have been reported in the USA (24% (15)) and Denmark (45% (16)). 67Contrary to their intended benefits, NNS have been inconsistently associated with metabolic 68 derangements and adverse effects on cardiometabolic health in adults (17)(18)(19) and children (20); 69 however, few studies have investigated the m...

show abstract

Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials

Cited by 297 publications

References 95 publications

Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health

Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health

Consumption of sugar‐sweetened and artificially sweetened soft drinks and risk of cancers not related to obesity

Non-nutritive sweetener consumption during pregnancy affects adiposity in mouse and human offspring

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