In this science post, we are taking a closer look at sugar and non-nutritive sugars (NNS), alternatively known as artificial sweeteners. We already examined sugar quite closely, discussing all the reasons why it is beneficial to minimize the intake of it, especially if Maximizing The Program. However, let’s take a closer look at how sugar and NNS affect us and more specifically our brain, and how they may influence our bodies and even the choices we make.
Why do we like sugar?
Sugar provides energy to our bodies in the form of calories. Humans, like most other creatures, have evolved to enjoy it. Our primitive ancestors were scavengers. Sugary foods are excellent sources of energy, so we have evolved to find sweet foods particularly palatable. Foods with unpleasant, bitter and sour tastes can be unripe, poisonous or rotting. These foods could cause sickness, so we are more likely to avoid those foods.
We need food to survive, and we need the amount that nature has provided for us in the perfect package, which is food in its whole form. This often includes fibre or other substances that allow for slower digestion, do not cause a fast rise in blood sugar and create a feeling of satiety.
Therefore, to maximize our survival as a species, this innate brain system has us seeking out these foods.
Sugar comes in a variety of forms. To recap, glucose is the simplest form of carbohydrate and only has one sugar molecule, which is called a monosaccharide. Other monosaccharides that may sound familiar include fructose, galactose and ribose, which the body also processes or may produce for energy.
We have discussed the importance of how our body breaks down our food into these simple sugars to provide energy to the body in the science post on insulin and how added sugar affects our bodies. But let’s take a deeper dive into how added sugar affects our brain and nervous system, after a refresher on how our body processes these added sugars.
What is added sugar or free sugars?
The World Health Organization (WHO) has been cautioning people to reduce their intake of “free sugars” to less than 10% of daily calories since 1989. The WHO states that doing so can lower the risk of becoming obese or overweight or experiencing tooth decay. Free sugars include both the sugars naturally found in honey and fruit juice, as well as sugar added to food and drinks. On food labels, added sugars include words such as glucose, fructose, corn syrup, brown sugar, dextrose, maltose and sucrose, as well as many others.
The most significant sources of added sugar in today’s diet consist primarily of the simple sugar fructose. Fructose is a fairly sweet, naturally occurring sugar. It comes from most fruits and even some vegetables.
However, the majority of sources of fructose that people tend to consume are table sugar (which is called sucrose, made from sugar cane or beets and is composed of 50% glucose and 50% fructose), honey, agave nectar, fruit juices, palm sugar and (HFCS) high fructose corn syrup (HFCS is a highly processed and inexpensive substitute for cane sugar that was introduced in the 1970s, which is made from corn. It’s used to sweeten a variety of processed foods, including soda, candy, baked goods and cereals). Today’s sugars are often refined and concentrated.
After we ingest food, the stomach and small intestine go right to work breaking the food down into its simplest form of glucose, which is absorbed and then released into the bloodstream. Once in the bloodstream, glucose can be used immediately by the cells for energy or stored in our bodies to be used later. However, glucose and fructose are metabolized very differently by the body. Before it can be used by the body, fructose needs to be converted into glucose, which is conducted by the liver. While every cell in the body can use glucose, the liver is the only organ that can metabolize fructose when ingested in significant amounts.
Before the mass production of refined sugar, humans rarely consumed fructose in high amounts. But as food science has developed over the years, our food has greatly changed from its very simple former self. When people eat a diet that is high in calories and high in fructose, the liver is thought to become overloaded and starts turning the fructose into fat. Many scientists believe that excess fructose consumption may be a key driver in many of the most serious diseases today. These include obesity, type 2 diabetes, insulin resistance, heart disease and even cancer. However, more human evidence is needed. Researchers debate the extent to which fructose contributes to these disorders, but there is a considerable body of evidence justifying the concerns.
The Data Behind Sugar
In 2015, the WHO further suggested reducing free sugar daily intake to less than 5% of calories (about 6 teaspoons) for optimizing health. In the United States, in 2017–2018, the average daily intake of added sugars was 17 teaspoons.. Added sugar also accounts for 14% of the average person’s daily calorie intake. Most of this comes from beverages, including energy drinks, alcoholic drinks, soda, fruit drinks and sweetened coffee and teas.
