Artificial sweeteners change gut microbiota and can alter glucose spikes after meals

Author(s): Jesslyn Thay, Source: Cell , Date: 31 August 2022

New research has found that some sugar substitutes and artificial sweeteners can still cause blood glucose spikes, in addition to altering the gut microbiome. The study published in Cell found that non-nutritive sweeteners actually are not inert, as previously thought, and can cause changes in an individual’s glycaemic response.

The trial focussed on four common sugar substitutes (saccharin, sucralose, aspartame and stevia) and their effects on the 120 participants were monitored over two weeks. All the sweeteners changed the gut and oral microbiomes, in addition saccharin and sucralose significantly impaired glycaemic responses.

Sucralose and Saccharin are poorly absorbed in the gut with the majority of the sweetener and its metabolites being excreted. Whereas, the sweetener stevia was metabolised readily by gut bacteria, supplementation over two weeks showed an increase in certain types ofbacteria but noticeably Bacteroides coprophilus, Parabacteroides goldsteinii, and a Lachnospira spp – some of which are pathogenic.

In participants who consumed saccharin, their stool samples saw an elevation in the production of a certain type of amino acid echoing patterns seen in people with diabetes, found the researchers.

Researchers found that the sweeteners impacted gut microbiota by several direct and indirect mechanisms, and that metabolites may induce microbial growth inhibition of pathogens but also commensals.

In contrast, the sweetener aspartame is metabolised well by host enzymes in the proximal regions of the gastrointestinal tract altering the microbiome through multiple interactions. This result was found in both humans and animal models in the study.

The researchers emphasised that further research was needed around how sweeteners interact with microbiota and whether the immune system is affected. They also did not recommend the consumption of sugar over sweeteners, stating sugar: “is strongly linked to cardiometabolic diseases and other adverse health effects”.  


Suez, J., Cohen, Y., Valdés-Mas, R., Mor, U., Dori-Bachash, M., Federici, S., Zmora, N., Leshem, A., Heinemann, M., Linevsky, R., Zur, M., Ben-Zeev Brik, R., Bukimer, A., Eliyahu-Miller, S., Metz, A., Fischbein, R., Sharov, O., Malitsky, S., Itkin, M., Stettner, N., Harmelin, A., Shapiro, H., Stein-Thoeringer, C., Segal, E. and Elinav, E., 2022. Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance. Cell,. DOI: