Two cans of diet drinks per week, or 2 to 3 sugars per day, is sufficient to increase the risk of type 2 diabetes.
Synthetic sweeteners are said to be at risk for type 2 diabetes (T2D), even at very low doses. This is what reveals a French study presented at the congress of the Francophone Society of Diabetes which takes place from March 28 to 31, in Lille. The mechanism of this association is based on stimulation of sugar receptors and variability in the microbiota maintained by sweeteners.
This work, carried out at the Institut Gustave Roussy (Villejuif), began in 1993. Between that date and 2011, 61,440 women participating in the E3N cohort study, from MGEN, were followed. They reported consuming 1 to 2 cans of light drinks per week, so very moderate doses. Yet at this level, researchers have shown increased risk of developing T2DM compared to women who did not consume this type of drink at all.
The study has since continued by focusing more particularly on sweeteners present in the diet, in the form of candies or powder, as well as in low-sugar dairy products.
2 to 3 sweets per day
The results, also published in the journal Annals of Nutrition and Metabolism, are surprising in terms of frequency and duration of consumption. The more sweeteners women consumed in the form of sweeteners or powder, the more they were at risk of developing T2DM, with a relative risk of 1.83. And the longer they used it, the more the risk increased compared to women who never used it. The risk was thus doubled in those who had consumed sweeteners for 10 years.
Although the researchers do not give a threshold dose, they have nevertheless found that it is enough to 2 to 3 sugars per day to be at risk. These results are independent of other risk factors for developing T2DM, in particular weight, BMI, etc.
Mechanisms to be elucidated
However, this work does not establish a causal link between diabetes and sweeteners, but an association. And the mechanisms that make it possible to explain it are, for the moment, only hypotheses. The strong appetite for sugar that is very often found in people who very frequently consume sweeteners can lead to overconsumption of calories, sugar but also other foods. In fact, in these people, the sugar receptors are therefore very activated, an activation maintained by sweeteners.
Another hypothesis lies in the intestinal microbiota: chronic and intense consumption of sweeteners can modify the variability of the microbiota. And we know that simple variability in intestinal bacterial populations can be associated with glucose intolerance, or insulin resistance.
The men undoubtedly concerned
Are some sweeteners more at risk? For Guy Fargherazzi, “many products exist, but today we are unable to conclude on the toxicity of a particular sweetener. However, when the study began in 1993, the major commercial sweetener was aspartame, so it is very likely that aspartame was involved in our study. It is true that today stevia occupies a large place, but no study today has reliable data and hindsight like our work to conclude to an effect of stevia. “
This observational study is only interested in women. Would men present the same risks? For Guy Fargherazzi, the mechanisms that can explain this association are not a priori linked to sex. So it would undoubtedly be found, but it remains to be confirmed by studies.
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