Other common sources are snacks. These don’t just include the obvious, like brownies, cookies, donuts and ice cream. You can also find large quantities of added sugar in bread, salad dressing, granola bars, cereals and even fat-free yogurts, to name a few.
A health report released on October 20, 2021 from Statistics Canada found that in a 2015 Canadian Community Health Survey (CCHS), the total sugar intake in Canada per person was estimated at 105.6 g/day. To help consumers, the Food and Drug Administration (FDA) has developed a new food label that lists added sugars separately, which manufacturers are required to use.
Canada has also updated their food labels, which now identify the total percentage of sugars in a product. This change was imposed by the Canadian Food Inspection Agency (CFIA), with compliance to be enforced by Dec 15, 2022.
Check out the video to see how sugar can be hidden in the foods we buy.
How does sugar affect our brain?
There is an increasing body of research that tells us excess sugar could be as addictive as some street drugs and have similar effects on the brain. The concept of food addiction is a very controversial subject among scientists and clinicians. While it is true that you can become physically dependent on certain drugs, it is debated whether you can be addicted to food when you need it for basic survival. Some caution us in our language when using words like addiction when describing things like food. The drug crisis is very serious, and those with addiction are physiologically driven to get more drugs. This can also be said for those with other addictions, such as alcohol and sex. They may resort to crime and violence to do so, whereas those seeking out food wouldn’t necessarily go to those lengths. However, our environment today is abundant with sweet, energy-dense, processed foods, which we have easy access to. Our portion sizes have also increased to a much greater degree. It is clear that these foods are having some effect on us as well as our drive to have more of them.
Given the rise of obesity, one could argue against the theory that sugar can be addictive to some degree. Despite the differing opinions on this, researchers and nutritionists can agree that sugar has addictive properties and we need to be consuming less of it. Furthermore, in certain individuals with certain predispositions, this could manifest as having a compulsion towards sugary foods.
Check out this video on the effects of sugar and the brain.
Dopamine
Sugar increases activity in certain parts of our brains, which means those parts become excited due to the incoming nutrition. When we eat sweet foods, the brain’s reward system (the mesolimbic dopamine system) gets activated. Brain activation happens because of electrical activity that occurs within cells called neurons. A neuron is a nerve cell that sends and receives electrical and chemical signals.
All brain activity occurs in the form of electricity that is sent down small “wires” or “tunnels” in the neurons called axons. The electrical signal through the axons then results in the release of brain chemicals called neurotransmitters, which are a chemical substance released by neurons in the brain that send messages to our bodies and muscles.
Interconnected with the hormones involved in satiety and hunger are neurotransmitters, one of which includes dopamine. Eating sugar releases opioids and dopamine in our bodies. This is the link between added sugar and compulsive behaviour. Dopamine has a direct effect on activating the reward and pleasure centres in the brain, which can affect both mood and food intake.
Those who struggle with obesity often have a blunted dopamine pathway because of chronic exposure to highly palatable foods, such as those that are high in added sugar and fats. This over-exposure, which leads to a blunted response when eating, has been suggested to contribute to increased reward-seeking behaviour, including overeating.
When a certain behaviour causes an excessive release of dopamine, you experience sensations of pleasure that you are inclined to re-experience, and so repeat the behaviour. As you repeat that behaviour more and more, your brain adjusts to release less dopamine.
The only way to feel the same amount of pleasure as before is to repeat the behaviour in increasing amounts and frequency. This then leads to the blunted response that was described above, subsequently leading one to seek out more sugar which ultimately leads to substance (sugar) abuse and weight gain. Also, every time we have sugar, we reinforce neuropathways, causing the brain to become increasingly hardwired to crave sugar, from a habit formation perspective.
Check out these videos to learn more about the dopamine reward system and the mesolimbic dopamine pathway system.
Check out this video about the potentially addictive effects of sugar on the brain.
Hypothalamus
The hypothalamus (a small region of the brain located at the base of the brain, near the pituitary gland) is involved in the integration of signals directed to it from hormones like leptin (from adipose or fat cells), ghrelin (from the digestive system) and insulin (the pancreas), along with many other hormones that regulate our hunger and satiety. Your metabolism constantly adjusts up or down based on a variety of signals. The set-point theory also suggests that your weight may go up or down temporarily but will ultimately return to its normal set range. The signaling system we have in place helps to maintain our weight.
