Non-sugar sweeteners linked to alterations in gut, stool microbiome
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Key takeaways:
- Non-sugar sweeteners induce alterations in microbiome composition.
- Some changes observed in the gut microbiome differed from stool samples.
- More studies are needed to better understand mechanisms.
Adults who consume non-sugar sweeteners have differences in gut and stool microbiome compositions compared with those who do not consume non-sugar sweeteners, according to study findings published in iScience.
In an analysis of the duodenal luminal microbiome and stool microbiome of a small group of adults, microbial differences were observed both for adults who consumed non-sugar sweeteners with aspartame as well as those who consumed non-aspartame non-sugar sweeteners compared with controls. Additionally, there were some differences between the aspartame and non-aspartame groups.
“The alterations in microbial diversity and composition as well as microbial metabolic pathways identified in this study raise concerns regarding the potential impacts of non-sugar sweeteners on metabolic and gastrointestinal health,” Ruchi Mathur, MD, endocrinologist and professor of medicine at Cedars-Sinai, told Healio. “Patients and providers should be aware of these findings, and individuals may consider moderating their consumption of non-sugar sweeteners. However, further research is needed to fully understand the underlying mechanisms and long-term implications.”
Mathur and colleagues analyzed duodenal luminal aspirates among 99 adults aged 18 to 85 years who underwent a standard of care esophagogastroduodenoscopy at Cedars-Sinai. Consumption of non-sugar sweeteners was self-reported. Fasting blood samples were collected for all participants. A subset of 40 adults also provided a stool sample for analysis.
Of the study group, 35 adults consumed non-aspartame non-sugar sweeteners, nine consumed aspartame only and 55 adults did not consume a non-sugar sweetener.
Alterations in the gut microbiome
Duodenal microbial alpha diversity was lower in the non-aspartame non-sugar sweetener group compared with the control group. There were no differences between the aspartame group and either the non-aspartame non-sugar sweetener group or the control group.
The relative abundance of Firmicutes was higher for adults consuming non-aspartame non-sugar sweeteners compared with controls, and the relative abundance of Proteobacteria was lower among the non-aspartame group vs. controls. No differences at the phylum level were observed between the aspartame and control group.
Among the 40 adults who submitted stool samples, no differences in stool microbial alpha or beta diversity were observed between the two groups. At the phylum level, the relative abundance of Chloroflexi, Epsilonbacteraeota and Fusobacteria were lower among the non-aspartame group vs. the control group. The non-aspartame non-sugar sweetener group had a higher abundance of Lentisphaerae and Proteobacteria than controls. The aspartame group had lower relative abundance of Euryarchaeota, Chloroflexi and Spirochaetes, and a higher relative abundance of Proteobacteria than controls.
“Interestingly, in the duodenum, the relative abundance of known bacterial disruptors Escherichia, Klebsiella and Salmonella (all from phylum Proteobacteria) was lower in both the non-aspartame non-sugar sweetener and aspartame groups compared to controls,” Mathur said. “This was in contrast to the stool findings, which showed an increase in the relative abundance of these organisms in those who consumed non-aspartame non-sugar sweeteners and aspartame. What this discrepancy means for the human host is to be determined, but it does show that the microbial ecology in various segments of the gut responds differently to these sweeteners.”
More studies needed
In blood samples, levels of interleukin-1 beta were lower in the non-aspartame non-sugar sweetener group compared with controls (P = .042). The aspartame group had lower levels of IL-10 (P = .025) and IL-6 (P = .025) than controls. Mathur said these decreased levels in circulating inflammatory markers indicated possible alterations in host immune responses that were associated with the microbiome changes observed in the study.
“Future research should focus on elucidating the mechanisms underlying the identified effects of non-sugar sweeteners on the gut microbiome,” Mathur said. “This includes investigating the specific pathways through which non-sugar sweeteners influence microbial diversity, composition and metabolic functions. Prospective studies could provide insights into the long-term consequences of non-sugar sweeteners consumption on health outcomes. Understanding the nuances between the effects of different types of non-sugar sweeteners, such as non-aspartame non-sugar sweeteners and aspartame, as explored here, could guide personalized recommendations. Further investigations with larger sample sizes, and consideration of absolute volume and frequency of non-sugar sweetener consumption, would contribute to a more comprehensive understanding of this important topic.”
For more information:
Ruchi Mathur, MD, can be reached at ruchi.mathur@cshs.org.
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