Sugar Substitutes, Gut Health and Type 2 Diabetes

The whole conversation around the risks of consuming sugar, added sugars, and artificial sugar substitutes is confusing for anyone, especially those with diabetes.

The health risks associated with consuming too much sugar in your foods and drinks are alarming. But sugar is sneaky. When you think you figured it out, you look closely at nutrition labels, only to discover manufacturers have ways of hiding sugar in foods and drinks marketed as ‘healthy.’

When you know, a 16 oz bottle of Coke contains almost ten teaspoons of sugar; you think you’re making a better choice by reaching for a Diet Coke or Coke Zero. But recent studies suggest that fake sugars can also have unexpected effects on your gut and metabolic health and even promote food cravings and insulin resistance, leading to Type 2 diabetes. Not to mention, quitting Diet Coke can lead to headaches and withdrawal symptoms. I know because I’ve experienced the vicious cycle of quitting Diet Coke several times without much success.

And what about these murmurs that diet drinks make you fat? Morning TV shows love to share results from studies that have found using artificial sweeteners and drinking high amounts of diet soda is associated with an increased risk of obesity and metabolic syndrome. One study also reported a link between the high consumption of diet drinks and the increase in belly fat in older adults.

Drinking water is a great alternative. But if you’re like me, you enjoy a carbonated drink from time to time. So what do you do? A glance at the cold drinks shelves at my local bodega reveals a plethora of diet drinks. Every company offering a popular sugar-sweetened beverage now offers a sugar-free alternative. Each contains a list of ingredients a mile long with names only a scientist could understand.

If you’re wondering why sugar substitutes seem more prevalent in our food and drink choices, one reason could be the Food and Drug Administration’s proposal to stop companies from labeling a food “healthy” unless it adheres to strict new limits on added sugars. Savvy companies can conform to the proposed rules by replacing added sugars in foods with artificial sweeteners.

“When companies reformulate their foods to contain less sugar, it leads them to use more non-nutritive sweeteners,” said Jotham Suez, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, told the Washington Post.

Studies show that when countries such as Chile and Australia instituted similar policies to reduce sugar consumption, there was an increase in artificially sweetened foods and beverages.

“These low-calorie sweeteners are ubiquitous in the food supply, and so people often aren’t even aware that they’re consuming them,” said Allison Sylvetsky, an associate professor in the Department of Exercise and Nutrition Sciences at George Washington University.

Many sugar substitutes are often hundreds of times sweeter than table sugar. Some are synthetic, while others, like stevia and monk fruit extract, are referred to as “natural” because they’re derived from plants.

The confusion surrounding what to do makes me feel like I’m talking from two sides of my mouth. Divabetic has hosted several Sugar-Free Baking Programs on Zoom, and we have shared dozens of Sugar-Free Dessert Recipes. Both of these offerings have proven to be very popular with our community. We’ve even rewarded our followers with free gift baskets of popular artificial sweeteners. But after seeing the new findings, I’m unsure how to proceed.

The World Health Organization cautioned people to limit their intake of sugar substitutes because of their potential for “undesirable” long-term effects, including detrimental effects on gut and metabolic health.

What the heck is Gut Health?

Gut health refers to the health of the entire digestive system — the parts of our body responsible for breaking down our food into individual nutrients we use to run our bodies.

If you suffer from frequent discomfort, gas, bloating, constipation, diarrhea, and heartburn, your gut has difficulty processing food and eliminating waste. People with chronic fatigue may have imbalances in the gut.

Health Studies Seem To Only Make It More Confusing!

According to a Cedars-Sinaistudy, one type of bacteria in the gut may contribute to the development of Type 2 diabetes, while another may protect from the disease. The researchers admitted it is too early to know how people can change their microbiome to reduce their diabetes risk.

In the meantime, experts recommend using artificial sweeteners sparingly because science changing all the time. Many of these old and new sugar substitutes seem destined to spur ongoing concerns and confusion. All we can hope for is to use them in moderation as we strive to live our best diabetes lives.