Acute Impact of Non-Sugar Sweeteners on Glycemia in Middle-Aged and Older Adults with Prediabetes

Abstract

The consumption of non-sugar sweeteners (NSS) has significantly increased over the years, particularly in middle-aged and older adults who are coincidentally at increased risk of developing impaired glucose tolerance. However, the understanding of how individual NSS impacts glycemia in this at-risk population is unknown. The objective of these two different three-group randomized crossover studies was to determine if the intake of commonly consumed NSS has an acute effect on glucose and insulin. Participants (n=14) were middle-aged and older adults ≥40 years old with prediabetes, who consume <1 serving of NSS per week. The first study compared aspartame and sucralose to a control condition (an identical testing condition containing the same calories, added sugar, and macronutrient composition, but no NSS), while the second study compared saccharin and acesulfame potassium (Ace-K) to the same control condition. Sucralose had a significant effect on glucose (13±4 mg/dL; p=0.017) but no impact on insulin concentrations compared to control (0.4±6.5 mg/dL), while aspartame did not exert any effect on either of the study outcomes. No significant impact on glycemia was noted for either saccharin and Ace-K compared to control, however, saccharin had a significant impact on insulin secretion (1328±751 mIU/mLxmin; p=0.05) and Ace-K demonstrated decreased insulin sensitivity (3±2; p=0.028) compared to control. These findings suggest that NSS may impact blood glucose and insulin concentrations in middle-aged and older adults with prediabetes, albeit differentially as NSS have different biochemical structures and metabolizing pathways. Limitations to existing NSS literature are addressed and recommendations for future directions are suggested.