Low and Zero Calorie Sweeteners Possibly Mediating Mental Health Disorders Through the Gut Microbiome Público
Dowd, Madeline (Summer 2023)
Published
Abstract
Mental health disorders, such as anxiety and depression, have been increasing substantially over the past 25 years, causing a public health burden all around the world. Additionally, low- and zero-calorie sweeteners used in place of traditional sweeteners to sweeten foods due to their potential health benefits have been increasing in consumption. Additionally, focus on the digestive system from mouth to anus known as the gastrointestinal (GI) tract, specifically the gut-brain axis, has been shifting in the scientific community as the GI tract’s links to various biological processes have been emerging. It has been theorized that the GI tract may play a role in mental health disorders’ prevalence and severity. Additionally, some research has analyzed the possible implications these low and zero calorie sweeteners may have on the GI microbiome. The goal of this literature review was to bridge the gap in this space to investigate if low and zero calorie sweeteners were mediating mental health disorders through the gut microbiome. This was done by analyzing 24 published studies on either low and zero calorie sweeteners’ associations with mental health disorders, mental health disorders’ associations with the GI tract, and low and zero calorie sweeteners’ associations with the GI tract. Overall, it was concluded that low and zero calorie sweeteners are mediating mental health disorders and mental health disorders are altering the GI microbiome composition. Specifically, increased sucralose consumption and increased depression prevalence and severity of symptoms were associated with the GI microbiome through decreasing the abundance of the Bacteroides genus. Additional evidence supporting whether other L/Z calorie sweeteners are mediating mental health disorders through the GI microbiome is not robust. It is advised that additional research be conducted on whether the low and zero calorie sweeteners that are affecting mental health disorders are affecting similar GI bacteria that the mental health disorders are affecting. This additional research could be done via experiments analyzing the effects of varying pre-measured amounts of L/Z calorie sweeteners that are below the average daily intake limit in human subjects.
Table of Contents
1.0 Comprehensive Review of the Literature. 1
1.1 Aim 1: Low/Zero Calorie Sweeteners and Mental Health Disorders. 2
1.2 Aim 2: Mental Health Disorders and the Gut Microbiome Composition. 5
1.3 Aim 3: Low/Zero Calorie Sweeteners and the Gut Microbiome Composition. 7
1.4 Overall Aim: Are L/Z Calorie Sweeteners Acting through the Gut Microbiome to Mediate Mental Health Disorders? 8
1.5 Problem Statement. 9
1.6 Purpose Statement. 10
1.7 Research Questions. 10
1.8 Significance Statement. 12
2.1 Search Strategy. 12
2.1a Aim 1: Is There an Association Between Mental Health Disorders and L/Z Calorie Sweeteners? 12
2.1b Aim 2: Is the Gut Microbiome Composition Associated with Mental Health Disorders? 13
2.1c Aim 3: Are L/Z Calorie Sweeteners Affecting the Gut Microbiome Composition? 13
2.2 Inclusion and Exclusion Criteria. 14
2.2a Aim 1: Is There an Association Between Mental Health Disorders and L/Z Calorie Sweeteners? 14
2.2b Aim 2: Is the Gut Microbiome Composition Associated with Mental Health Disorders? 15
2.2c Aim 3: Are L/Z Calorie Sweeteners Affecting the Gut Microbiome Composition? 15
2.3 Measurements. 16
2.3a Mental Health Disorders’ Assessments. 16
2.3b Gastrointestinal Tract Microbiome Composition Assessments. 19
3.0 Results. 21
3.1 Aim 1: Is There an Association Between Mental Health Disorders and L/Z Calorie Sweeteners? 21
Table 1: Articles Analyzing L/Z Calorie Sweeteners’ Potential Associations with Mental Health Disorders. 23
3.2 Aim 2: Is the Gut Microbiome Composition Associated with Mental Health Disorders? 32
Table 2: Studies Analyzing the Potential Association Between Mental Health Disorders and the Gut Microbiome Composition. 34
Table 3: Significant Phyla Alterations in Subjects with Mental health Disorders. 41
Table 4: Significant Family Alterations in Subjects with Mental Health Disorders. 44
Table 5: Significant Genera Alterations in Subjects with Mental Health Disorders. 47
Table 6: Significant Species Alterations in Subjects with Mental Health Disorders. 52
3.3 Aim 3: Are L/Z Calorie Sweeteners Effecting the Gut Microbiome Composition? 54
Table 7: Summaries of Studies Analyzing L/Z Calorie Sweeteners’ Potential Associations with the Gut Microbiome. 56
3.4 Overall: Are L/Z Calorie Sweeteners Acting Through the Gut Microbiome to Mediate Mental Health Disorders? 66
4.0 Discussion and Conclusions. 69
4.1 Key Findings. 69
4.2 Strengths. 72
4.2a Strengths of the Studies’ Approaches. 72
4.2b Strengths of This Literature Review’s Approaches. 74
4.3 Weaknesses and Limitations. 76
4.3a Weaknesses and Limitations of the Studies’ Approaches. 76
4.3b Weaknesses and Limitations of This Literature Review’s Approach. 81
4.4 Implementation and Recommendations. 83
4.4a Further Research. 83
4.4b Public Health Implications: Current Policies and How They Should Change Regarding L/Z Calorie Sweeteners. 85
4.4c Public Health Implications: Nutritional Recommendations as Supplemental Treatment for Mental Health Disorders. 88
4.5 Summary and Restated Findings. 89
Bibliography. 90
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