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Nonnutritive Sweeteners and Their Role in the Gastrointestinal Tract

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Sweeteners

Part of the book series: Reference Series in Phytochemistry ((RSP))

Abstract

Non-nutritive sweeteners (NNS) were once thought to be metabolically inert, but have recently been shown to exert physiologic activity in the gastrointestinal tract. Mechanisms underlying their activity include binding to sweet taste receptors in enteroendocrine L-cells and pancreatic beta cells, through influencing glucose transport, and through altering the gut microbiota. The majority of in vitro studies demonstrate that NNS elicit gut hormone secretion and stimulate insulin release; and, findings from rodent models largely support these data. However, whether NNS affect gut hormones, insulin responses, glucose absorption, or microbiota in humans is not clear. Further research investigating the extent to which NNS exert clinically relevant activity in the gastrointestinal tract is required to determine whether these commonly consumed replacements for added sugars are beneficial or detrimental to human health.

Disclosures

The authors have no conflicts of interest.

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Abbreviations

FDA:

United states food and drug administration

GRAS:

Generally recognized as safe

NNS:

Non-nutritive sweetener

References

  1. Abou-Donia MB, El-Masry EM, Abdel-Rahman AA et al (2008) Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A 71:1415–1429

    Article  CAS  Google Scholar 

  2. Brown AW, Bohan Brown MM, Onken KL et al (2011) Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women. Nutr Res 31:882–888

    Article  CAS  Google Scholar 

  3. Brown RJ, Rother KI (2012) Non-nutritive sweeteners and their role in the gastrointestinal tract. J Clin Endocrinol Metab 97:2597–2605

    Article  CAS  Google Scholar 

  4. Brown RJ, Walter M, Rother KI (2012) Effects of diet soda on gut hormones in youths with diabetes. Diabetes Care 35:959–964

    Article  CAS  Google Scholar 

  5. Brown RJ, Walter M, Rother KI (2009) Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion. Diabetes Care 32:2184–2186

    Article  CAS  Google Scholar 

  6. Carakostas MC, Curry LL, Boileau AC et al (2008) Overview: the history, technical function and safety of rebaudioside A, a naturally occurring steviol glycoside, for use in food and beverages. Food Chem Toxicol 46(Suppl 7):S1–S10

    Article  CAS  Google Scholar 

  7. Chatsudthipong V, Muanprasat C (2009) Stevioside and related compounds: therapeutic benefits beyond sweetness. Pharmacol Ther 121:41–54

    Article  CAS  Google Scholar 

  8. Corkey BE (2012) Banting lecture 2011: hyperinsulinemia: cause or consequence? Diabetes 61:4–13

    Article  CAS  Google Scholar 

  9. Finger TE, Kinnamon SC (2011) Taste isn’t just for taste buds anymore. F1000 Biol Repord 3:20

    Google Scholar 

  10. Ford HE, Peters V, Martin NM et al (2011) Effects of oral ingestion of sucralose on gut hormone response and appetite in healthy normal-weight subjects. Eur J Clin Nutr 65:508–513

    Article  CAS  Google Scholar 

  11. Fowler SP, Williams K, Hazuda HP (2015) Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the san antonio longitudinal study of aging. J Am Geriatr Soc 63:708–715

    Article  Google Scholar 

  12. Fowler SP, Williams K, Resendez RG et al (2008) Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring) 16:1894–1900

    Article  Google Scholar 

  13. Fujita Y, Wideman RD, Speck M et al (2009) Incretin release from gut is acutely enhanced by sugar but not by sweeteners in vivo. Am J Physiol Endocrinol Metab 296:E473–E479

    Article  CAS  Google Scholar 

  14. Gardener H, Rundek T, Markert M et al (2012) Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study. J Gen Intern Med 27:1120–1126

    Article  Google Scholar 

  15. Grice HC, Goldsmith LA (2000) Sucralose – an overview of the toxicity data. Food Chem Toxicol 38(Suppl 2):S1–S6

    Article  CAS  Google Scholar 

  16. Grotz VL, Munro IC (2009) An overview of the safety of sucralose. Regul Toxicol Pharmacol 55:1–5

    Article  CAS  Google Scholar 

  17. Gurley BJ, Swain A, Williams DK et al (2008) Gauging the clinical significance of P-glycoprotein-mediated herb-drug interactions: comparative effects of St. John’s wort, Echinacea, clarithromycin, and rifampin on digoxin pharmacokinetics. Mol Nutr Food Res 52:772–779

    Article  CAS  Google Scholar 

  18. International Programme on Chemical Safety Acesulfame Potassium. Available at http://www.inchem.org/

  19. International Programme on Chemical Safety (Inchem) Saccharin. Available at http://www.inchem.org/

  20. Jang HJ, Kokrashvili Z, Theodorakis MJ et al (2007) Gut-expressed gustducin and taste receptors regulate secretion of glucagon-like peptide-1. Proc Natl Acad Sci U S A 104:15069–15074

