Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance

Suez, Jotham; Cohen, Y.; Valdés-Mas, Rafael; Mor, Uria; Dori-Bachash, Mally; Federici, Sara; Zmora, Niv; Leshem, Avner; Heinemann, Melina; Linevsky, Raquel; Zur, Maya; Brik, Rotem Ben-Zeev; Bukimer, Aurelie; Eliyahu-Miller, Shimrit; Metz, Alona; Fischbein, Ruthy; Sharov, Olga; Malitsky, Sergey; Itkin, Maxim; Stettner, Noa; Harmelin, Alon; Shapiro, Hagit; Stein‐Thoeringer, Christoph K.; Segal, Eran; Elinav, Eran

doi:10.1016/j.cell.2022.07.016

Cited by 128 publications

(88 citation statements)

References 150 publications

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“…Although NNS have minimal or no calories and are used in minute quantities, their long-term health effects remain controversial, (23) with emerging evidence suggesting they may have detrimental consequences at least for some individuals. (24) Therefore, while it is undoubtedly in the interest of public health to reduce intake of added sugars, their replacement by NNS should be cautious and complemented by policies that promote replacement of SSBs by healthier alternatives, such as plain water or tea. A detailed analysis of the changes in NNS across the entire food and drink supply and its implications in Australia is available elsewhere (25) .…”

Section: Discussionmentioning

confidence: 99%

Trends in sugar content of non-alcoholic beverages in Australia between 2015 and 2019 during the operation of a voluntary industry pledge to reduce sugar content

Pinho-Gomes

Dunford

Jones

2022

Public Health Nutr.

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Objectives: To investigate changes in mean sugar content of non-alcoholic beverages (overall and sugar-sweetened beverages) available for purchase in Australia and to compare signatories versus non-signatories of the Australian Beverages Council voluntary pledge from 2018 Design: Retrospective observational study Setting: Australia Participants: About 1,500 non-alcoholic beverages per year included in the FoodSwitch Monitoring Datasets for 2015-2019 Results: Overall, mean sugar content fell by 1.3g/100mL (17.1%) from 7.5g/100mL in 2015 to 6.2g/100mL in 2019. SSBs have accounted for about 56% of all beverages available for purchase since 2015. Between 2015 and 2019, the sugar content of SSBs dropped by about 10% (0.8g/100mL). Soft drinks and milk-based drinks were the categories with the largest decrease in sugar content. The greater reduction in sugar observed for beverages overall than SSBs suggests at least some of the overall decrease in sugar content is due to the appearance of new products with low or no-sugar rather than reformulation. Over the same period, beverages with added non-nutritive sweeteners increased from 41% to 44%. The decrease in sugar content for all beverages and SSBs was, in general, larger for non-signatories than signatories of the voluntary industry pledge. Conclusions: Between 2015 and 2019, the small reduction in sugar content of non-alcoholic beverages in Australia resulted from the combined effects of introducing low or no-sugar products and reformulation of some categories of SSBs. Further policy and regulatory measures are required to reap the most benefit that sugar reduction among non-alcoholic beverages can bring to population health.

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Section: Discussionmentioning

confidence: 99%

Trends in sugar content of non-alcoholic beverages in Australia between 2015 and 2019 during the operation of a voluntary industry pledge to reduce sugar content

Pinho-Gomes

Dunford

Jones

2022

Public Health Nutr.

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“…Recently, some studies have reported that artificial sweeteners worsen glucose clearance in mice and humans [ 5 , 7 ]. In mice, only one week of saccharin, sucralose, and aspartame administration caused glucose intolerance.…”

Section: Artificial Sweeteners and Metabolismmentioning

confidence: 99%

“…A significant effect on the microbiome composition was observed in the sucralose and saccharin groups. These results suggest that preexposure affected the individual microbiome heterogeneity at baseline, the relationship between the host and the microbiome, and the sucralose-induced glucose intolerance [ 7 ].…”

Section: Artificial Sweeteners and Metabolismmentioning

confidence: 99%

“…However, substituting sugar-sweetened food and beverages with those that have been artificially sweetened may not be as beneficial as once thought [ 4 ]. Recently, it was reported that artificial sweeteners can affect glucose tolerance through changes in the microbiota composition [ 5 , 6 , 7 , 8 ]. Moreover, artificial sweeteners have side effects in terms of obesity, cardiovascular disease, and mortality [ 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Is the Use of Artificial Sweeteners Beneficial for Patients with Diabetes Mellitus? The Advantages and Disadvantages of Artificial Sweeteners

