Rapid Review Quiz: Artificial Sweeteners

Romesh Khardori, MD, PhD


November 14, 2022

In a recent cohort study with 121,490 participants, researchers found that consuming drinks sweetened with sugar more than once a day was linked to a higher risk for IBD. This was not true for natural juices or drinks sweetened artificially.

The team studied the participants' intake of beverages with 24-hour diet recalls from 2009 to 2012. They sorted participants into three groups on the basis of consumption levels: the reference group consumed 0 unit (glass/can/250 mL/carton)/d, 0-1 unit/d, and > 1 unit/d.

Most participants (66.3%) did not drink any sugar-sweetened beverages. Participants who reported drinking > 1 unit/d were more likely to consume higher amounts of total energy and sugar and have a higher BMI.

During a follow-up period of about 10 years, the investigators documented 510 IBD cases: 367 cases of ulcerative colitis (UC) and 143 cases of Crohn's disease (CD). Compared with people who did not drink sugar-sweetened beverages, those who drank < 1 unit/d had a significantly higher IBD risk; however, the trend was statistically nonsignificant; the positive association was significant for CD but not for UC (in line with previous research).

The researchers found no positive link between IBD risk and intake of natural juices and artificially-sweetened beverages and noted that the inflammatory role of artificial sweeteners is still debated. They also suggested that fiber and bioactive compounds in natural juices might mitigate the effects of natural sugars.

Study limitations were that all participants in the UK Biobank were older than 40 years at baseline; the survey was validated but it was self-reported and subject to recall bias; and almost all participants — nearly 97% — were White.

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