    Article  CAS  Google Scholar 

  21. Jeppesen PB, Gregersen S, Alstrup KK et al (2002) Stevioside induces antihyperglycaemic, insulinotropic and glucagonostatic effects in vivo: studies in the diabetic Goto-Kakizaki (GK) rats. Phytomedicine 9:9–14

    Article  CAS  Google Scholar 

  22. Li F (2013) Taste perception: from the tongue to the testis. Mol Hum Reprod 19:349–360

    Article  CAS  Google Scholar 

  23. Lown KS, Bailey DG, Fontana RJ et al (1997) Grapefruit juice increases felodipine oral availability in humans by decreasing intestinal CYP3A protein expression. J Clin Invest 99:2545–2553

    Article  CAS  Google Scholar 

  24. Ma J, Bellon M, Wishart JM et al (2009) Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects. Am J Physiol Gastrointest Liver Physiol 296:G735–G739

    Article  CAS  Google Scholar 

  25. Ma J, Chang J, Checklin HL et al (2010) Effect of the artificial sweetener, sucralose, on small intestinal glucose absorption in healthy human subjects. Br J Nutr 104:803–806

    Article  CAS  Google Scholar 

  26. Mace OJ, Affleck J, Patel N et al (2007) Sweet taste receptors in rat small intestine stimulate glucose absorption through apical GLUT2. J Physiol 582:379–392

    Article  CAS  Google Scholar 

  27. Magnuson BA, Burdock GA, Doull J et al (2007) Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Crit Rev Toxicol 37:629–727

    Article  CAS  Google Scholar 

  28. Margolskee RF, Dyer J, Kokrashvili Z et al (2007) T1R3 and gustducin in gut sense sugars to regulate expression of Na+-glucose cotransporter 1. Proc Natl Acad Sci U S A 104:15075–15080

    Article  CAS  Google Scholar 

  29. Masubuchi Y, Nakagawa Y, Ma J et al (2013) A novel regulatory function of sweet taste-sensing receptor in adipogenic differentiation of 3T3-L1 cells. PLoS One 8:e54500

    Article  CAS  Google Scholar 

  30. Mattes RD, Popkin BM (2009) Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 89:1–14

    Article  CAS  Google Scholar 

  31. Miller SA, Frattali VP (1989) Saccharin. Diabetes Care 12:74–80

    Article  CAS  Google Scholar 

  32. Nakagawa Y, Nagasawa M, Yamada S et al (2009) Sweet taste receptor expressed in pancreatic beta-cells activates the calcium and cyclic AMP signaling systems and stimulates insulin secretion. PLoS One 4:e5106

    Article  Google Scholar 

  33. Nettleton JA, Lutsey PL, Wang Y et al (2009) Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 32:688–694

    Article  CAS  Google Scholar 

  34. O’connor L, Imamura F, Lentjes M et al (2015) Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia 58:1474–1483

    Article  Google Scholar 

  35. Otabe A, Fujieda T, Masuyama T et al (2011) Advantame – an overview of the toxicity data. Food Chem Toxicol 49(Suppl 1):S2–S7

    Article  CAS  Google Scholar 

  36. Palmnas MS, Cowan TE, Bomhof MR et al (2014) Low-dose aspartame consumption differentially affects gut microbiota-host metabolic interactions in the diet-induced obese rat. PLoS One 9:e109841

    Article  Google Scholar 

  37. Pepino MY (2015) Metabolic effects of non-nutritive sweeteners. Physiol Behav 152:450–455

    Article  CAS  Google Scholar 

  38. Pepino MY, Bourne C (2011) Non-nutritive sweeteners, energy balance, and glucose homeostasis. Curr Opin Clin Nutr Metab Care 14:391–395

    Article  CAS  Google Scholar 

  39. Pepino MY, Tiemann CD, Patterson BW et al (2013) Sucralose affects glycemic and hormonal responses to an oral glucose load. Diabetes Care 36:2530–2535

    Article  CAS  Google Scholar 

  40. Peters JC, Wyatt HR, Foster GD et al (2014) The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity (Silver Spring) 22:1415–1421

    Article  Google Scholar 

  41. Renwick AG (2006) The intake of intense sweeteners – an update review. Food Addit Contam 23:327–338

    Article  CAS  Google Scholar 

  42. Roberts A, Renwick AG, Sims J et al (2000) Sucralose metabolism and pharmacokinetics in man. Food Chem Toxicol 38(Suppl 2):S31–S41

    Article  CAS  Google Scholar 

  43. Rogers PJ, Hogenkamp PS, De Graaf C et al (2015) Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes (Lond) 40:381

    Article  Google Scholar 

  44. Sanz Y, Santacruz A, Gauffin P (2010) Gut microbiota in obesity and metabolic disorders. Proc Nutr Soc 69:434–441

    Article  CAS  Google Scholar 

  45. Schiffman SS, Rother KI (2013) Sucralose, a synthetic organochlorine sweetener: overview of biological issues. J Toxicol Environ Health B Crit Rev 16:399–451

