Insulin Resistance Scientist Explains New Human Study on Artificial Sweeteners, Sucralose, Aspartame

Intro (0s)

• Artificial sweeteners, specifically sucralose and aspartame, have an impact on blood sugar levels, giving a metallic trunk to the blood sugar readings (1s).
• The speaker's blood sugar reading is 63, but they feel good, indicating a normal experience despite the condition (8s).
• This experience is typical for individuals with type one, where 99% of the time things are under control, but there are instances where things may not be as expected (13s).

New Sucralose Study (22s)

• A recent study on sucralose, an artificial sweetener, has shown its potential negative impact on human insulin resistance, adding to the growing body of research suggesting that artificial sweeteners may not be as harmless as previously thought (1m12s).
• The concept of replacing sugar with artificial sweeteners that have no calories but taste like sugar was initially seen as a positive development, but as people began consuming them more and adhering to them at higher levels, studies in preclinical models started to reveal signs of dysglycemia and insulin resistance (1m37s).
• Research in rodents has consistently shown that chronic consumption of artificial sweeteners like sucralose can lead to higher glucose levels and insulin resistance, despite initial skepticism that these findings would not translate to humans (2m6s).
• However, multiple human studies have now pointed to the possibility that artificial sweeteners may have negative effects, with sucralose being a primary focus of negative data, particularly when consumed in large volumes over time (2m42s).
• The study in question specifically looked at the impact of sucralose on human insulin resistance and found significant negative effects, contributing to the growing concern about the safety of artificial sweeteners (3m8s).
• Dr. Andrew Kutnik, a diabetes and metabolic health researcher at the Sansom Diabetes Research Institute, highlights the importance of this research and its implications for human health (52s).

Do We Know The Metabolic Effects of Sucralose? (3m10s)

• Human studies have shown that chronic consumption of sucralose can lead to insulin resistance, and this is not the only study to demonstrate this effect (3m10s).
• Replacing high fructose corn syrup or sugar with artificial sweeteners like sucralose may not be beneficial for metabolic health, as some sweeteners may have detrimental effects on metabolism in some individuals (3m21s).
• The metabolic effects of sucralose are not fully understood, and it is unclear whether it affects insulin response or acts at a cellular level (4m17s).
• Studies using insulin clamps have shown that chronic consumption of sucralose can lead to insulin resistance, but the mechanisms behind this effect are still unknown (4m44s).
• Emerging evidence suggests that changes in the microbiome composition may play a role in the development of insulin resistance caused by sucralose consumption (5m25s).
• The exact mechanisms by which sucralose leads to insulin resistance are still unclear, but may involve intermediary steps such as inflammation (5m58s).
• Insulin resistance is often linked to inflammation, and changes in the microbiome may facilitate this process (6m0s).
• The science behind the metabolic effects of sucralose is still emerging and not yet fully refined (5m49s).

RxSugar (6m6s)

• Artificial sweeteners can alter the microbiome composition, potentially leading to changes in the inflammatory response and insulin resistance in some individuals (6m7s).
• The use of artificial sweeteners may be a net win if it means shifting away from a worse alternative, but there are still many questions surrounding their effects (6m24s).
• Sucrose is not the only sweetener available, and there are also natural and artificial options, with emerging evidence suggesting that these sweeteners are not all the same (6m42s).
• RX sugar is a brand that offers a natural sweetener alternative, and the owner, Steve, has put together a team of medical advisors and experts (7m2s).
• RX sugar offers a product called Swy sticks, which are chocolate sticks that come in various flavors, including caramel, chocolate, vanilla, and chocolate mint (7m18s).
• A 20% discount link is available for RX sugar products, which can be accessed by using the code "td20" at RXsugar.com (7m49s).
• The chocolate caramel flavor of the Swy sticks is a personal favorite, and a link to the discount is available below (7m44s).

