Pearlman Michelle, Obert Jon, Casey Lisa
Department of Medicine, Division of Gastroenterology and Hepatology, University of Texas Southwestern Medical Center, 5323 Harry Hines, K5.136, Dallas, TX, 75390, USA.
Division of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA.
Curr Gastroenterol Rep. 2017 Nov 21;19(12):64. doi: 10.1007/s11894-017-0602-9.
The purpose of this paper is to review the epidemiology of obesity and the evolution of artificial sweeteners; to examine the latest research on the effects of artificial sweeteners on the host microbiome, the gut-brain axis, glucose homeostasis, and energy consumption; and to discuss how all of these changes ultimately contribute to obesity.
Although artificial sweeteners were developed as a sugar substitute to help reduce insulin resistance and obesity, data in both animal models and humans suggest that the effects of artificial sweeteners may contribute to metabolic syndrome and the obesity epidemic. Artificial sweeteners appear to change the host microbiome, lead to decreased satiety, and alter glucose homeostasis, and are associated with increased caloric consumption and weight gain. Artificial sweeteners are marketed as a healthy alternative to sugar and as a tool for weight loss. Data however suggests that the intended effects do not correlate with what is seen in clinical practice. Future research should focus on the newer plant-based sweeteners, incorporate extended study durations to determine the long-term effects of artificial sweetener consumption, and focus on changes in the microbiome, as that seems to be one of the main driving forces behind nutrient absorption and glucose metabolism.
本文旨在回顾肥胖症的流行病学及人工甜味剂的发展历程；审视关于人工甜味剂对宿主微生物群、肠-脑轴、葡萄糖稳态和能量消耗影响的最新研究；并探讨所有这些变化最终如何导致肥胖。
尽管人工甜味剂是作为一种糖替代品开发出来以帮助降低胰岛素抵抗和肥胖症的，但动物模型和人类的数据均表明，人工甜味剂的作用可能会导致代谢综合征和肥胖症流行。人工甜味剂似乎会改变宿主微生物群，导致饱腹感降低，改变葡萄糖稳态，并与热量消耗增加和体重增加有关。人工甜味剂作为糖的健康替代品和减肥工具进行销售。然而，数据表明预期效果与临床实践中观察到的情况并不相关。未来的研究应聚焦于新型植物基甜味剂，纳入更长的研究时长以确定食用人工甜味剂的长期影响，并关注微生物群的变化，因为这似乎是营养吸收和葡萄糖代谢背后的主要驱动力之一。
