Non-caloric artificial sweeteners (NAS) are among the most widely used food additives worldwide, regularly consumed by lean and obese individuals alike. NAS consumption is considered safe and beneficial owing to their low caloric content, yet supporting scientific data remain sparse and controversial. Here we demonstrate that consumption of commonly used NAS formulations drives the development of glucose intolerance through induction of compositional and functional alterations to the intestinal microbiota. These NAS-mediated deleterious metabolic effects are abrogated by antibiotic treatment, and are fully transferrable to germ-free mice upon faecal transplantation of microbiota configurations from NAS-consuming mice, or of microbiota anaerobically incubated in the presence of NAS. We identify NAS-altered microbial metabolic pathways that are linked to host susceptibility to metabolic disease, and demonstrate similar NAS-induced dysbiosis and glucose intolerance in healthy human subjects. Collectively, our results link NAS consumption, dysbiosis and metabolic abnormalities, thereby calling for a reassessment of massive NAS usage.
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European Nucleotide Archive
Sequencing data are deposited in the European Nucleotide Archive accession PRJEB6996.
We thank the members of the Elinav and Segal laboratories for discussions. We acknowledge C. Bar-Nathan for germ-free mouse caretaking. We thank the Weizmann Institute management and the Nancy and Stephen Grand Israel National Center for Personalized Medicine (INCPM) for providing financial and infrastructure support. We thank G. Malka, N. Kosower and R. Bikovsky for coordinating the human clinical trials, and M. Pevsner-Fischer, T. Avnit-Sagi and M. Lotan-Pompan for assistance with microbiome sample processing. C.A.T. is the recipient of a Boehringer Ingelheim Fonds PhD Fellowship. G.Z.-S. is supported by the Morris Kahn Fellowships for Systems Biology. This work was supported by grants from the National Institute of Health (NIH) and the European Research Council (ERC) to E.S., and support and grants to E.E. provided by Y. and R. Ungar, the Abisch Frenkel Foundation for the Promotion of Life Sciences, the Gurwin Family Fund for Scientific Research, Leona M. and Harry B. Helmsley Charitable Trust, Crown Endowment Fund for Immunological Research, estate of J. Gitlitz, estate of L. Hershkovich, Rising Tide foundation, Minerva Stiftung foundation, and the European Research Council. E.E. is the incumbent of the Rina Gudinski Career Development Chair.
Extended data figures
This file contains Supplementary Tables 1-7.
About this article
Nature Reviews Nephrology (2019)