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Artificial Sweeteners – Health threat or Health miracle?

Deputy Online Editor, Daisy Scott, discusses the different sides of the health argument around the effects that artificial sweeteners may be having on people's health
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Artificial Sweeteners – Health threat or Health miracle?

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Deputy Online Editor, Daisy Scott, discusses the different sides of the health argument around the effects that artificial sweeteners may be having on people’s health

There has been lots of research published recently into the effects that artificial sweeteners (AS) can have on our health and there have been both positive and negative findings. 

Artificial Sweeteners (E.g. Erythritol, Aspartame and Saccharin) are common replacements for table sugar in “low-calorie” and “low-carbohydrate”. Today, AS are described as one of the most important achievements in the food industry to date but they are also poorly understood substances with unknown effects on human health. Erythritol can be produced by fermenting corn and is 70% as sweet as sugar. 

This article will discuss the two sides of the health arguments that have been put forward on the impact that AS can have on peoples health

Elevated risk of blood clotting – 

Findings recently published in Nature Medicine suggests that the popular artificial sweetener erthyritol can be linked to an increased risk of blood clotting, heart attack and strokes in people with elevated risk factors for heart disease. This study looked at over 4,000 people in both the United States and Europe who were already undergoing cardiac evaluation. It found that subjects with higher blood erythritol levels were at an elevated risk of developing a heart attack or stroke.

Erthyritol can be linked to an increased risk of blood clotting, heart attack and strokes in people with elevated risk factors for heart disease

Although these results may seem scary, they do need to be viewed with a pinch of salt as the patients in the study already had elevated risk factors for heart disease and therefore were under cardiac evaluation. 

The authors of the study appreciate that this study needs follow-up studies to confirm this trend for the general population as the study was run on selected patients. Also, critics of the study say that the major limitation of the study is that the clinical observations demonstrate association and not causation. 

“Sugar-free” products, including those containing erythritol, are often recommended for individuals with diabetes or metabolic syndrome as an option to help them manage their sugar and calorie intake. Therefore, it could make people anxious to hear that the artificial sweeteners may cause increased risk of blood clotting and heart attacks. 

Stanley Hazen, chairman of the Department of Cardiovascular & Metabolic Sciences in the Lerner Research Institute has said that “Sweeteners like erythritol have rapidly increased in popularity in recent years but there still needs to be more in-depth research into their long-term effects. It is important that further safety studies are conducted to examine the long-term effects of artificial sweeteners in general, and erythritol specifically, on risks for heart attack and stroke, particularly in people at higher risk of cardiovascular disease. 

Antibiotic Resistance – 

However, it is not all bad when it comes to artificial sweeteners. There is recent evidence to suggest that artificial sweeteners can inhibit multidrug-resistant pathogen growth. 

Antimicrobial resistance is one of the most pressing concerns of modern times. The discovery of penicillin marked the beginning of a golden age in antibiotic discovery, with many new classes of antibiotics being discovered regularly. However, since the beginning of the 1990’s, this rate of antibiotic discovery has dramatically slowed down to nearly a standstill. This, along with the rapid emergence of bacterial pathogens that exhibit resistance to first-line antibiotic treatment has led to an antibiotic resistance crisis worldwide. Deaths attributed to antimicrobial resistance (AMR) reached $4.95 million in 2019 and it is estimated to reach a cumulative global cost of $100 trillion by 2050. However, new drug development is associated with significant financial and time commitments, with the average new drug taking up to 20 years and $1.33 billion to bring to the market. The high cost and long-time frame, combined with the high failure rate of novel active pharmaceutical agents in the pipeline, make it clear that alternative methods are required. 

New drug development is associated with significant financial and time commitments, with the average new drug taking up to 20 years and $1.33 billion to bring to the market.

Antibiotic resistance arises thanks to bacteria’s ability to adapt in response to drugs. It occurs naturally but overprescribing drugs in humans and misuse in animals is only making the situation worse. McCarthy has said “It has created a dangerous situation where a “post-antibiotic era” is becoming a reality. It threatens all aspects of healthcare, from cancer treatment to dental work”. Antibiotic resistance is currently considered to be one of the biggest threats to global health and food security by the WHO.

A recent study has found that artificial sweeteners display robust antibacterial activity against some of the most prevalent MDR bacterial pathogens. These pathogens are a major cause of nosocomial infections and can persist in the body even after being treated with antimicrobial agents. The three artificial sweeteners of choice in this study were saccharin, cyclamate and acesulfame-K. It was found that they could reduce a bacteria’s resistance to common antibiotics meaning that less of the antibiotic is needed for effective treatment. 

Artificial sweeteners can inhibit the growth of multidrug-resistant pathogens, disrupt virulence associated behaviours and potentiate antibiotic activity. Ace-K can inhibit a range of virulence traits such as biofilm formation, motility and natural transformation. As well as this, it weakens the bacterial cell membrane which leads to a loss of morphology. The growth inhibition and anti-virulence effects displayed by the AS tested in the study suggest that they may have therapeutic potential to prevent or treat infections. 

Dr Ronan McCarthy has said that “We discovered that these same sweeteners that you have with your coffee or in your “sugar free” soda could kill very dangerous bacteria and make them easier to treat”. 

The team on this study are planning to run further tests and are optimistic that all three sweeteners in the study could potentially offer new treatments for multidrug-resistant infection. If we are going to continue using artificial sweeteners, we really need to find out the long-term effects that they can have on people’s health whether that is for heart disease or the effective treatment of bacterial infections.  

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