Objective: Consumption of low-calorie sweeteners (LCS) is associated with abnormalities of glucose metabolism. Here we evaluate the effects of sucralose ingestion, versus sucralose taste (i.e., sham feeding), on metabolic responses to a labeled oral glucose tolerance test (OGTT) in subjects with normal weight and obesity.
Research Design and Methods: Ten normal-weight (BMI: 23±1 kg/m2) and 11 subjects with obesity (BMI: 38±6 kg/m2), all non-habitual users of LCS, underwent 3 dual-tracer OGTTs preceded by consuming 48 mg of sucralose, water, or sham feeding sucralose in randomized order. Indices of β-cell function and insulin sensitivity (SI) were estimated by using oral minimal models of glucose, insulin and C-peptide kinetics.
Results: Compared to water, sucralose ingestion (but not sham feeding) increased the glucose incremental area under the curve by 30±10% in both groups. In contrast, sucralose had different effects on plasma insulin concentrations in these groups (P<0.01). Sucralose ingestion decreased the magnitude of the glucose-induced increase in insulin concentrations 20-40 min post-glucose load in normal-weight subjects, but increased it 90-120 min post-glucose load in subjects with obesity. Sucralose sham-fed similarly decreased the magnitude of the glucose-induced increase in insulin concentrations within 60 min of the OGTT in both groups. In addition, sucralose ingestion (but not sham feeding) increased SI in normal-weight subjects by 52±20% but did not affect SI in subjects with obesity (P<0.02). Sucralose did not affect glucose kinetics or indices of the sensitivity of the β-cell response to glucose in either group.
Conclusions: Acute sucralose ingestion differentially affects glucose metabolism in subjects with normal weight versus obesity. In addition, our findings underscore a physiological role for sweetness in glucose homeostasis, which supports the notion that sweetness should be used in moderation.
M. Pepino: None. A.D. Nichol: None. K. Rother: None. C. Salame: None.
National Institutes of Health (P30DK020579, P60DK020579, P30DK056341); National Institute of Diabetes and Digestive and Kidney Diseases