Some researchers (Jung & Kim, 2013) believe that the reactive signal system stops working efficiently over time and leptin and insulin resistance develop, causing us to gain weight. The thought is that foods that are high in fat and sugar (like many processed foods available today) lead to not only inflammation in the body, but also in the brain. Because the hypothalamus is so important in regulating and interpreting the signals involved in hunger, satiety and metabolism, inflammation can lead to a disruption in the pathway of these signals and even in how fat is stored. This can lead to weight gain. This further corroborates the negative impact that sugar and processed high-fat foods have on our brains.
Managing Cravings
Many people experience food cravings. Cravings can occur particularly when one is stressed, hungry or their gastronomic senses are inundated with the sight, sound and aroma of their favourite foods being prepared.
To overcome cravings, we need to inhibit our natural response to indulge in these tasty foods. A network of inhibitory neurons is critical for adjusting our behaviour. These neurons are concentrated in the prefrontal cortex, a key area of the brain involved in decision-making, impulse regulation and delaying gratification.
Inhibitory neurons are like the brain’s brakes and release the neurotransmitter GABA or Gamma Aminobutyric Acid. GABA is considered an inhibitory neurotransmitter because it blocks, or inhibits, certain brain signals and decreases activity in your nervous system. When GABA attaches to a protein in your brain known as a GABA receptor, it produces a calming effect. This can help with feelings of anxiety, stress and fear. It may also help to prevent seizures.
Research in rats has shown that eating high-sugar diets can alter inhibitory neurons. Rats that were fed a high-sugar diet were also less able to regulate their behaviour and make decisions.
This shows that what we eat can potentially influence our ability to make choices that are beneficial to us and may underlie why diet changes can be so difficult for people.
A 2017 study asked people to rate how much they wanted to eat a high-calorie snack when they were hungry versus when they had recently eaten. The people who regularly ate a high-fat, high-sugar diet rated their cravings for snack foods higher, even when they were not hungry. This suggests that regularly eating high-sugar foods could heighten cravings, creating a negative feedback loop of wanting more and more of these foods.
However, there is good news. Our taste buds can adapt to accept less sugar in a fairly short period of time. Following a plan like The Livy Method that promotes eating nutrient-rich, whole foods that are naturally lower in sugar is a great way to support the body in addressing cravings. Reducing sugar (especially concentrated sugars) not only limits the amount of sugar ingested, but also makes less sweet foods seem sweeter. This is a common finding by members when participating in The Program. In fact, members often comment on how they start to enjoy the natural taste and flavours of the food they eat. They also describe how when they indulge in sweet or processed food, it doesn’t taste as good as they remember, or they can taste the chemicals and additives in the food that they never noticed before.
Sugar and Memory
Another brain area that can be affected by high sugar diets is the hippocampus. The hippocampus is a part of the brain found in the inner folds of the bottom middle section of the brain, known as the temporal lobe. Its main functions involve human learning and memory.
The hippocampus is part of the limbic system, which is associated with the functions of feeling and reacting. The limbic system is situated on the edge of the cortex, and it includes the hypothalamus and the amygdala. These structures help control different bodily functions, such as the endocrine system and what is commonly known as the “fight or flight” response.
The hippocampus helps humans process and retrieve two kinds of memory - declarative memories and spatial relationships.
Declarative memories are those related to facts and events. Examples include learning how to memorize speeches or lines in a play.
Spatial relationship memories involve pathways or routes. For example, when a cab driver learns a route through a city, they use spatial memory. Spatial relationship memories appear to be stored in the right hippocampus.
The hippocampus is also where short-term memories are turned into long-term memories. These are then stored elsewhere in the brain. Research has shown that nerve cells continue to develop throughout adulthood, and that the hippocampus is one of the few places in the brain where new nerve cells are generated.
Similar to animal research, there is emerging evidence that a Western-style (WS) diet – high in saturated fat and added sugar – impairs human hippocampal functioning. However, the conditions under which this occurs are not fully understood.
