“From Friday (6 April 2018), millions of children across the UK will benefit from the government’s key milestone in tackling childhood obesity, as the Soft Drinks Industry Levy comes into effect.” Or, will they?
Childhood obesity is one of the most serious public health challenges of the 21st century. Overweight and obese children are likely to stay obese into adulthood and more likely to develop noncommunicable diseases like diabetes and cardiovascular diseases at a younger age.
According to estimates from Public Health England, two thirds of adults and a quarter of children between two and 10 years old are overweight or obese. Obese children are more likely to become overweight adults and to suffer premature ill health and mortality, and by 2034, 70 per cent of adults are expected to be overweight or obese.
The fundamental causes behind the rising levels of childhood obesity are a shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other healthy micronutrients. Choosing healthy foods for infants and young children is critical because food preferences are established in early life.
One of the UK Governments interventions to tackle obesity has been the introduction of the “sugar tax”, adding up to 24p per liter on sugary drinks. Not surprisingly, this has resulted in a sharp increase of artificial sweeteners in soft drinks as sugar replacement.
Although artificial sweeteners have been considered safe, accumulating evidence indicates that they can induce glucose intolerance and disturb energy levels in the human body. In particular, the gut microbiome has been demonstrated to play a role in these processes. In a study from 2017 Acesulfame-K increased the abundance of Bacteroides bacteria in the gut microbiome which is associated with obesity and indeed resulted in a significantly higher body weight.
Toxic products generated by gut bacteria can enter systemic circulation and induce chronic inflammation. The above study found that Acesulfame-K may increased the risk of developing systemic chronic inflammation.
Another study from 2015 reviewed the nutritional benefits and risks related to intense sweeteners [IS]- analyzing 10,989 scientific papers. It found that – contrary to claims that use of artificial sweeteners leads to weight loss, “no conclusion can be drawn as to the long-term effect of replacing caloric sweeteners with IS on the weight of regular adult consumers of sweet products.” It further found that “most of the prospective observational studies undertaken in children show that IS use is paradoxically associated with weight gain.”
“Some studies … suggested that aspartame consumption may be involved in triggering epileptic seizures and migraines.”
Sucralose [e.g. Splenda, E955, Canderel Yellow] was found to be mutagenic at elevated concentrations. Cooking with sucralose at high temperatures was reported to generate a potentially toxic class of compounds. It alters the microbial composition in the gastrointestinal tract (GIT), with relatively greater reduction in beneficial bacteria.
The artificial sweetener aspartame remains one of the most controversial food additives. A study found that people who consumed high-aspartame diets, had more irritable mood, exhibited more depression, and performed worse on spatial orientation tests. Chronic use of aspartame was found to cause liver injury, depletion of Glutathione (GSH) [an important antioxidant] and to trigger the blockade of an important detoxification pathway [trans-sulphuration pathway].
Diabetic neuropathy is one of the three major complications of Diabetes mellitus (DM). . The artificial sweetener Sorbitol was found in a study from 2015 to damage Schwann cells which regulate peripheral nerve function, which can make the neuropathy worse.
Instead of loading foods with unhealthy artificial sweeteners, and as one of the study rightly states “for the general population, the overall assessment of potential risks and benefits does not justify the long-term use of IS as sugar substitutes, particularly in beverages” we should skip the artificially-sweetened and sugar-sweetened frankenfoods and replace them with natural foods and – when it comes to drinks – water.
Dr Oliver Frey MD MRCGP