Artificial sweeteners and type 2 diabetes

Are you a little (or very) confused about artificial sweeteners? Many of us try to avoid sugar at all costs, often replacing it with sweeteners whose names sound more like things you’d find in a lab rather than on your plate. It seems a few clarifications are in order.

Digestion | Healthy Eating

Sonia Chartier

30 March 2017

Sugar’s dark side

We all know about sugar’s dark side: it makes us fat and erodes our teeth, and eating too much of it can eventually lead to all kinds of health problems, including type 2 diabetes. That’s why it seems logical to choose foods sweetened with calorie-free sugar replacements, because after all, “diet” means healthier, right? Wrong! Many of those sweeteners don’t yield the results we want—in many cases, the opposite is true!

First of all, you’ve probably seen them everywhere: in yogurt, desserts, breakfast cereals, condiments and especially soft drinks. Once you start reading ingredient labels, regardless of the product, there’s a good chance you’ll find mysterious ingredients whose name ends in “ose”, “ol” or “ame”: sucralose, sorbitol and the ubiquitous aspartame. But it’s important to differentiate between polyalcohols (aka sugar alcohols) and synthetic sweeteners.

Polyalcohols and synthetic sweeteners

Polyalcohols such as sorbitol, erythritol, maltitol, mannitol and xylitol are typically manufactured, but they also occur naturally in plants. They’re found above all in products, including chewing gum, labelled “sugar-free” or with “no added sugars.” They taste more like natural sugars and cause fewer problems. They don’t sweeten as much as artificial sweeteners and in large quantities they can cause stomachache.

Researchers are now taking a closer look at the previously unknown effects of artificial sweeteners such as aspartame, acesulfame-potassium, cyclamate, saccharine and sucralose. They sweeten much more than sugar and their glycemic index is much lower, verging on zero. The way they work is actually quite simple: they provide a sweet taste, but the body doesn’t recognize them as nutrients and doesn’t derive any energy from them. Other than aspartame, which contains 4 calories/gram, artificial sweeteners are calorie-free.

The dark side of artificial sweeteners

We use them to avoid getting fat and eat less sugar, but does it really work?

According to the latest research, diet soft drinks and artificial sweeteners increase the risk of obesity and accelerate the development of excess abdominal fat. A recent study showed that drinking at least one diet soda per day is associated with a 36% greater risk of metabolic syndrome , a known precursor to a wide range of chronic illnesses.

It’s not a disease in itself, but rather a set of symptoms, including high blood pressure, excess abdominal fat, abnormal cholesterol levels and high triglycerides. The more of these conditions you have, the more likely it is that you’ll suffer from heart disease, diabetes, a stroke, colorectal cancer, and so on.

The same seven-year study noted a 67% higher risk of contracting type 2 diabetes. And the study focused on diet soft drinks, which consumers typically choose as a healthy alternative to sugar-packed beverages.

The study’s authors also noted that these artificial sweeteners directly changed the nature of people’s intestinal flora, affecting their glucose tolerance . The sweeteners don’t activate the brain’s reward and satisfaction centre the same way as natural sugars do, leading to overconsumption of products containing the artificial sweeteners. So basically, consuming more sweet food creates a sugar addiction.

We know that artificial sweeteners:

  • Do not in themselves constitute a means of losing weight
  • Can actually lead to weight gain or an increase in body mass index (BMI)
  • Reduce your energy intake
  • Are less effective than reducing your caloric intake and exercising more
  • Can cause cravings, whose purpose is to make you consume the energy your body lacks
  • Can lead to overeating

As it turns out, the best way to avoid these pitfalls is to limit your consumption of added sugars and sugar substitutes. While we like to explore, we tend to crave foods we’re used to. So logically, the fewer sweet foods we eat, the less we’ll want to eat them.


Nettleton J.A. et al. Diabetes Care. 2009 Apr; 32(4): 688–694.
Suez J. et al. Nature. 2014 Oct 9;514(7521):181-6
Yale J Biol Med. 2010 Jun; 83(2): 101–108


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