According to a scientific systematic review (Taylor et al., 2021), regular consumption of a Western-style diet places individuals at higher risk for mild cognitive impairment and dementia. With progressive memory loss and hippocampal damage being an early feature and neurological sign of dementia, diet-induced hippocampal impairment may have significant ramifications by initiating or speeding up the disease process. Furthermore, the same physiological changes associated with a Western-style diet, including increased hippocampal inflammation and reduced hippocampal neurogenesis (the formation of new neurons), are associated with the pathology of dementia.
There are also further consequences in having an impaired hippocampus resulting from the Western-style diet. The hippocampus has a role in appetite regulation because it recalls previously consumed food to assist with conscious adjustment of intake. When satiated, the hippocampus may automatically inhibit the retrieval of pleasant food-related memories.
Thus, when looking at food when satiated, it will no longer lead to the recollection of how pleasant it is to eat, thereby dulling desire. It is suggested that impaired hippocampal inhibition leads to an increase in the intake of the very foods (highly palatable sweet and fatty foods) that caused the hippocampal damage in the first place, creating a “vicious cycle.” This model is called the vicious cycle model and is likely to lead to slow, long-term weight gain.
Finally, the hippocampus seems to be involved in appetitive interoception. Interoception is the perception of sensations from inside the body. This includes the perception of physical sensations related to internal organ function, such as a heartbeat, respiration and satiety, as well as the autonomic nervous system activities that are related to emotions. Hippocampal impairment has been linked to interoceptive insensitivity, which can result in a disconnection with hunger/satiety and thirst cues. This may lead to overconsumption, resulting in weight gain and obesity over the long term.
Check out this video on the hippocampus and limbic system:
Check out this video on the effects of sugar on the brain and hippocampus:
Non-Nutritive Sweeteners (NNS)
From reviewing this information, it can be seen that a diet high in sugar, especially when paired with poor quality fats (often seen in processed foods), has detrimental effects on not only our bodies, but our brain.
This is why there is a market for non-nutritive sweeteners. The purpose of these products is to satisfy the desire for a sweet taste, with few or negligible calories. The thought is that people can continue to enjoy the taste of “sweet,” while being able to manage weight/weight loss and health issues such as diabetes.
NNS are made with chemical alternatives by altering existing sugars or amino acids, or are made from the derivatives of plants. Some examples of NNS are aspartame (Equal, NutraSweet), cyclamate (Sucaryl, Sugar Twin, Sweet ‘N Low), saccharin, sucralose (Splenda), sugar alcohols (mannitol, sorbitol, and xylitol - Note: if you eat too much of them, sugar alcohols can cause diarrhea and bloating), polydextrose, stevia, steviol glycosides and erythritol, amongst many others. The regulation of NNS varies in different countries, allowing for different product availability depending on where you live. NNS is found in many different products and may even be listed as an ingredient that is not identified as a low-sugar product, or used as an additive.
The Science Behind the Use of NNS
When going down the rabbit hole of research into this area, it is honestly difficult to navigate how NNS truly affects us. There have been many studies that report the safety of these products, which does allow for wide-scale use of them through regulatory bodies such as the FDA and Health Canada. However, it is identified that there is still a need for both further primary research and high-quality comprehensive systematic reviews including meta-analyses to inform future recommendations about the health benefits and risks of NNS, to advise and support health care practice and public health decision-making. There are noted controversies of the existing evidence surrounding the use of different artificial sweeteners.
Although NNS maintains a similar palatability as natural sugars, the way the body processes them is different. Interestingly, the gut microbiota may play a major role in the physiological effects of artificial sweeteners on body weight regulation and glucose homeostasis. According to Pang, Goossens & Blaak (2021), there is mechanistic evidence that artificial sweeteners may induce
The gut microbiota appears to react differently to NNS than to real sugar. These organisms become less able to break down real sugars the more they are exposed to artificial sweeteners. Not being able to break down sugars is a concern because this change in the microbiota can affect the ability of our bodies to digest and process the nutrients from the food we eat. This can potentially lead to deficiencies in vitamins and minerals.