    Article  CAS  Google Scholar 

  46. Schmiedlin-Ren P, Edwards DJ, Fitzsimmons ME et al (1997) Mechanisms of enhanced oral availability of CYP3A4 substrates by grapefruit constituents. Decreased enterocyte CYP3A4 concentration and mechanism-based inactivation by furanocoumarins. Drug Metab Dispos 25:1228–1233

    CAS  Google Scholar 

  47. Steinert RE, Frey F, Topfer A et al (2011) Effects of carbohydrate sugars and artificial sweeteners on appetite and the secretion of gastrointestinal satiety peptides. Br J Nutr 105:1320–1328

    Article  CAS  Google Scholar 

  48. Suez J, Korem T, Zeevi D et al (2014) Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 514:181–186

    Article  CAS  Google Scholar 

  49. Suez J, Korem T, Zilberman-Schapira G et al (2015) Non-caloric artificial sweeteners and the microbiome: findings and challenges. Gut Microbes 6:149–155

    Article  CAS  Google Scholar 

  50. Suzuki H, Sugiyama Y (2000) Role of metabolic enzymes and efflux transporters in the absorption of drugs from the small intestine. Eur J Pharm Sci 12:3–12

    Article  CAS  Google Scholar 

  51. Swithers SE (2013) Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab 24:431–441

    Article  CAS  Google Scholar 

  52. Swithers SE, Davidson TL (2008) A role for sweet taste: calorie predictive relations in energy regulation by rats. Behav Neurosci 122:161–173

    Article  Google Scholar 

  53. Swithers SE, Laboy AF, Clark K et al (2012) Experience with the high-intensity sweetener saccharin impairs glucose homeostasis and GLP-1 release in rats. Behav Brain Res 233:1–14

    Article  CAS  Google Scholar 

  54. Sylvetsky A, Rother KI, Brown R (2011) Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions. Pediatr Clin North Am 58:1467–1480, xi

    Article  Google Scholar 

  55. Temizkan S, Deyneli O, Yasar M et al (2015) Sucralose enhances GLP-1 release and lowers blood glucose in the presence of carbohydrate in healthy subjects but not in patients with type 2 diabetes. Eur J Clin Nutr 69:162–166

    Article  CAS  Google Scholar 

  56. Thiebaut F, Tsuruo T, Hamada H et al (1987) Cellular localization of the multidrug-resistance gene product P-glycoprotein in normal human tissues. Proc Natl Acad Sci U S A 84:7735–7738

    Article  CAS  Google Scholar 

  57. Toyono T, Seta Y, Kataoka S et al (2007) CCAAT/Enhancer-binding protein beta regulates expression of human T1R3 taste receptor gene in the bile duct carcinoma cell line, HuCCT1. Biochim Biophys Acta 1769:641–648

    Article  CAS  Google Scholar 

  58. US Food and Drug Administration (2004) Guidance for industry: frequently asked questions about GRAS. In: Center for Food Safety and Applied Nutrition (ed) United States Department of Health and Human Services. Silver Spring, Maryland

    Google Scholar 

  59. United States Food and Drug Administration (2015) Additional information about high-intensity sweeteners permitted for use in food in the United States. Silver Spring, Maryland

    Google Scholar 

  60. United States Food and Drug Administration (2014) Food additives permitted for direct addition to food for human consumption; Advantame. In: Department of Health and Human Services (ed) United States Department of Health and Human Services. Silver Spring, Maryland

    Google Scholar 

  61. Whitehouse CR, Boullata J, Mccauley LA (2008) The potential toxicity of artificial sweeteners. AAOHN J 56:251–259, quiz 260–251

    Article  Google Scholar 

  62. Wu T, Zhao BR, Bound MJ et al (2012) Effects of different sweet preloads on incretin hormone secretion, gastric emptying, and postprandial glycemia in healthy humans. Am J Clin Nutr 95:78–83

    Article  CAS  Google Scholar 

  63. Yadav SK, Guleria P (2012) Steviol glycosides from Stevia: biosynthesis pathway review and their application in foods and medicine. Crit Rev Food Sci Nutr 52:988–998

    Article  CAS  Google Scholar 

  64. Zheng Y, Sarr MG (2013) Effect of the artificial sweetener, acesulfame potassium, a sweet taste receptor agonist, on glucose uptake in small intestinal cell lines. J Gastrointest Surg 17:153–158; discussion p 158

    Article  Google Scholar 

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Acknowledgements

This work was supported in part by the intramural research program of the National Institute of Diabetes and Digestive and Kidney Diseases and in part by the Department of Exercise and Nutrition Sciences at the George Washington University.

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Correspondence to Allison C. Sylvetsky .

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Sylvetsky, A.C., Abdelhadi, J., Issa, N., Rother, K.I. (2018). Nonnutritive Sweeteners and Their Role in the Gastrointestinal Tract. In: Mérillon, JM., Ramawat, K. (eds) Sweeteners. Reference Series in Phytochemistry. Springer, Cham. https://doi.org/10.1007/978-3-319-27027-2_4

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