Study Links Artificial Sweeteners to Endothelial and Metabolic Dysfunction

A new study suggests that exposure to high levels of either sugar or artificial sweeteners can lead to cardiovascular and metabolic dysfunction, as seen both in vivo and in endothelial cell cultures in rats.

Presented in late April at the 2018 Experimental Biology meeting, the study used a model of BB diabetes-resistant (BB-DR) rats to examine both blood plasma and endothelial changes in response to high concentrations of glucose and fructose, as well as aspartame and acesulfame potassium.

“Despite the addition of these non-caloric artificial sweeteners to our everyday diets, there has still been a drastic rise in obesity and diabetes,” notes lead researcher Brian Hoffmann, PhD, an assistant professor of biomedical engineering at the Medical College of Wisconsin and Marquette University, in a press release. “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.”

Impaired endothelial function and lipid metabolism

The researchers found that when exposed to high levels (25 mM) of glucose, cultured vascular endothelial cells extracted from the subject rats showed signs of impaired glycosylation.

Exposure to aspartame and acesulfame potassium also led to endothelial impairment, but gene expression analyses suggested that the mechanisms were different from those involved in glucose exposure.

Separately, for three weeks, rats were fed a diet high in either glucose, fructose, aspartame, or acesulfame potassium. A comprehensive metabolomics analysis of plasma showed “unique signatures of alterations in lipid metabolism” as a result of exposure to both types of artificial sweeteners.

Overall, the researchers note, the results suggest that both sugar and artificial sweeteners can “lead to unique mechanisms of vascular impairment and homeostatic alterations that may be important during the onset and progression of diabetes and obesity.”

Lessons for patients

Hoffmann cautions that moderation, rather than abstinence, is the overall lesson from the study for most people when it comes to all types of added sweeteners.

“In moderation, your body has the machinery to handle sugar,” he notes. “It is when the system is overloaded over a long period of time that this machinery breaks down.”

At the very least, though, the study suggests that replacing sugars with artificial sweeteners is a flawed strategy for overall health. “We…observed that replacing these sugars with non-caloric artificial sweeteners leads to negative changes in fat and energy metabolism,” says Hoffmann.

“If you chronically consume these foreign substances, as with sugar, the risk of negative health outcomes increases,” Hoffmann stresses. “As with other dietary components, I like to tell people moderation is the key if one finds it hard to completely cut something out of their diet.”

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