Coingestion of Sucralose with Sugar (8m1s)

• Consuming sucralose with sugar may have a surprising effect on blood sugar levels, potentially causing them to remain stable or even decrease, especially for individuals who crave sweet tastes (8m1s).
• Certain products, such as those from RX sugar, offer alternatives to traditional candy bars with fewer negative metabolic effects, and they also provide sweeteners like syrups for coffee and granulated sweeteners (8m28s).
• Research has suggested that co-ingesting sucralose with sugar may have worse effects than consuming either sucralose or sugar alone, potentially due to an additional insulin response (8m57s).
• Studies have utilized experimental designs to co-administer sugar with sucralose, whether chronically or acutely, and have observed higher glycemic responses, indicating potential negative effects on glucose tolerance (9m30s).
• The combination of sucralose and sugar has been used in glucose tolerance tests to assess glycemic tolerance, with results showing negative effects, which initially suggested that sucralose may not be as benign as previously thought (9m52s).
• Dr. Dom D'Agostino and Dr. Kyle Gillette are mentioned as part of the Advisory Board for RX sugar, and Dr. Kyle Gillette has discussed the potential negative effects of co-ingesting sucralose with sugar (8m50s).

Thomas’ Response to Monk Fruit When Fasting (10m3s)

• Research has co-administered artificial sweeteners to study their impact on glucose control and glucose tolerance tests, which may indicate insulin resistance if higher glucose levels are observed (10m3s).
• Emerging evidence suggests that artificial sweeteners may cause insulin resistance in humans, not just in pre-clinical models, although the exact mechanism is not fully understood (10m16s).
• The microbiome may play a role in the potential insulin resistance caused by artificial sweeteners, based on pre-clinical evidence, and could be linked to inflammatory responses (10m32s).
• The impact of the microbiome is often underestimated, and it is a significant factor that can have a substantial influence (10m44s).
• The speaker shares a personal experience as a type 1 diabetic, using a continuous glucose monitor (CGM) to track glucose levels and observe the effects of certain substances (11m3s).
• The speaker's personal experience with a CGM allows for a nuanced understanding of the effects of artificial sweeteners on glucose levels (11m5s).

Types of Sweeteners & Their Effects (11m14s)

• Monk fruit sweetener has been observed to cause a drop in glucose levels in a fasted state, indicating a potential insulin response, although not everyone may experience this effect (11m14s).
• The speaker is highly insulin sensitive and prefers monk fruit over sucralose or aspartame, but notes that individual responses to sweeteners can vary (11m38s).
• There are emerging studies on other sweeteners that suggest they may have different effects on the body, although more research is needed to fully understand these effects (11m59s).
• Sweeteners can be categorized into three main groups: high-caloric sweeteners like high-fructose corn syrup and sugar, artificial sweeteners like sucralose and aspartame, and naturally derived sweeteners like Stevia, monk fruit, and allulose (12m11s).
• Naturally derived sweeteners are often preferred by consumers because they are not chemically synthesized and have less available data on potential negative effects (12m52s).
• Emerging evidence suggests that naturally derived sweeteners may have different metabolic effects compared to artificial sweeteners, with some studies indicating potential benefits (13m3s).
• Allulose, a sweetener derived from fruit, has shown promise in preclinical models, with evidence suggesting it may have a more significant metabolic effect than other non-caloric sweeteners (13m27s).
• Stevia, monk fruit, and allulose are all non-caloric sweeteners with a sweet flavor, but may have different effects on the body due to their unique compositions and properties (13m50s).

Allulose Benefits (14m0s)

