For those trying to live a healthy lifestyle, the choice between sugar and artificial sweeteners such as saccharin can be confusing. A new study led by researchers at The Ohio State University Wexner Medical Center and The Ohio State University College of Medicine found that the sugar substitute saccharin does not lead to the development of diabetes in healthy adults, as previous studies have suggested. The study’s findings have been published in the journal Microbiome.

“It’s not that the findings of previous studies are wrong, they just didn’t adequately control for things like underlying health conditions, diet choices and lifestyle habits,” said George Kyriazis, assistant professor of biological chemistry and pharmacology at Ohio State and senior author of the study.

“By studying the artificial sweetener saccharin in healthy adults, we’ve isolated its effects and found no change in participants’ gut microbiome or their metabolic profiles, as it was previously suggested.”

Kyriazis collaborated with researchers at Ohio State’s College of Food, Agricultural and Environmental Sciences, Ohio State’s College of Arts and Sciences, Sanford Burnham Prebys Medical Discovery Institute in California and the Translational Research Institute for metabolism and Diabetes at Advent-Health in Florida.

Non-caloric artificial sweeteners are often consumed as a substitute for dietary sugars, and saccharin is one of six artificial sweeteners approved by the US Food and Drug Administration (FDA).

The use of artificial sweeteners has increased dramatically over the past decade due to growing awareness of the negative health outcomes associated with consuming too much sugar, study authors noted.

“Previous studies elsewher have suggested that consuming artificial sweeteners is associated with metabolic syndrome, weight gain, obesity and non-alcoholic fatty liver disease. These findings have raised concerns that consuming them may lead to adverse public health outcomes, and a lack of well-controlled interventional studies contributed to the confusion,” said study first author Joan Serrano, a researcher in the department of biological chemistry and pharmacology at Ohio State.

A total of 46 healthy adults aged 18-45 with body mass indexes of 25 or less completed this randomised, double-blind, placebo-controlled study.

Participants ingested capsules that contained the maximum acceptable daily amount of either saccharin or lactisole (a sweet taste receptor inhibitor), or saccharin with lactisole or placebo every day for two weeks. The maximum acceptable daily amount of saccharin is 400 milligrams per day, which is far more than the average consumer would consume.

The study excluded people with acute or chronic medical conditions or taking medications that could potentially affect metabolic function, such as diabetes, bariatric surgery, inflammatory bowel disease or a history of malabsorption, and pregnant or nursing.

Researchers also tested for 10 weeks the effects of an even higher dose of saccharin in mice that genetically lack sweet taste receptors, finding the same results: the artificial sweetener did not affect glucose tolerance, or cause any significant gut microbiota changes or apparent adverse health effects.

“Sugar, on the other hand, is well-documented to contribute to obesity, heart disease and diabetes,” Kyriazis said. “So when given the choice, artificial sweeteners such as saccharin are the clear winner based on all of the scientific information we currently have.”

The research team says future research will study each FDA-approved sweetener individually to examine if there are any differences in how they’re metabolised. Researchers will study these substances over a longer period of time to ensure they are safe for daily use.