November 02, 2016
PracticeUpdate Editorial Team
November 2, 2016—New Orleans, Louisiana— Sucralose may lead to insulin resistance in people with obesity, according to new research from Washington University School of Medicine in St. Louis. The results were presented at ObesityWeek 2016, from October 31 – November 4.
Marta Yanina Pepino de Gruev, PhD, now at the University of Illinois, Urbana Champaign, presented these preliminary results of a small study in which normal-weight subjects and subjects with obesity took an oral glucose tolerance test after consuming sucralose.
Dr. Pepino de Gruev explained that it is unclear whether nonnutritive sweeteners are metabolically active, a topic widely discussed in the public health and scientific communities.
Dr. Pepino de Gruev and colleagues found in a previous study that sucralose, the most commonly used nonnutritive sweetener, increased insulinemic responses to an oral glucose tolerance test in subjects with obesity who did not use nonnutritive sweeteners regularly.
In many other studies, however, mostly in healthy lean adults and in which use of nonnutritive sweeteners was not controlled for, sucralose did not exert an effect on glycemic or insulin responses to ingestion of glucose or other carbohydrates.
Dr. Pepino de Gruev and coinvestigators, therefore, set out to determine whether the acute sucralose effects they found in obese individuals in their previous study was replicable, and whether it would generalize to lean subjects, after controlling for prior history of nonnutritive sweetener use.
The study population was composed of eight normal-weight (body mass index 22.9 ± 1.0 kg/m2) and seven obese subjects (body mass index 37.9 ± 4.7 kg/m2) who did not use nonnutritive sweeteners regularly and were “insulin-sensitive” (based on a Homeostasis Model Assessment of Insulin Resistance score <2.6).
Participants consumed sucralose (experimental condition) or water (control condition) 10 minutes before a glucose load in a 5-h modified oral glucose tolerance test on two separate occasions.
Preliminary results demonstrated that sucralose did not affect the glucose area under the curve in either the lean or obese group. In obese subjects, however, sucralose ingestion increased insulin and C-peptide area under the curves more than water (18 ± 10% and 12 ± 6% respectively, both P < .02).
Dr. Pepino de Gruev interpreted this increased rise with sucralose as suggesting increased insulin resistance.
In lean subjects, no statistically significant differences were observed for sucralose vs water ingestion in insulin or C peptide area under the curves.
Dr. Pepino de Gruev concluded, “The metabolic effects of sucralose in subjects with obesity were of small magnitude but replicable and statistically significant. Whether these acute effects of sucralose could influence how the body handles sugar long term is unknown.”
She added, “We need to do more research, but our findings suggest that sucralose may exert adverse effects on glucose metabolism in subjects with obesity, a population who frequently are advised to use nonnutritive sweeteners to help control their weight.”