Category: Nutrition


Artificial Sweeteners – Alzheimer’s and Stroke

To those of you who follow my blog, the recent study demonstrating a remarkably increased risk for stroke, as well as Alzheimer’s disease, in relation to consumption of artificially-sweetened beverages should not come as a surprise.

First, let me break down what the researchers did, and learned. The stroke portion of the study evaluated 2,888 adults (age 45+), while the dementia arm focused on 1,484 adults (age 60+). The researchers reviewed food frequency questionnaires for the years 1991 to 2001 and determined how often the participants consumed artificially-sweetened beverages.

The report reveals that the risk of stroke in those consuming one or more artificially sweetened sodas a day was almost tripled, with a similar finding for Alzheimer’s risk.

These are breathtaking findings because clearly, when it comes to stroke as well as Alzheimer’s disease, modern medicine has precious little to offer patients.

The reason these findings should not come as a surprise is because both stroke and Alzheimer’s disease share a similar mechanism in terms of their cause. Both of these issues are primarily inflammatory disorders. As I have discussed earlier, research indicates that the changes induced in the gut bacteria in humans when they are exposed to artificial sweeteners creates a much more inflammatory environment. This explains, for example, why there’s a dramatically increased risk for both obesity as well as diabetes (both are inflammatory disorders) in relation to consumption of these artificial sweeteners. And both of these diseases are powerfully related to both stroke and Alzheimer’s in and of themselves. The authors stated:

Artificial sweeteners have been shown to cause glucose intolerance in mice by altering gut microbiota and are associated with dysbiosis and glucose intolerance in humans.

So, let’s be clear: there’s no advantage to drinking sugar-free, low- or no-calorie this or that, despite what the advertisements and commercials might lead you to believe.

Always be kind to your gut microbes!

You can learn more about ways to protect your brain in the revised edition of Dr. Perlmutter’s groundbreaking book, Grain Brain, due out December 2018. Pre-order your copy today!

  • John Forkosh

    Do artificial sweeteners “actively” affect gut bacteria, or is it just the absence of sugar that’s responsible? That is, I use artificial sweeteners in coffee and tea, so can I just drink a cup or two per day with real sugar to ameliorate the gut bacteria effect, and the other five or six cups with artificial sweetener? Or, if it’s an “active” effect, is it all artificial sweeteners, just the aspartame-containing ones, or what?

    • Regina Fugate

      Don’t drink either…artificial or sugar

  • Cary Brandon

    Both are bad. Food should be fuel. They should be limited. Will power is something you have to have. We are bombarded with poor food. Make good choices and read the labels

  • Joyce Wright Pierce

    I found this rather interesting. My mother has used artificial sweetners and drank a ton of diet soda sodas. She is 90 and has been a diabetic since her early 50’s. She has Alzheimers and just suffered an ITA Stroke. What about Stevia?

  • ELuria

    Is Stevia an “artificial sweetener?”

  • Debbie

    Does this include things like “Quest” bars?

  • Debbie

    Yeah, and is “stevia” OK to use?🙏

    • Liz

      Valid question, since research has shown stevia can have the same effect as artificial sweeteners in tricking the brain/body into thinking it is sugar and leading to body weight gain. See toward the end of this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855968/

      • spacebirdmom

        This is a serious bummer. I had pretty much given up stevia, because of it having an effect on insulin, but seeing this seems to confirm a choice in cutting it out!

    • maria

      In the past, Dr. Perlmutter said stevia is okay to use, but I would like to hear if he still has the same opinion. I think some people believe it has a similar effect on insulin as sugar.

    • David Perlmutter

      It is the one I advise if someone MUST use a sweetener.

      • Bill Shane

        My wife and I grow our own. It’s amazing how sweet one little Stevia leaf can taste. Combine with ginger and seltzer water and you’ll have your own ginger ale.

    • Barbara

      I make sure I use organic unrefined stevia when possible. I avoid most processed foods because most of time that process involves chemicals, preservatives and artificial colorings to make that product.

  • Ronna Berezin

    Does this include the artificial sugar in Garden of Life protein bars?

  • Debbie

    Solid advice, I appreciate it all, I’m just looking for that “loop~hole” to satisfy my sugar tooth without all those calories 😟
    It IS a poor food “product” choice, thanks everyone for the imput,

    • AnnieLaurie Burke

      The calories are not the issue at all. Sugar is actually a relatively low-calorie food. The “sugar tooth”, as you call it, is what is hurting your health. You CAN wean yourself off sweet addiction, and you will be surprised how your cravings change as you do it.

    • vanwin

      If you knew you would die in one month as a result of taking any form of sugar what would you do? The answer has to be stop it, give it all up right now.

  • Foster


  • Alfonso Enriquez

    Dr. Perlmuter, did the study you mention included stevia among the sugar substitutes?

  • Foster

    Stevia has been used for generations in latin america to help diabetes,so I doubt if it is inflamatory or hurts the gut. Perhaps whole leaf stevia would be best to use. I bought on amazon.

    • David Perlmutter

      It is the sweetener I suggest if someone MUST have one.

