Artificial Sweeteners and Metabolic Syndrome: Paradox of Physiological Behavior or Neuroendocrine Mechanisms

Abstract

Artificial sweeteners owing to their non-caloric nature were proposed as a healthful means with the prospective benefits. Epidemiological data indicate direct relationship between artificial sweetener intake and increase in body weight, glycemic status, and adiposity. Despite strong association, evidence is still lacking in establishing the causal relationship between artificial sweeteners and various risk factors for the development of metabolic syndrome. In vitro studies have disclosed that artificial sweeteners similar to glucose/fructose bind to sweet-taste receptors on the tongue and intestinal mucosa stimulating enhanced sugar absorption, through glucagon like peptide-1 (GLP-1) secretion. Human studies failed to recapitulate these effects, advocating that artificial sweeteners rather serve to promote food consumption rather than improving satiety. Therefore, enhanced         food consumption, disallowance of caloric adjustments could in some measure explain body   weight gain with the use of artificial sweeteners. However, the physiological behavior and neuroendocrine mechanisms by which the non-caloric sweeteners may stimulate appetite needs further scrutiny.