This Artificial Sweetener Could Do Serious Damage to Your Gut, Study Finds

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• Artificial sweeteners could do serious harm to gut health, new research shows.
• Researchers found that exposure to the artificial sweetener neotame may disrupt the lining of the intestines and the balance of gut bacteria.
• Experts explain how sugar substitutes could impact your gut health and the digestive system.

Artificial sweeteners have been known to raise the risk of everything from heart disease to cancer. Now, researchers are adding gut damage to the list.

A study published in Frontiers in Nutrition looked at how an artificial sweetener known as neotame impacted gut health. Researchers conducted a model of the intestine in a lab to investigate the effects of neotame exposure. They added two common species of bacteria—Escherichia coli and Enterococcus faecalis—which are often found in the digestive tract to replicate the behavior of the gut microbiome.

The study found that neotame exposure caused increased cell death and leakiness in the walls of the intestine. Researchers also determined that the artificial sweetener caused the usually harmless gut bacteria to begin acting in ways that could cause disease—such as forming into masses and adhering to and potentially invading cells of the intestinal lining.

Although this study did not test the effects of neotame exposure in a living person's gut, the results suggest that exposure to it may disrupt the lining of the intestines and the balance of gut bacteria (a.k.a. the gut microbiome), which could eventually potentially lead to irritable bowel syndrome (IBS) and sepsis.

But what about other fake sugars? Artificial sweeteners may lead to symptoms like gas and bloating because they are fermented in the large intestine, says Austin Chiang, M.D., gastroenterologist and chief medical officer of endoscopy at Medtronic. "It's not fully understood how artificial sweeteners impact gut health or lead to any gut health conditions, but there are some studies that suggest that some artificial sweeteners can alter the gut microbiota," Dr. Chiang explains. Altering the gut microbiome may also increase your risk of metabolic disorders such as type 2 diabetes and disrupt the body's ability to regulate blood sugar levels, leading to glucose intolerance, says Andrew Boxer, M.D., gastroenterologist of Gastroenterology Associates of New Jersey.

In addition to disrupting the balance of gut bacteria, artificial sweeteners have been shown to promote inflammation and compromise gut barrier function in animal studies, says Dr. Boxer. Also, "artificial sweeteners may interfere with the body's ability to regulate appetite and energy intake, which could impact gut health indirectly." Changes in appetite regulation could influence dietary patterns and nutrient absorption, affecting overall gut function, he explains.

If you are someone who already struggles with digestive issues, artificial sweeteners may make them worse. "Some artificial sweeteners, such as sorbitol, mannitol, and xylitol, can be fermented by gut bacteria, leading to gas, bloating, and abdominal discomfort, particularly in individuals with sensitive digestive systems," says Dr. Boxer.

Artificial sweeteners have also been linked to leaky gut syndrome, due to increased intestinal permeability where the walls of the intestines allow more than water and nutrients to pass through (ie. "leak"). "In conditions like Crohn's disease, where there's already compromised gut barrier function, increased permeability can worsen inflammation and symptoms," Dr. Boxer adds. Artificial sweeteners may also lead to symptoms such as diarrhea or constipation, which are common in conditions like IBS, Dr. Boxer adds.

The bottom line

While this study did not look at how sugar substitutes impact cancer risk, this research does show how this sweetener may lead to damage and dysregulation to the GI tract, says Dr. Boxer. "The major takeaway is that [artificial sweeteners] can be incredibly dangerous to our GI tract, causing something as simple as gas and bloating to something as dangerous as putting us at risk for certain cancers." Overall, avoiding processed food or chemicals is ideal, notes Dr. Boxer.

Still, there are some who may benefit from artificial sweeteners, like those living with types of diabetes or obesity, says Dr. Chiang. "Substituting sugar may have greater, more definitive health benefits than avoiding these sweeteners. Ultimately, the decision to avoid artificial sweeteners is a patient-by-patient decision."

Madeleine Haase

Madeleine, Prevention's assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention's social media platforms.