  • AnnieLaurie Burke

    The bottom line is that Americans need to ditch their sugar addiction. The craving for so much sweet taste in the diet is unnatural. Even many modern vegetable varieties, such as some corn and tomato cultivars, have been bred to have a higher sugar content to give American sugar junkies their sweet fix when consuming what should be healthful veggies.

    • David Perlmutter

      That’s a key nutritional change we all need to make.

  • joanna

    I’m doing intermittent fasting every day and it’s totally killed my cravings. I’ve not eaten breakfast at all since I was a child & now I just have a mug of beautiful coffee with cream when I wake, a homemade unflavoured & unsweetened yogurt at mid day & a healthy vegetable based evening meal. It works for me!

    • David Perlmutter

      I enjoy an intermittent fast as well. Glad this is working for you.

      • joanna

        And for you too I guess 😀

    • wisdomandtruth

      You must be aware that the food you cited cannot be getting even minimum daily requirements of any nutrients. Long term deprivation of nutrients is conducive to a healthy life.

      • joanna

        Your comment doesn’t make sense at all. I eat an extremely healthy diet and I am totally fit and healthy. I simply do not over eat whereas probably most people do. There is a formula to calculate how many calories are needed by any particular individual which is based on the usual numbers- gender, age, height & weight. That is what I go by for myself.

  • What about XYLITOL? It’s ment to be partially transformed in SCFA or SCT by intestinal bacteria, allthough in excess tends to cause some mild diarrea that would indicate some effect in GI microbiome

  • mn

    does this apply to erythritol? just read this on amazon review: … It
    is known however, that Erythritol feeds a few types of harmful bacteria
    e.g. brucella…

    • carole noddings

      I’d be interested to know this also as I’ve started using Erythritol

  • Chuck Hartz

    My son in law is addicted to diet drinks and I’m very concerned. Is there a podcast on this yet?

    • David Perlmutter

      Not yet, but I do write on the subject. If you type that into the search bar, some blog posts should come up.

  • Mark

    Thank you for sharing! Interesting the authors also concluded, “Sugar-sweetened beverages were not associated with stroke or dementia”. From all we currently know, would have expected at least some positive correlations, understanding the mechanisms may differ.

    • David Perlmutter

      Glad you took the time to read the study itself Mark!

  • renebeaulieu

    As a health coach I advise my clients that have a strong sugar craving to use a little bit of L-Glutamine under the tong or in a bit of water when the craving hits and it has helped reduce or eliminated the carving. Just make sure you get a good source of L-Glutamine as I have seen some very poor quality. I like North Coast fermented L-Glutamine. One other thought and this one is predominant in many of my female clients. If you crave Chocolate in particular try Magnesium as this can be one reason some people crave chocolate.

    • Bill Shane

      When you first start boosting your Magnesium intake, don’t venture too far from a bathroom.

  • Diane Hearn

    In at attempt to wean myself from sugar I first tried to drink my coffee and tea with no sweetener, but just couldn’t adjust to it. So I have been using Sweet Leaf Stevia sweetener with organic Stevia. It comes in a bottle and one drop is enough to give a little sweet taste to my tea (three for coffee). I don’t drink soda at all. I’m wondering if this is ok, or might it be better for me just to use a little honey instead.

    • MarkTaylor

      Please let me know when you find out. I’ve been asking the identical question.

  • Kelley

    After years of consuming extremely high amounts of aspartame, I am nervous the toxins have settled into my tissues/fat. Is there any way to “detox” the chemicals from the body?

    • Yes of course you can detox. Start doing research. I drink a detox tea daily, take spirulina, chlorella, & other vitamins & supplements. These days you pretty much need to help your body all you can. Toxins are thrown at us from everywhere. Its definately not like it used to be. 😊

  • AnnieLaurie Burke

    For those still having a problem weaning themselves from sugar, JJ Virgin, whom Dr. P has featured in the past, recently gave a presentation where she suggested that foods with a sour taste can quickly squelch a sugar craving — she mentioned sauerkraut, kimchee and similar foods, which also offer the benefits of fermented foods. I think she may have explained why I never developed a big sweet tooth as a child — I was a huge fan of old-fashioned kosher (fermented) pickles, and lemon slices with a dash of salt (no sugar). Our neighborhood grocery store (I grew up long before supermarkets became widespread) had a barrel of those pickles. While my brother and sister were spending their nickels on candy, I headed for the pickle barrel. The lemon habit I picked up from my maternal grandfather, a farmer in a rural area with very limited access to medical care. Grand-Daddy worked up until the day he died some months after his 89th birthday.

  • carole noddings

    Isn’t Stevia normally mixed with another substance because it is extremely sweet, like xylitol or erythritol? I haven’t seen any problems with erythritol unless you have more than 50g at once. Is it better for gut bacteria than xylitol. It’s difficult for the average person to go cold turkey on sugar. I’m eating keto but work long hours and sometimes I want sweetness. I’m using sukrin which is erythritol and stevia. What’s the general view erythritol or xylitol? I tried stevia drops and they were difficult to measure and didn’t taste nice. Thanks

  • Laura

    Is honey alright if used moderately or is also bad 🙁 Thanks for all the wonderful information. Laura

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