Review of the scientific evidence and technical opinion on noncaloric sweetener consumption in gastrointestinal diseases

• Published in: Revista de Gastroenterología de México (English Edition) 2019-10, Vol.84 (4), p.492-510
• Main Authors: Bueno-Hernández, N., Vázquez-Frías, R., Abreu y Abreu, A.T., Almeda-Valdés, P., Barajas-Nava, L.A., Carmona-Sánchez, R.I., Chávez-Sáenz, J., Consuelo-Sánchez, A., Espinosa-Flores, A.J., Hernández-Rosiles, V., Hernández-Vez, G., Icaza-Chávez, M.E., Noble-Lugo, A., Romo-Romo, A., Ruiz-Margaín, A., Valdovinos-Díaz, M.A., Zárate-Mondragón, F.E.
• Format: Article
• Language: English
• Subjects: Cirrhosis; Cirrosis; Edulcorantes no calóricos; Gastrointestinal symptoms; Inflamación; Inflammation; Microbiota; Noncaloric sweeteners; Síntomas gastrointestinales
• ISSN: 2255-534X; 2255-534X
• DOI: 10.1016/j.rgmxen.2019.08.001

The present review of noncaloric sweeteners (NCSs) by the Asociación Mexicana de Gastroenterología was carried out to analyze and answer some of the most frequent questions and concerns about NCS consumption in patients with gastrointestinal disorders, through a thorough review of the medical literature. A group of gastroenterologists and experts on nutrition, toxicology, microbiology, and endocrinology reviewed and analyzed the published literature on the topic. The working group formulated conclusions, based on the scientific evidence published, to give an opinion with respect to NCS ingestion. Current evidence does not confirm the carcinogenic potential of NCSs. However, the studies analyzed showed that saccharin could have a proinflammatory effect and that polyols can cause gastrointestinal symptoms and manifestations, depending on the dose and type of compound. The ingestion of xylitol, erythritol, sucralose, aspartame, acesulfame K, and saccharin could increase the secretion of the gastrointestinal hormones that regulate intestinal motility, and stevia and its derivatives could have a favorable effect on the percentage of liver fat. Caution should be taken in recommending aspartame consumption in patients with chronic liver disease because it reduces the ratio of branched-chain amino acids to aromatic amino acids. In addition, NCS ingestion could modify the composition of the intestinal microbiota, having an effect on gastrointestinal symptoms and manifestations. It is important to continue conducting causality studies on humans to be able to establish recommendations on NSC consumption. Esta revisión de la Asociación Mexicana de Gastroenterología sobre edulcorantes no calóricos (ENC) se realizó con el fin de analizar y responder a través de una amplia revisión bibliográfica, algunas de las preguntas y preocupaciones más frecuentes sobre la ingestión de ENC en pacientes con alteraciones gastrointestinales. Un grupo de gastroenterólogos, expertos en nutrición, toxicología, microbiología y endocrinología, revisó y analizó la literatura publicada en este tópico. El grupo de trabajo generó conclusiones basadas en la evidencia científica publicada para emitir una opinión respecto a su ingestión. En este sentido, la evidencia existente hasta el día de hoy no confirma el potencial carcinogénico de los ENC; sin embargo, los estudios evaluados mostraron que la sacarina podría tener un efecto proinflamatorio y los polioles pueden causar síntomas y manifestacio