• Artificial sweeteners like sucralose and aspartame are often considered a better option for people with obesity or type 2 diabetes due to their lack of glycemic response, but emerging evidence suggests that some alternatives may have unique benefits (14m0s).
• Allulose, a molecule derived from fructose with the third carbon flipped, has been shown in animal studies to cause a vagal nerve response that increases endogenous GLP-1 production, which can lower glucagon production and slow gastric emptying (14m29s).
• GLP-1 production is also associated with a lower glycemic response, making allulose a potentially potent molecule for managing blood sugar levels, particularly for people with pre-diabetes, type 2 diabetes, or type 1 diabetes (16m3s).
• Human studies on allulose are limited, but two recent studies have shown promising results, including one that found co-administering allulose with sugar blunted the glycemic magnitude post-administration and appeared to have a neutral or lowering effect on insulin response (16m39s).
• Another study found that administering allulose to patients with type 2 diabetes during Ramadan, prior to their feeding window, had beneficial effects on blood sugar management (17m36s).
• The human evidence for allulose is still preliminary, and more research is needed to confirm its effects, but the available data suggest that it may be a useful tool for managing blood sugar levels (17m19s).
• A study on individuals with type 2 diabetes showed that those who consumed allulose, a low-caloric sugar substitute, had a lower glucose response after a prolonged fast, suggesting that allulose may have a beneficial effect on glucose metabolism (18m2s).
• Allulose is a molecule similar to fructose but with a different structure, making it non-caloric, and has been shown in preclinical and in vitro models to have potential metabolic benefits (18m30s).
• A personal experiment was conducted by an individual with type 1 diabetes, who tested the effects of allulose on glucose response and insulin needs, and found a reduction in glucose spike and insulin needs after consuming allulose with a meal (20m6s).
• The experiment was conducted in a controlled setting, with variables such as food order, time of day, and insulin sensitivity controlled, and used an automatic insulin delivery system to measure glucose response (19m26s).
• The results of the experiment suggest that allulose may have a potent metabolic effect, specifically in reducing the glycemic burden of postprandial glucose response, and may also have a glucagon-lowering effect (20m27s).
• The individual also saw a reduction in insulin needs not only postprandially but also when co-administering allulose with every meal over two straight days, suggesting that the glucagon-lowering effect may be real (20m41s).
• Patients with type 1 diabetes have higher basal levels of glucagon and a higher amplitude of glucose release from the liver, making them more insulin-resistant, and allulose may have a beneficial effect on these parameters (21m11s).

Dr. Koutnik’s Blood Sugar Drop Alarm - Living with Type-1 (21m21s)

• Lowering glucagon at each meal can reduce glucose spillage, potentially requiring less insulin to control glucose release, which may be beneficial in the context of type 1 diabetes (21m24s).
• The effects of artificial sweeteners, such as sucralose and aspartame, seem to normalize some of the disregulated metabolic responses that occur in type 1 diabetes, but more research is needed to confirm this (21m48s).
• The individual's personal experience with type 1 diabetes shows that 99% of the time, things are under control, but certain scenarios, such as intense exercise, can have a potent impact on glucose control (22m43s).
• In people without type 1 diabetes, insulin is released immediately to bring down high blood sugar levels, but for individuals with type 1 diabetes, insulin is taken and can take three to four times longer to take effect (23m11s).
• After intense exercise, there is an insulin-sensitizing response and increased glucose uptake, which can cause blood sugar levels to drop if not managed properly (23m35s).
• In this scenario, the system may not be prepared for the increased glucose uptake and insulin sensitivity, leading to a potential mismanagement of insulin and a drop in blood sugar levels (24m3s).
• The individual's continuous glucose monitor (CGM) alerted them to a low blood sugar level of 63, which they felt was not reflective of their actual condition (22m15s).
• The individual had to adjust their insulin settings to prevent a repetitive low blood sugar event (22m30s).

Sweeteners Have Differing Effects/Responses (24m26s)

• Artificial sweeteners and natural forming sweeteners may have differing effects and responses in the body, and not all of them seem to have the same response (25m19s).
• Some sweeteners, such as caloric-based sweeteners, have been discussed, as well as artificial sweeteners like sucralose and aspartame, and natural forming sweeteners that may have metabolic benefits (25m32s).
• Allulose is a sweetener that has been studied extensively in animal and in-vivo data, and there is emerging human data on its effects, particularly in the context of insulin sensitivity and glucose uptake (25m47s).
• In some cases, individuals may experience increased insulin sensitivity and glucose uptake independent of insulin, allowing them to consume meals with little to no insulin (24m32s).
• This increased insulin sensitivity can be beneficial, but it is not a common occurrence and may not be applicable to everyone (24m52s).

Erythritol (25m52s)

