Sucralose vs. sugar: Which is better for your gut health?

Evan Walker
Evan Walker TheMediTary.Com |
A spoonful of sucralose artificial sweetener spilled on a table counterShare on Pinterest
A study investigates whether sucralose is a safer alternative to gut health compared to sugar. ‘CWP, LLC’/Stocksy United
  • The continual rise in obesity worldwide has reemphasized the need for healthier sugar substitutes.
  • The past few years have seen various new sugar substitutes become available.
  • Previous research shows some artificial sweeteners can potentially cause health issues.
  • Researchers from the University of Vienna found that consuming the artificial sweetener sucralose did not cause an increase in bacterial endotoxin levels in the body, compared to consuming sugar.

A new study in Austria examined how artificial sweetener sucralose impacts our gut health and found that it may be a safer alternative to consuming sugar.

While sugar substitutes have been popular for some time, the Health Organization" rationale="Highly respected international organization">continual rise in global obesity numbers has reemphasized the need for Healthier alternatives to the sweet stuff we all enjoy.

The past few years have seen various new sugar substitutes become available, including aspartame, sucralose, erythritol, monk fruit, and stevia leaf extracts.

While the Food and Drug Administration (FDA) approves all sugar substitutes for use in foods, previous research has shown some artificial sweeteners can potentially cause health issues such as increased risk for cardiovascular disease, modifications to the gut microbiome, and depression.

Now, researchers from the University of Vienna in Austria found when consumed, the artificial sweetener sucralose did not cause an increase in bacterial endotoxin levels in the body when compared to consuming sugar, also known as sucrose.

This study was recently published in the journal Nutrients.

For this study, researchers recruited 18 non-smoking participants with a specified Body Mass Index (BMI) range. Only 11 participants reportedly completed the study.

Study participants were asked not to eat intense sweeteners for three weeks before the study. For the study, they were given dietary adjustments based on different nutrition guidelines.

On certain days, the study participants were fed a light breakfast and a drink containing sucrose, sucralose, or a sucralose-maltodextrin blended beverage.

Upon analysis, the researchers reported those who drank the sucrose-sweetened drink had higher bacterial endotoxin levels in their blood plasma compared to those who consumed the sucralose-sweetened or sucralose-maltodextrin blended beverage.

To see if the increase in endotoxin levels in blood plasma was due to changes in intestinal barrier function, the scientists used a model of colon cells. These cells were grown in a membrane dividing an upper and lower chamber. The upper chamber was treated with either sucralose or sucrose and then exposed to bacterial endotoxin. If treatment with the sweeteners affects the intestinal barrier, bacterial endotoxin should pass through the cell layer and be detectable in the lower chamber.

Researchers reported no significant change in bacterial endotoxin levels in the lower chamber when cells were treated with sucralose.

However, when cells were treated with sucrose, there was a significant increase in bacterial endotoxin levels in the lower chamber. Additionally, there was a boost in intestinal fatty acid binding protein (iFABP) concentration, which can be a sign of intestinal barrier disruption.

After reviewing this study, Monique Richard, a registered dietitian nutritionist, owner of Nutrition-In-Sight, and national media spokesperson for the Academy of Nutrition Dietetics told Medical News Today she was struck by how limited the participant sample size was and would have liked more information on the study participants.

“I also observed that 110gm of sucrose was given in a beverage which would equate to a little over 26 teaspoons of sugar, higher than most regular soft drinks,” Richard continued. “The glycemic response, metabolic process, and affected gut health from the cascade of this intense concentration are not necessarily surprising.”

“The findings from this study do not conclusively provide evidence that artificial sweeteners such as sucralose are a ‘better alternative’ to sucrose or that they do not affect a person’s overall metabolic Health in other ways — it is much more complex.

It would be important to see a larger sample and specifically gather more standard baseline control factors for the human participants. More research on artificial sweeteners’ impact on satiety, taste-bud and sensory receptors, and neurotransmitter activity in the brain would also be important to explore. A deeper dive into the diversity of gut microbiomes being affected — as we have seen some limited research related to artificial sweeteners affecting diversity — would also be interesting.”

– Monique Richard, registered dietitian nutritionist

Dr. Amy Sapola, Director of Pharmacy at The Chef’s Garden and a certified wellness coach with a degree in nutrition, agreed.

“This study, in particular, needs to be conducted in a much larger population, in type 2 diabetics, and for a longer duration, with daily consumption,” she told Medical News Today. “Overall, I am less interested in advocating for more research dollars going to studying artificial sweeteners, and more interested in this type of funding going to communicating the message that there are many unsweetened beverages that are less expensive and will better support overall health.”

Richard said whatever sugar substitute you incorporate into your diet is an individual decision.

She recommends asking yourself these questions when considering a beverage with an artificial sweetener or sweetened beverage such as a soft drink, energy drink, or coffee drink:

  • How often am I drinking this? How much am I having? Do I always want more or crave food to eat with it?
  • Do I understand how those ingredients may affect my health?
  • How do I feel after? Do I experience any bloating, gastrointestinal discomfort, or headaches?
  • How may my taste buds be affected? For example, does fruit taste sweet to me? (hint: it is naturally sweet, and should)
  • Is this something that is supporting my nutritional needs or simply for pleasure? Are there better alternatives?

Dr. Sapola said the safest and healthiest beverages and foods you can consume are not artificially sweetened:

“Think about filtered water, sparkling waters, club soda, mineral water, unsweetened non-dairy milk, organic teas, water with fruit squeezed into it,” she detailed. “Instead of going for artificially sweetened foods consider mindfully eating a few bites of the real version of what you are craving — which is often much more satisfying — or try naturally sweet foods such as sweet potatoes, fresh fruit — like bananas, which can also be used to sweeten baked goods — berries, or a 70% or higher good quality dark chocolate, such as Lindt.”

“Also consider pairing naturally sweet foods along with foods that contain fiber, protein, and/or fat in order to slow down the rise in blood glucose,” Dr. Sapola added. “For example, with a sweet potato, eat the skin of the sweet potato (has fiber and phytonutrients), add coconut oil (fat), and pumpkin seeds (vitamins, minerals, fat, and protein).”

“What is important to remember is that the purpose of food — to fuel our bodies — with the highest quality of ingredients we can find should be our focus,” Richard concluded. “When we narrow in on meeting our needs with the appropriate servings of whole foods and natural hydration from quality, not synthetically or artificially manufactured sources, it automatically tends to push out a lot of room for adding unnecessary calories or lower/no-calorie foods with no benefits to our overall health possible.”

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