Artificial sweeteners may increase the risk of type 2 diabetes | 人造甜味剂可能会增加2型糖尿病的风险

Most people like desserts. However, sugar brought about by sweetness is not so popular. High sugar intake can lead to a series of health problems, obesity, metabolic syndrome, type 2 diabetes, heart disease, liver disease and even cancer.

So “smart” people have an idea. They make artificial sweeteners, which provide sweetness but no calories. Artificial sweeteners are now commonly used in diet drinks. It sounds like a good idea. But research shows that zero-calorie artificial sweeteners may be sugar and more likely to cause type 2 diabetes.

In a study by researchers at the University of Adelaide in Australia, one problem is that artificial sweeteners can impair the body’s natural response to glucose and impair the system’s ability to control blood sugar.

In a study of 27 healthy people without diabetes, the intake of artificial sweeteners sucralose (found in Splenda) or acesulfame K (acesulfame K) only lasted for two weeks, and it produced blood sugar levels. negative effect. The usage amount is equivalent to 1.5 liters of weight loss drink per day.

A key finding is that the use of artificial sweeteners reduces the intestinal peptide GLP-1, which helps regulate blood sugar after eating. The research report was submitted at the European Diabetes Research Association in Lisbon, Portugal.

As the intestinal peptide GLP-1 decreases, people tend to eat more food, causing blood sugar levels to rise, which can lead to type 2 diabetes. This means that drinking beverages with artificial sweeteners may increase the risk of diabetes.

The scale of this study is small. Critics believe that the results may not apply to the general population. This may be true, but this is not the first study to show that the intake of artificial sweeteners may increase the risk of glucose intolerance and diabetes.

Earlier studies have shown that drinking aspartame diet soda can increase the risk of type 2 diabetes by 67% and the risk of metabolic syndrome by 36% every day.

In addition, a report published in the journal “Endocrinology and Metabolism Trends” showed that artificial sweeteners may lead to the risk of weight gain, obesity, metabolic syndrome and other related problems (such as type 2 diabetes).

In another study published in Applied Physiology, Nutrition and Metabolism Research, scientists also found that the intake of aspartame is associated with an increased risk of glucose intolerance in people who already have obesity .

Glucose intolerance means that the body cannot process glucose normally. Normally, the body produces insulin to deal with blood sugar. But the amount of insulin produced by glucose intolerant patients is not enough to process glucose normally. Glucose intolerance or insulin insensitivity is a precursor to type 2 diabetes. This condition leads to high blood sugar. High blood sugar causes a series of health problems, including weight gain, obesity, inflammation and type 2 diabetes.

Four cans of diet soda or diet drinks may increase fat production and inflammation every day

In April 2017, a research report presented at the 99th Annual Meeting of the German Robbie Society in Orlando, Florida also found that sucralose promotes metabolic dysfunction and leads to fat accumulation.

This study tested sucralose on stem cells obtained from human adipose tissue at a dose similar to four cans of weight loss soda a day. Researchers found that ingesting artificial sweeteners increased the expression of genes related to adipogenesis and inflammation.

According to Dr. Sabyasachi Sen, lead author of the George Washington University study in Washington, DC, low-calorie sweeteners promote additional fat formation by allowing more glucose to enter the cells and increasing inflammation that is more harmful to obese people. The increased blood sugar in the cells has a greater impact on diabetic patients.

Artificial sweeteners change gut flora and worsen metabolic diseases

This is a little-known fact. Artificial sweeteners have been shown to induce glucose intolerance by altering gut microbes.

A study led by Eran Elinav of the Weizmann Institute of Science in Rehovot, Israel, showed that mice fed with artificial sweeteners for 11 weeks developed glucose intolerance.

Researchers also learned that artificial sweeteners can change the intestinal flora of animals, thereby affecting the glucose response. The same group of researchers also tested the effects of artificial sweeteners on the human body. They found that some people developed glucose intolerance within just one week of exposure to the maximum acceptable daily dose of artificial sweeteners.

At least one study has shown that Splenda can reduce the number of beneficial bacteria in the large intestine by up to 50%. This change is expected to affect the risk of diabetes. Previous research has linked certain bacterial patterns in the gut to the risk of type 2 diabetes. Therefore, eating artificial sweeteners will change the intestinal flora and increase the risk of type 2 diabetes. (David Liu)

１０／０３／１７（ｊｋｚｘ．ｃｏｍ）　－　大多数人喜欢甜点。但是，由甜味带来的糖并不那么受欢迎。高糖摄入量会导致一系列健康问题，肥胖，代谢综合征，2型糖尿病 (type 2 diabetes)，心脏病，肝脏疾病甚至癌症。