Iizuka

2022

Nutrients

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Artificial sweeteners have been developed as substitutes for sugar. Sucralose, acesulfame K (ACE K), aspartame, and saccharin are artificial sweeteners. Previously, artificial sweeteners were thought to be effective in treating obesity and diabetes. Human meta-analyses have reported that artificial sweeteners have no effect on body weight or glycemic control. However, recent studies have shown that artificial sweeteners affect glucose absorption in the intestinal tract as well as insulin and incretin secretion in humans and animals. Moreover, artificial sweeteners alter the composition of the microbiota and worsen the glycemic control owing to changes in the gut microbiota. The early intake of ACE K was also shown to suppress the taste response to sugar. Furthermore, a large cohort study showed that high artificial sweetener intake was associated with all-cause mortality, cardiovascular risk, coronary artery disease risk, cerebrovascular risk, and cancer risk. The role of artificial sweeteners in the treatment of diabetes and obesity should be reconsidered, and the replacement of sugar with artificial sweeteners in patients will require the long-term tracking of not only intake but also changes in blood glucose and weight as well as future guidance based on gut bacteria data. To utilize the beneficial properties of artificial sweeteners in treatment, further studies are needed.

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“…18 A recent randomised-control study supports the personalised nature of the microbiome, where non-nutritive sweeteners supplementation resulted in personalised effects on the microbiome but also the metabolome. 70 Every patient has their own individual microbiome, this is why it is hard to suggest one diet to suit them all. Evidence supporting this statement could be from a recent randomised control which showed benefits from an individualised diet in 58 individuals with IBS.…”

mentioning

confidence: 99%

Is the Microbiome the cause of Irritable Bowel Syndrome and Inflammatory Bowel Disease? Lessons to consider from odontology

O.P¹

2022

Preprint

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An increasing amount of research is pointing to the disrupted microbiome as the aetiology of Irritable bowel syndrome (IBS) and Inflammatory Bowel Disease(IBD). The true cause of the diseases is still not fully elucidated and the various treatments used are not truly effective in the long run, especially for IBD, since a true cure is not known to exist. Treatment failure is common for IBD and surgery is used when all else fails or in emergencies, many times leading to a perceived lower quality of life, not to mention the enormous cost for society for treatment up until that point and after. Although it is clear that the microbiome has a major role in the disease, it seems the majority of the research and treatments are still focused on treating and understanding the inflammation and not the primary cause of the inflammation in the first place. This was also the case for many decades in the search for the cause of periodontitis and gingivitis, a destructive and nondestructive inflammatory disorder respectively, the first resulting in loss of tissue supporting the teeth. There was much uncertainty and confusion until it was fully established that the microbiome was the cause. Periodontal treatments primarily nowadays reflect the cause, i.e. the removal of microbes. There is no doubt, however, that the inflammatory pathways are important in both diseases and the purpose of this text is not to dispute this in respect to gastrointestinal disorders too. However, a different view on inflammation and associated disorders is explored to explain the nature of extraintestinal manifestations. The aim of this report is not to fully review the literature to try and establish a true causality as there are many reviews that explore the microbial aspects of IBS and IBD. Instead, the objective is to above all reflect on what has been learned in the field of odontology/stomatology and discuss relevant gastrointestinal research in order to propose tentative hypotheses and questions regarding IBS and IBD aetiology. Perhaps it could help soften the confusion regarding the microbial aetiology while guiding future research and treatments, primarily regarding microbial transplants, antibiotics and diet. The microbial link to some gastrointestinal cancers is also discussed.

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Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance

Cited by 128 publications

References 150 publications

Trends in sugar content of non-alcoholic beverages in Australia between 2015 and 2019 during the operation of a voluntary industry pledge to reduce sugar content

Trends in sugar content of non-alcoholic beverages in Australia between 2015 and 2019 during the operation of a voluntary industry pledge to reduce sugar content

Is the Use of Artificial Sweeteners Beneficial for Patients with Diabetes Mellitus? The Advantages and Disadvantages of Artificial Sweeteners

Is the Microbiome the cause of Irritable Bowel Syndrome and Inflammatory Bowel Disease? Lessons to consider from odontology

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