We know that sugar, consumed in large amounts, increases the risk of a range of health concerns. A recent study showed that artificial sweeteners may have similar consequences, but through completely different biochemical pathways.

During recent years, excessive sugar intake has been conclusively paired with obesity, diabetes, and cardiovascular disease—all of which are now solidly tied to the overconsumption of sugar.

As sugar's sweet reputation grew steadily more sour, artificial sweeteners took the opportunity to rise to fame.

Today, tens of thousands of products include artificial sweeteners, making them one of the most used food additives in the world. With zero calories, they make diet drinks and low-calorie snacks sweet enough to be enjoyed by even the most sugar-hooked consumers.

But, as it is often said, "all that glitters is not gold." Increasingly, studies are being published that reject artificial sweeteners' whiter-than-white image. Evidence is now mounting that consuming large amounts of these chemicals could also lead to obesity and metabolic disorders.

The findings of the most recent study to fling mud at artificial sweeteners were presented at the Experimental Biology 2018 conference, held in San Diego, CA, yesterday.

The research was led by Brian Hoffmann, PhD, an assistant professor in the Department of Biomedical Engineering at the Marquette University and Medical College of Wisconsin in Milwaukee.

A fresh look at sweeteners

Hoffmann explains why this topic interests him, saying, "Despite the addition of these non-caloric artificial sweeteners to our everyday diets, there has still been a drastic rise in obesity and diabetes."

This study is the most in-depth exploration—to date—of the biochemical changes wrought by artificial sweeteners in the body. To achieve this level of detail, they used a technique called unbiased high-throughput metabolomics.

Metabolomics refers to the study of the products of metabolism within cells, tissues, and animals.

They wanted to understand how sugar and sweeteners impact the lining of blood vessels—the vascular endothelium—in both cell cultures and rats.

So, they focused on two sugars (glucose and fructose) and the zero-calorie sweeteners aspartame and acesulfame potassium. To compare the similarly sweet yet calorifically opposed compounds, they fed them to rats and assessed them after 3 weeks.

Interestingly, the experiments revealed that sugar and artificial sweeteners both impaired the way that blood vessels worked. But, these impairments were achieved in different ways:

"In our studies, both sugar and artificial sweeteners seem to exhibit negative effects linked to obesity and diabetes, albeit through very different mechanisms from each other."

–Brian Hoffmann, PhD

The authors conclude that the vascular changes they observed "may be important during the onset and progression of diabetes and obesity."

Biochemical changes

Both sugar and artificial sweeteners produced changes in the levels of fats, amino acids, and other chemicals in the rats' blood. In particular, artificial sweeteners seemed to change how the body processes fat and gets its energy.

Further work will now be needed to unravel what these changes might mean in the long-term.

Also, the sweetener acesulfame potassium was found to slowly build up in the body. At higher concentrations, damage to blood vessels was more severe.

"We observed that, in moderation, your body has the machinery to handle sugar; it is when the system is overloaded over a long period of time that this machinery breaks down," explains Hoffmann.

"We also observed that replacing these sugars with non-caloric artificial sweeteners leads to negative changes in fat and energy metabolism."

The question we all want answered is "which is safer, sugar or sweeteners?" But, of course, when it comes to our internal chemistry, nothing is that clear cut. As Hoffmann says, "It is not as simple as 'stop using artificial sweeteners' being the key to solving overall health outcomes related to diabetes and obesity."

But, Hoffmann warns, "If you chronically consume these foreign substances (as with sugar) the risk of negative health outcomes increases."

Once again, it seems that moderation is the best course of action.