于是“聪明”人有了一个想法。他们制造出人造甜味剂 (artificial sweeteners)，它提供甜味，但没有卡路里。人造甜味剂现在常用于减肥饮料中。听起来好像是个好主意。但研究表明，零卡路里的人造甜味剂可能必糖更可能导致2型糖尿病。

在澳大利亚阿德莱德大学研究人员的一项研究中显示，一个问题是，人造甜味剂会损害人体对葡萄糖的自然反应，并损害系统控制血糖的能力。

在对没有糖尿病的27名健康人的研究中，摄入人造甜味剂三氯蔗糖(sucralose)（在Splenda中发现）或乙酰磺胺酸钾 (acesulfame K )仅持续两周，便产生对血糖水平不利的影响。使用量相当于每天1.5升减肥饮料。

一个关键的发现是，使用人造甜味剂减少肠肽GLP-1，这个肽有助于调节饮食后的血糖。该研究报告在葡萄牙里斯本的欧洲糖尿病研究协会提交的。

由于肠肽GLP-1降低，人们往往会吃更多的食物，引起血糖水平升高，这可以导致他们得2型糖尿病。这意味着饮用含有人造甜味剂的饮料可能会增加糖尿病的风险。

这项研究规模很小。批评者认为该结果可能不适用于一般人群。这可能是真的，但这不是第一个研究表明摄入人造甜味剂可能增加葡萄糖不耐 (glucose intolerance) 和糖尿病风险。

早先的研究表明，饮用阿斯巴甜减肥苏打水每天将2型糖尿病风险提高67％，代谢综合征 (metabolic syndrome) 风险增加36％。

另外在“内分泌与新陈代谢趋势”杂志上发表的一篇报告显示，人造甜味剂可能会导致体重增加，肥胖，代谢综合征和其他相关问题（如2型糖尿病）的风险。

在另一项发表在应用生理学，营养与代谢研究中的研究中，科学家们还发现，阿斯巴甜 (aspartame) 的摄入量与已经患有肥胖症的人群的葡萄糖不耐症风险增加有关。

葡萄糖不耐症意味着身体不能正常处理葡萄糖。通常，身体产生胰岛素对付血糖。但葡萄糖不耐症患者产生的胰岛素的量不足以正常处理葡萄糖。葡萄糖不耐受或胰岛素不敏感是2型糖尿病的前兆。这种情况导致高血糖。高血糖引起一系列健康问题，包括体重增加，肥胖，炎症和2型糖尿病。

四罐减肥苏打水 (diet soda or diet drinks) 每日可能会增加脂肪生产，炎症

2017年4月，在佛罗里达州奥兰多内举办的德行罗毕社会第99届年会上提交的一份研究报告也发现三氯蔗糖促进代谢功能障碍，导致脂肪积累。

这项研究测试了三氯半乳蔗糖对人体脂肪组织取得的干细胞，剂量类似于四罐减肥苏打水一天。研究人员发现食入人造甜味剂增加脂肪生成和炎症相关基因的表达。

华盛顿特区乔治华盛顿大学研究的主要作者Sabyasachi Sen博士表示，低热量甜味剂通过允许更多的葡萄糖进入细胞并增加对肥胖者更有害的炎症来促进额外的脂肪形成。细胞中增加的血糖对糖尿病患者影响更大。

人造甜味剂改变肠道菌群(gut flora)，恶化代谢疾病

这是一个鲜为人知的事实，人造甜味剂已被证明通过改变肠道微生物来诱导葡萄糖不耐。

以色列Rehovot的魏茨曼科学研究所的Eran Elinav领导的一项研究表明，用人造甜味剂喂养11周的小鼠产生葡萄糖不耐症。

研究人员还了解到，人造甜味剂可以改变动物肠道菌群，从而影响葡萄糖的反应。同一组研究人员还测试了人造甜味剂对人体的影响。他们发现，一些人在暴露于最大可接受的每日剂量的人造甜味剂仅仅一周便产生了葡萄糖不耐症。

至少有一项研究表明，Splenda可将大肠中有益细菌的数量减少高达50％。这种变化预计会影响糖尿病的风险。先前的研究已经将肠道中的某些细菌模式与2型糖尿病的风险联系起来。所以，吃人造甜味剂会改变肠道菌群，增加2型糖尿病的风险。(刘大卫)

来源：

• The Guardian September 14, 2017
• European Association for the Study of Diabetes, Abstract #193
• Food Navigator September 14, 2017
• PLoS One. 2014; 9(10): e109841.
• Trends Endocrinol Metab. 2013 Sep; 24(9): 431–441.
• Applied Physiology, Nutrition and Metabolism July 2016
• Healthline April 11, 2017
• Newswise April 1, 2017
• Daily Star April 5, 2017
• EurekAlert April 3, 2017
• Nature September 17, 2014 [Epub ahead of print]
• Scientific American September 17, 2014
• J Toxicol Environ Health A. 2008;71(21):1415-29