Artificial sweeteners may age brain by 1.6 years: study

Evan Walker
Evan Walker TheMediTary.Com |
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  • Low-calorie sweeteners and sugar substitutes such as aspartame, saccharin, and xylitol have been used since the early 1900s.
  • Past studies show there may be potential health risks to using sugar substitutes, including cognitive issues.
  • A new study provides more evidence suggesting a correlation between sugar substitute use and cognitive decline.

Low-calorie sweeteners and sugar substitutes have been around for a long time. The first artificial sweetener, saccharin was first sold to consumers in the early 1900s.

Since the 1970s, the U.S. Food & Drug Administration (FDA) has approved six sugar substitutes for food additive use, including saccharin, sucralose, and aspartame, as well as sugar alcohols like xylitol and erythritol, and plant-based sugar substitutes like stevia and monk fruit.

Previous research shows there are some benefits to using sugar substitutes, including a reduced blood sugar spike for people with diabetes, and they may help protect the teeth from cavities and decay.

However, there have also been a number of studies showing the potential health risks of sugar substitutes, such as a possible negative impact on the gut microbiome. And low-calorie sweeteners have been linked to a higher risk of certain health conditions, such as heart attack and stroke, metabolic syndrome, obesity, migraine, and cancer.

Now, a new study recently published in Neurology, the medical journal of the American Academy of Neurology, provides more evidence suggesting a correlation between sugar substitute use and cognitive decline.

Additionally, researchers reported that in the study participant group that consumed the most artificial sweeteners, those under the age of 60 and those with diabetes had the fastest cognitive decline.

“One of the most surprising findings for me was that the association between low- and no-calorie sweetener consumption and cognitive decline was only significant among participants younger than 60 years old,” Suemoto said. “I had expected the association to be more evident in older adults, since they are at higher risk of dementia and cognitive impairment. Instead, our results suggest that midlife exposure to sweeteners may be particularly harmful, which is important because midlife is a critical period for setting the trajectory of brain health.”

“Cognitive decline and dementia are thought to begin developing decades before symptoms become noticeable, so exposures during midlife may accelerate these processes and have long-term consequences,” she continued. “This emphasizes the importance of understanding dietary habits earlier in adulthood, when preventive strategies could have the greatest impact.”

“Our study suggests that high consumption of artificial sweeteners may be linked to faster cognitive decline. While more research is needed before making firm recommendations, it would be reasonable for people to reduce their intake as much as possible, ideally avoiding these products altogether.”
— Claudia Kimie Suemoto, MD, PhD

MNT spoke with Kamal Wagle, MD, a geriatric specialist with Hackensack University Medical Center’s Center for Memory Loss and Brain Health in New Jersey, about this study, who commented that it is a noteworthy piece of research that adds to our understanding of how diet might affect long-term brain health.

Correlation not causation

“While the finding that high consumption is linked to a faster decline is thought-provoking, it’s crucial to immediately highlight what the researchers themselves pointed out: this study shows a link, not a cause. It doesn’t prove that sweeteners are responsible for cognitive decline. It’s possible that other lifestyle factors associated with high sweetener consumption are at play. The fact that the link was stronger in people under 60 and those with diabetes is particularly interesting and tells us where we need to focus more attention.”
— Kamal Wagle, MD

“As a next step, I would like to see research that tries to understand the ‘why’ behind this link,” he continued. “This study was observational, so a more controlled study would be helpful to move closer to determining causation. Furthermore, research into the biological mechanisms is needed: how might these specific sweeteners affect brain cells or vascular health?”

For readers who may want to lower their consumption of low- and no-calorie artificial sweeteners, we asked Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, for her top tips.

“The new findings add to a pattern of concerns, not causations, that may be associated with intake of artificial sweeteners,” Richard commented. “The end result may signal caution and conscientiousness — not conclusivity — and it reinforces my usual guidance to individuals and families to prioritize whole foods and savor Mother Nature’s sweeteners sparingly when necessary.”

Richard said, in addition to meeting with a registered dietitian nutritionist (RDN) to assess your individual needs, concerns, and dietary patterns, some general tips to minimize the use of artificial sweeteners in general include:

  • Conduct a Sweetener Audit: Scan labels of foods you regularly consume for common sweeteners such as aspartame, sucralose, saccharin, acesulfame-K, neotame, advantame, and erythritol/xylitol to track your daily “sweet hits” (drinks, bars, yogurts, and gums) for a week.
  • Taper Intake: Try decreasing, by 25% or 50%, the amount of sweetener you use over two to four weeks to none, or to naturally flavored seltzer, unsweet tea, or water with citrus, berries, herbs, or a combination.
  • Check Your Tastebuds With an Apple Test: On a scale of 1-10, with 10 being very sweet, how does an apple rate? It may indicate that you’ve frequently chosen sweetened foods often and are not as sensitive to naturally sweet food such as fruit. Over time, taste buds can be “retrained” and the “natural sweet” radar restored.
  • Swap Out Sweetener With Flavor: Use vanilla, cinnamon, cocoa, citrus zest, ginger, mint, or cardamom to boost satisfaction in coffee, yogurt, and oatmeal.
  • Use a Touch of Mother Nature’s Sugar: Try honey, maple syrup, fruit, pure sugarcane, agave, or monk fruit to sweeten beverages, baked goods, dressings, sauces or desserts — a little goes a long way.

“Don’t fear, but do add flavor and see how you can filter out the ‘hyper-sweet’ and synthetic additives in the diet for a Healthier body and brain,” Richard added.

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