(P06-07-26) Non-Sugar Sweetener Consumption and Glycemic Control in Middle-Aged and Older Adults with Prediabetes: Results From a Double-Blinded Randomized Controlled Feeding Trial

Objectives: Middle-aged/older adults are at increased risk for glucose intolerance, insulin resistance, and type 2 diabetes, and simultaneously, are among the highest consumers of non-sugar sweeteners (NSS). NSS are widely used, but the understanding of how they influence glucose homeostasis in this high-risk population remains limited. We hypothesize that a diet containing sucralose but not aspartame will impair glucose tolerance compared to an identical diet without NSS.

Methods: A three-arm randomized controlled feeding trial was used to isolate glycemic responses to 2 different NSS. Adults, age ≥40 yrs with prediabetes, completed a 2-week standardized eucaloric lead-in diet followed by a 4-week randomized intervention with the same diet and daily individualized doses (25% of Acceptable Daily Intake, mg/kg) of either sucralose, aspartame, or a control (dextrose). The diet replicated usual US dietary intake (e.g., macronutrients, added sugars, diet quality). Repeated-measures ANOVA was used to assess fasting glucose and glucose tolerance (2hr OGTT, samples taken every 30 min) at baseline and post-intervention between groups.

Results: At baseline, mean fasting glucose was 99.2±9.4, 102.6±11.7, 106.4±16.6 mg/dL and mean 2-hr glucose was 105.8±11.4, 91.0±37.7, 109.4±16.7 mg/dL in the aspartame (n=9), sucralose (n=9), and control groups (n=8), respectively, with no differences between groups (p > 0.05). Post-intervention fasting glucose was 101.1±9.2, 102.8±14.1, 104.4±9.7 mg/dL, while 2-hr glucose values were 104.6±20.7, 101.5±34.7, 111.8±4.3 mg/dL in the aspartame, sucralose, and control groups, respectively. During the OGTT, delta-glucose AUC was 200.6±1463.8, 375.1±2473.7, and 582.9±3043.5 mg·min/dL in the aspartame, sucralose, and control groups, respectively (p > 0.05).  Similar patterns were observed for delta-iAUC (214.3±1410.7, 302.0±2327.0, and 612.7±3107.9 mg·min/dL, respectively (p > 0.05).

Conclusions: The results of the present study suggest that diets supplemented with sucralose or aspartame do not impair glucose tolerance in middle-aged/older adults with prediabetes. Future studies with larger, more diverse populations are needed to identify differences among NSS and to inform NSS intake guidelines for those at risk of developing type 2 diabetes.

Funding Sources: National Institute on Aging