Sweeteners and the Gut Microbiome: Effects on Gastrointestinal Cancers - Review

Sep 24, 2026

Uploaded by Rizky

Worldwide, demand for natural and synthetic sweeteners in the food industry as an alternative to refined sugar is increasing, driving research on safety and health effects. The gut microbiome is critical for metabolizing selected sweeteners, which may influence overall health outcomes. This review summarizes current knowledge on how the gut microbiome metabolizes selected sweeteners and examines effects of five sweeteners and their metabolites on GI cancer-related pathways. Observed positive effects on apoptosis and cell cycle arrest require further mechanistic investigation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Abstract

1. Introduction

1.1. Natural and Synthetic Sweeteners

1.2. Metabolization of Sweeteners by Gut Microbiome

1.3. Sweeteners and Gastrointetional Cancers

nutrients Review Sweeteners and the Gut Microbiome: Effects on Gastrointestinal Cancers Raghad Khalid AL-Ishaq 1, Peter Kubatka 2 and Dietrich Büsselberg 1, * Citation: AL-Ishaq, R.K.; Kubatka, P.; Büsselberg, D. Sweeteners and the Gut Microbiome: Effects on Gastrointestinal Cancers. Nutrients 2023, 15, 3675. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/nu15173675](10.3390/nu15173675) Academic Editors: Danielle Greenberg and John St. Peter Received: 19 July 2023 Revised: 16 August 2023 Accepted: 17 August 2023 Published: 22 August 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar; [rkmalishaq@hotmail.com](rkmalishaq@hotmail.com) 2 Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia; [peter.kubatka@uniba.sk](peter.kubatka@uniba.sk) * Correspondence: [dib2015@qatar-med.cornell.edu](dib2015@qatar-med.cornell.edu); Tel.: +974-4492-8334; Fax: +974-4492-8333 Abstract: Worldwide, the demand for natural and synthetic sweeteners in the food industry as an alternative to reﬁned sugar is increasing. This has prompted more research tobe conducted to estimate its safety and effects on health. The gut microbiome is critical in metabolizing selected sweeteners which might affect overall health. Recently, more studies have evaluated the relationship between sweeteners and the gut microbiome. This review summarizes the current knowledge regarding the role played by the gut microbiome in metabolizing selected sweeteners. It also addresses the inﬂuence of the ﬁve selected sweeteners and their metabolites on GI cancer-related pathways. Overall, the observed positive effects of sweetener consumption on GI cancer pathways, such as apoptosis and cell cycle arrest, require further investigation in order to understand the underlying mechanism. Keywords: sweeteners; non-nutritive sweeteners; steviol; saccharin; gut microbiome 1. Introduction 1.1. Natural and Synthetic Sweeteners Worldwide, the consumption of sugars of glucose or fructose syrup and sucrose has dramatically increased [1,2] . This prompted scientiﬁc discussions about their diverse effects on health conditions such as obesity, inﬂammatory responses, and metabolic conditions, which has motivated people to use natural and zero-caloric sweeteners as alternatives [3] . Sweeteners substitute for sugar, as they mimic their sweet taste [4] . Non-nutritive sweeteners (NNS) are often used to substitute reﬁned sugar in the food industry and the human diet since they provide the desired sweet taste while having a lower calorie content [5,6] . They can be naturally or synthetically produced, with the former having a higher quality, sweetness intensity, and quantity [7] . The consumption of NNS is not limited to people with metabolic conditions such as diabetes, but also to the general population, as they are commonly found in various food products [8] . As a result, efforts are made to measure and ensure the safety of those products. For example, the US Food and Drug Administration (US FDA) follows a speciﬁc process to approve new sweeteners, which includes determining the appropriate intake amounts, estimating toxicity levels, and evaluating the cumulative effects of the sweeteners. However, the recent WHO statement that lists aspartame as a potential carcinogen shows the necessity of investigating the mechanistic effects of those sweeteners on health and how they are related to cancer [2,9] . Examples of approved natural and synthetic sweetene

FAQs

What role does the gut microbiome play in sweetener effects?

The gut microbiome is critical for metabolizing selected sweeteners, and these metabolites may affect overall health and GI cancer-related pathways.

Why is research needed on sweeteners and cancer?

Sweetener use is debated with conflicting findings, and statements such as WHO identifying aspartame as a potential carcinogen motivate investigation of mechanistic links to cancer.

Which sweeteners are highlighted in the review?

The review addresses five selected sweeteners and their metabolites, including steviol (steviol glycoside) and saccharin as examples of natural and synthetic sweeteners, respectively.

Sep 24, 2026

Uploaded by Rizky