Hormonal responses to non-nutritive sweeteners in water and diet soda

Abstract

Background: Non-nutritive sweeteners (NNS), especially in form of diet soda, have been linked to metabolic derangements (e.g. obesity and diabetes) in epidemiologic studies. We aimed to test acute metabolic effects of NNS in isolation (water or seltzer) and in diet sodas.

Methods: We conducted a four-period, cross-over study at the National Institutes of Health Clinical Center (Bethesda, Maryland). Thirty healthy adults consumed 355 mL water with 0 mg, 68 mg, 170 mg, and 250 mg sucralose, and 31 individuals consumed 355 mL caffeine-free Diet Rite Cola™, Diet Mountain Dew™ (18 mg sucralose, 18 mg acesulfame-potassium, 57 mg aspartame), and seltzer water with NNS (68 mg sucralose and 41 mg acesulfame-potassium, equivalent to Diet Rite Cola™) in randomized order, prior to oral glucose tolerance tests. Blood samples were collected serially for 130 min. Measures included GLP-1, GIP, glucose, insulin, C-peptide, glucose absorption, gastric emptying, and subjective hunger and satiety ratings.

Results: Diet sodas augmented active GLP-1 (Diet Rite Cola™ vs. seltzer water, AUC, p = 0.039; Diet Mountain Dew™ vs. seltzer water, AUC, p = 0.07), but gastric emptying and satiety were unaffected. Insulin concentrations were nominally higher following all NNS conditions without altering glycemia. Sucralose alone (at any concentration) did not affect metabolic outcomes.

Conclusions: Diet sodas but not NNS in water augmented GLP-1 responses to oral glucose. Whether the trends toward higher insulin concentrations after NNS are of clinical importance remains to be determined. Our findings emphasize the need to test metabolic effects of NNS after chronic consumption.

Trial registration: The data for this manuscript were gathered from clinical trial #NCT01200940.

Keywords: Acesulfame-potassium; Diet soda; Gut peptides; Non-nutritive sweetener; Sucralose.

Figures

Fig. 1

Following a screening visit, subjects were randomized to consume either 355 mL water mixed with a sucralose dose of 0 mg (plain water control), 68 mg, 170 mg, or 250 mg (study arm 1) or 355 mL seltzer water (control), 355 mL caffeine-free Diet Rite Cola™ sweetened with 68 mg sucralose and 41 mg acesulfame-potassium, 355 mL caffeine-free Diet Mountain Dew™ sweetened with 18 mg sucralose, 18 mg acesulfame-potassium and 57 mg aspartame or 68 mg sucralose and 41 mg acesulfame-potassium in 355 mL of seltzer water (study arm 2) prior to an OGTT

Fig. 2

Serial data from OGTTs. Active glucagon-like-peptide 1 (GLP-1) (a) and gastric inhibitory peptide (GIP) (b) are shown after ingestion of either Diet Rite Cola™ ( with dashed line), Diet Mountain Dew™ ( with dotted line), 68 mg sucralose and 41 mg acesulfame-potassium in seltzer water ( with dashed and dotted line) or seltzer water ( with solid line) 10 min prior to a 75 g oral glucose load. Active GLP-1 was augmented in all three NNS conditions vs. the seltzer water condition. All data are expressed as mean ± standard error

Fig. 3

Serial data from OGTTs. Glucose (a), insulin (b), and C-peptide (c) are shown after ingestion of Diet Rite Cola™ ( with dashed line), Diet Mountain Dew™ ( with dotted line), 68 mg sucralose and 41 mg acesulfame-potassium ( with dashed and dotted line) or seltzer water ( with solid line). Insulin AUCs were 22 to 25% higher following all three NNS conditions vs. seltzer water (not statistically significant). All data are expressed as mean ± standard error