Experience The
I
Israeli researchers may have
pinned down link between artificial
sweeteners and diabetes, obesity.
St. Joe's
Wishes Good Health to All
This Rosh Hashanah and Beyond
A
By Jack Weiner,
President and CEO
St. Joseph Mercy
Oakland •I
Each Rosh Hashanah we wish everyone
Shana Tovah, a good year, filled with
peace, happiness, prosperity and good
health. At St. Joseph Mercy Oakland, we
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rtificial sweeteners — pro-
moted as aids to weight loss
and diabetes prevention
— could actually hasten the devel-
opment of glucose intolerance and
metabolic disease, and they could do
so in a surprising way: by changing the
composition and function of the gut
microbiota, the substantial population
of bacteria residing in our intestines.
These findings, the results of experi-
ments in mice and humans, were
published Sept. 17 in Nature. Dr. Eran
Elinav of the Rehovot-based Weizmann
Institute of Science's Department of
Immunology, who led this research
together with Professor Eran Segal of
the Department of Computer Science
and Applied Mathematics, says that the
widespread use of artificial sweeten-
ers in drinks and food, among other
things, may be contributing to the
obesity and diabetes epidemic that is
sweeping much of the world.
For years, researchers have been
puzzling over the fact that non-caloric
artificial sweeteners do not seem to
assist in weight loss, with some studies
suggesting that they may even have an
opposite effect.
Graduate student Jotham Suez in
Elinav's lab, who led the study, collabo-
rated with lab member Gili Zilberman-
Shapira and graduate students Tal
Korem and David Zeevi in Segal's lab
to discover that artificial sweeten-
ers, even though they do not contain
sugar, nonetheless have a direct effect
on the body's ability to utilize glucose.
Glucose intolerance — generally
thought to occur when the body can-
not cope with large amounts of sugar
in the diet — is the first step on the
path to metabolic syndrome and adult-
onset diabetes.
Lab Testing
Dis cov erRemarkable
The scientists gave mice water laced
with the three most commonly used
artificial sweeteners in amounts
equivalent to those permitted by the
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78
September 25 • 2014
U.S. Food and Drug Administration
(FDA). These mice developed glucose
intolerance, as compared to mice that
drank water or sugar water. Repeating
the experiment with different types of
mice and different doses of the arti-
ficial sweeteners produced the same
results — these substances were some-
how inducing glucose intolerance.
Next, the researchers investigated a
hypothesis that the gut microbiota are
involved in this phenomenon. They
thought the bacteria might do this by
reacting to new substances like artifi-
cial sweeteners, which the body itself
may not recognize as "food:' Indeed,
artificial sweeteners are not absorbed in
the gastrointestinal tract, but in passing
through they encounter trillions of the
bacteria in the gut microbiota.
The researchers treated mice with
antibiotics to eradicate many of their
gut bacteria; this resulted in a full
reversal of the artificial sweeteners'
effects on glucose metabolism. Next,
they transferred the microbiota from
mice that consumed artificial sweet-
eners to "germ-free" or sterile mice,
resulting in a complete transmission of
the glucose intolerance into the recipi-
ent mice.
This, in itself, was conclusive proof
that changes to the gut bacteria are
directly responsible for the harmful
effects to their host's metabolism. The
group even found that incubating the
microbiota outside the body, together
with artificial sweeteners, was suf-
ficient to induce glucose intolerance in
the sterile mice. A detailed character-
ization of the microbiota in these mice
revealed profound changes to their
bacterial populations, including new
microbial functions that are known to
infer a propensity to obesity, diabetes
and complications of these problems in
both mice and humans.
Does the human microbiome func-
tion in the same way? Elinav and Segal
How Sweet on page 80