Although different physiological processes are involved in the effect of NNS on metabolic health, meta-analyses of Randomised Control Trials (RCTs) and prospective cohort studies suggest that artificial sweeteners may have a neutral effect on body weight and glycemic control, respectively, or may have a beneficial effect on long-term body weight regulation. Even though the majority of human studies report no significant effects of artificial sweeteners on body weight and glycemic control, it should be emphasized that the study duration of most studies is limited. Furthermore, unlike rodent studies, long-term studies investigating the underlying physiological effects of body weight control and metabolic health of humans and NNS use are scarce and therefore warranted. This is important to consider when interpreting the results.
Notably, artificial sweeteners are metabolized differently and may not all elicit the same metabolic effect. For instance, components of NNS may affect the gut microbiota composition directly and others are easily digested and absorbed. It is also important to note that most NNS provide little-to-no energy, so should not affect your blood sugar. However, this is not true in the case of sugar alcohols. They are a carbohydrate and a hybrid form of sugar and alcohol. These products can affect your blood sugar, so those with diabetes should still be mindful of them.
Not all studies investigating the effects of artificial sweeteners on body weight control and glucose homeostasis take into account the different metabolic pathways of distinct artificial sweeteners. Therefore, human data on the effects of distinct artificial sweeteners are limited or lacking. The difference in metabolic fate of artificial sweeteners may underlie conflicting findings that have been reported related to their effects on body weight control, glucose homeostasis and underlying biological mechanisms. Thus, making conclusions about the metabolic effects of a single artificial sweetener on all artificial sweeteners is not appropriate.
An example of this is that there is growing evidence that indicates certain artificial sweeteners, like sucralose, reduce insulin sensitivity and affect gut bacteria.
It is recommended that future studies should consider the metabolic pathways of different artificial sweeteners. Also, further (long-term) human research investigating the underlying physiological pathways of different artificial sweeteners on microbiota alterations and their related metabolic pathway is warranted to evaluate the potential impact of their use.
Finally, although Stevia, in the purified form called stevioside (known as stevia extract or Stevia rebau- diana), is considered safe to use, whole stevia leaves or crude stevia extracts are not recommended, as there is not enough information about their potential impact on your health. There is concern that the raw stevia herb may harm your kidneys, reproductive system and cardiovascular system. It may also drop blood pressure too low or interact with medications that lower blood sugar.
The WHO has released this 2022 systematic review and meta-analysis of the health effects of the use of non-sugar sweeteners.
Currently, project SWEET (a European Commission Horizon 2020 funded project and human multicenter study) is being conducted over 5 years. It is supported by a consortium of 29 pan-European research and consumer and industry partners who will develop and review evidence on long-term benefits and potential risks involved in switching over to sweeteners and sweetness enhancers (S&SEs) in the context of public health and safety, obesity and sustainability. Check out their website to follow their findings.
Check out this excellent video synopsis on the complexity of reviewing the literature related to NNS.
Check out this video on the microbiome that includes some discussion on the effects of NNS on the microbiome.
The Takeaway on Sugar and NNS
After examining all the research on sugar and NNS, what is clear is that reducing both is beneficial to your health. The science is clear on the effect sugar has on the reward centre of the brain, as well as the impact of a diet high in sugar and fat on the incidence of obesity and disease, also causing inflammation in the body and the brain.
An alternative has been presented to feed our sugar cravings in the form of NNS, which are presented as a safe alternative. However, the question is why do we need to feed into our need and want of sugar, with an alternative that is processed, chemically altered, made in a lab, and still needs more long-term, rigorous human study? Other “sugar-free” products often contain additives, dyes, colours, flavours and preservatives. These products are often marketed as “healthy.”
The Livy Method recommends eating whole, natural foods, with the option of adding in natural sugars on occasion if desired. This, combined with proper hydration and eating to satisfaction, allows one to experience and enjoy food as it was meant to be experienced.
Sweetness inundates our senses, dulling them over time. By reducing the amount of sugar we eat, our taste buds can actually “reset” and less sweet foods taste sweeter. Therefore, we can enjoy eating foods in their natural state, while our bodies and brains reap all the nutritional benefits, becoming healthier because of it. Now that is truly sweet.
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