• Some artificial sweeteners, such as monk fruit, may have metabolic benefits, including lowering blood sugar levels, which could be beneficial for individuals with obesity, pre-diabetes, type 2 diabetes, or type 1 diabetes, or those struggling with hypoglycemia or variable glucose levels (25m52s).
• However, it's essential to consider whether the benefits of these sweeteners outweigh the potential risks and whether they add value to overall health (26m32s).
• A study on allulose (also known as ryol or ariol) found that higher levels of ariol in the blood were associated with increased incidences of cardiovascular disease and all-cause mortality (27m38s).
• The study measured ariol levels in blood samples from large epidemiological databases and found a correlation between higher ariol levels and adverse health outcomes (27m45s).
• However, it's crucial to be cautious when interpreting these results, as there may be underlying factors contributing to the association between ariol levels and health risks (28m6s).
• Researchers attempted to investigate whether consuming ariol causes high levels of ariol in the blood and found that it does, but this is not a surprising result (28m38s).
• The study also explored the potential effects of ariol on coagulation factors in a model system, but the results were preliminary and not conducted in a real-world human-based model system (29m0s).
• The study's findings caused a stir, particularly due to its publication in a reputable journal, but the title's claim that ariol induced adverse outcomes may be misleading (29m29s).
• A study on artificial sweeteners, specifically ariol, did not show any adverse biological effects in humans, despite being reported as such in the media (29m36s).
• Individuals with higher levels of inflammation, such as those with diabetes, have higher levels of endogenous ariol production, which may explain the association between ariol and poor health outcomes (29m56s).
• The original study's findings on the association between ariol and poor health outcomes may be due to the fact that individuals with inflammation, obesity, and type 2 diabetes have higher endogenous ariol production, rather than consuming ariol having adverse effects (30m24s).
• The levels of ariol in the study were very low and did not match the pharmacokinetics of someone consuming ariol, suggesting that the ariol was produced endogenously rather than being consumed (30m36s).
• Ariol is produced through the pentose phosphate pathway, which is also linked to metabolic distress and poor heart disease risk (30m47s).
• A similar study on xylol, another artificial sweetener, found that it was elevated in rodents and associated with poor health outcomes, but the study's findings were likely misrepresented and poorly titled (31m22s).
• The study's title was insinuating and not supported by the data, which may have been done to attract attention and clicks (32m26s).
• The messaging around the study's findings was suggestive and may have been exaggerated to produce clicks and attention (32m37s).
• The study's findings on ariol and xylol may have been misrepresented and poorly titled, but the intentions of the researchers are unknown (32m11s).
• A recent study on artificial sweeteners, specifically sucralose and aspartame, has been discussed, but the findings may not necessarily match the implications or speculations surrounding the study (33m6s).
• The study's results are not conclusive, and the potential negative effects of artificial sweeteners are still speculative and require further research (33m38s).
• A follow-up study administering artificial sweeteners to humans would be relatively quick, easy, and inexpensive to conduct, requiring only IRB approval and minimal funding (33m57s).
• The study's limitations and lack of human trials have led to speculation about the potential effects of artificial sweeteners, but the current evidence does not support the negative implications (34m28s).
• Sucralose, in particular, has received a bad reputation, but the evidence does not necessarily support this negative perception at this stage (34m36s).

Does Allulose Break a Fast? (34m44s)

• Allulose is a sugar substitute that may be perceived as "bad" due to initial negative information, but this perception can be difficult to change even with new evidence (34m45s).
• The initial message or information about a topic can have a lasting impact and be difficult to undo, as seen with the example of fat being perceived as "bad" for decades (35m7s).
• Allulose is essentially a flipped carbon fructose molecule, which raises the question of whether it would technically break a fast (35m39s).
• The answer to whether allulose breaks a fast depends on how one defines a fast, with some considering it a low-glucose intake that triggers low insulin release (36m30s).
• If a fast is defined as low glucose intake, then allulose may not break a fast, as it does not have a glycemic response and may even lower total insulin needs (37m3s).
• Allulose may actually augment a fast by facilitating metabolic switches, such as increasing epinephrine and glucagon, and promoting fatty acid oxidation and ketogenesis (37m10s).
• However, the impact of allulose on other metabolic pathways, such as AMPK, is not yet known (37m17s).
• The current evidence suggests that allulose is largely noncaloric and may lower total insulin needs, possibly by lowering background glucagon or postprandial glucagon (37m47s).
• The exact mechanism by which allulose may lower insulin needs is speculative and requires further research (37m58s).
• In theory, allulose may augment a fast if defined as lowering glucose needs or glucose in the blood, which facilitates a lowering of overall insulin requirements (38m13s).

Where to Find More of Dr. Koutnik (38m38s)

• Dr. Koutnik can be found on Instagram under the handle Andrew cnck PhD (38m46s)
• Dr. Koutnik has a website, Andrewkoutnik.com, where he provides free resources for people looking to learn more about metabolism (38m50s)
• The website also contains information about type 1 diabetes (38m58s)