Artificial Sweeteners and Metabolic Syndrome: Paradox of Physiological Behavior or Neuroendocrine Mechanisms

Haritha Boppa,Kamala Vasanthi Karyamsetty,Kusuma Naredla,Maha Lakshmi Meesala,Maheswara Reddy Mallu,Niranjan Babu Akula,Shaheena Dudekula,Trishanthi Thota

doi:10.9734/jpri/2020/v32i3330953

Haritha Boppa, Kamala Vasanthi Karyamsetty + Show 6 more

Open Access

https://doi.org/10.9734/jpri/2020/v32i3330953

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Abstract

Artificial sweeteners owing to their non-caloric nature were proposed as a healthful means with the prospective benefits. Epidemiological data indicate direct relationship between artificial sweetener intake and increase in body weight, glycemic status, and adiposity. Despite strong association, evidence is still lacking in establishing the causal relationship between artificial sweeteners and various risk factors for the development of metabolic syndrome. In vitro studies have disclosed that artificial sweeteners similar to glucose/fructose bind to sweet-taste receptors on the tongue and intestinal mucosa stimulating enhanced sugar absorption, through glucagon like peptide-1 (GLP-1) secretion. Human studies failed to recapitulate these effects, advocating that artificial sweeteners rather serve to promote food consumption rather than improving satiety. Therefore, enhanced food consumption, disallowance of caloric adjustments could in some measure explain body weight gain with the use of artificial sweeteners. However, the physiological behavior and neuroendocrine mechanisms by which the non-caloric sweeteners may stimulate appetite needs further scrutiny.

Highlights

1.1 Diabetes, Obesity and Metabolic Syndrome (DO & MS)According to the latest International Diabetes Federation (IDF) Atlas, around 415 million adults have diabetes globally with type 2 diabetes mellitus is reaching epidemic proportions [1]
On the contrary, denying the in vitro data that application of sucralose to L-cells stimulates glucagon like peptide-1 (GLP-1) secretion, equisweet loads of AS dissolved in 250 ml of water did not affect gastrointestinal GLP-1 secretion and showed only minimal effects on appetite compared to glucose or fructose load in a placebo-controlled, double-blind, six-way, crossover trial in healthy subjects [49]. These results suggest that both glucose and fructose increased satiety and fullness compared with water and that more than sweetness, the structural analogy of sweeteners to glucose could be important in determining the GLP-1 secretion response and glucose homeostasis
This review aimed to provide current and comprehensive information regarding the effects of artificial sweeteners on food intake, body weight, glycemic control, and sweet liking and craving

Summary

INTRODUCTION

According to the latest International Diabetes Federation (IDF) Atlas, around 415 million adults have diabetes globally with type 2 diabetes mellitus is reaching epidemic proportions [1]. Prospective cohort studies in adults have shown an association between artificial sweetener intake and the incidence of the metabolic syndrome and its components, including waist circumference, BMI, blood pressure, and fasting blood glucose [32,33] None of these studies established a causal relationship between ASB consumption and weight gain and do not confirm the hypothesis that the use of non-nutritive sweeteners causes increased weight gain. Individuals seeking to shed weight or maintain weight and control glucose levels often switch to artificial sweeteners in order to reduce their caloric intake in the form of sugars, but they tend to show increased fast-food consumption Consistent with this later statement, several prospective studies have found no strong relationship between AS consumption and weight change. Critical piece of evidence for interactions of artificial sweeteners with taste receptors is still lacking and needs molecular modeling and rigorous assessment of in vitro and in vivo effects

ALTERNATE MECHANISMS

Findings

CONCLUSIONS