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The American Diabetes Association states foods and drinks that use artificial sweeteners are an option that"may help curb your cravings for something sweet" if you have diabetes.They"re among a number of public health organizations spreading the deceptive and incorrect message that artificial sweeteners make a sensible alternative to sugar for diabetics even as the research continues to accumulate to the contrary.
美國糖尿病協會指出，如果你是一名糖尿病患者，透過食用含有人造甜味劑的食品和飲料"可能有助於遏制你對甜食的慾望"。該協會是傳播人造甜味劑可以作為糖尿病患者攝入的合理性替代糖的欺騙性和不正確訊息的眾多公共衛生機構之一，即使越來越多的研究成果正在得出與之完全相反的結論。

In a small， preliminary study presented at the European Association for the Study of Diabetes in Lisbon， Portugal， researchers at the University of Adelaide in Australia revealed that artificial sweeteners impair the body's response to glucose， reducing control of blood sugar levels.1，2 The study involved 27 healthy participants who were given either capsules of the artificial sweeteners sucralose(brand name Splenda) and acesulfame K in an amount equivalent to consuming 1.5 liters of diet drinks a day or a placebo.
在葡萄牙里斯本的歐洲糖尿病研究協會公佈的一項小型初步研究中，澳大利亞阿德萊德大學的研究人員發現，人造甜味劑會削弱人體對葡萄糖的反應，從而削弱人體對血糖水平的控制功能。[1，2]該研究有27名健康的參與者，他們分組分別服用了人造甜味劑三氯蔗糖(商標名Splenda)和安賽蜜K膠囊，劑量相當於每天飲用1.5升無糖飲料或安慰劑。

It took just two weeks for the artificial sweetener group to show adverse effects to their blood sugar levels， including a reduction in numbers of the gut peptide GLP-1， which limits the rise in blood sugar after eating.Lead study author Richard Young， associate professor at the University of Adelaide， said in a news release，"This highlights the potential for exaggerated post-meal glucose levels in high habitual NAS [noncaloric artificial sweeteners]users， which could predispose them to developing Type2diabetes."3
人造甜味劑組僅在兩週內就顯示出了人造甜味劑對血糖水平的不良影響，包括腸道肽GLP-1的數量減少，腸道肽GLP-1負責限制進食後血糖的升高。澳大利亞阿德萊德大學副教授理查德·楊(Richard Young)在一則新聞稿中表示："這明確表明了習慣性攝入非能量人造甜味劑的人在餐後存在血糖水平過高的可能性，這可能使他們很容易發展成2型糖尿病。"[3]

Science Increasingly Suggests Artificial Sweeteners Contribute to Glucose Intolerance， Diabetes
越來越多的科學研究表明人造甜味劑容易導致葡萄糖耐受不良和糖尿病

Critics of the University of Adelaide study suggested it was too small and"impossible from the data available" to conclude that the observed changes would lead to diabetes.4 However， it's not the first study to suggest such a link.For instance， drinking aspartame-sweetened diet soda daily increased the risk of Type2diabetes by 67 percent(regardless of whether the participants gained weight or not) and the risk of metabolic syndrome 36 percent in one study.5
針對阿德萊德大學這項研究的批評者認為，這個研究參與者的數量太小，並且"從現有的數據中不可能"得出結論：觀察到的變化會導致糖尿病[4]。然而，這並不是第一個提出這種關係的研究。例如，在一項研究中表明每天飲用含阿斯巴甜的無糖汽水會增加67%罹患2型糖尿病的風險(無論參與者體重是否增加)，增加36%代謝綜合症的風險。[5]

Artificial sweeteners may increase your risk of weight gain， obesity， metabolic syndrome and other related problems like Type2diabetes by inducing"metabolic derangements，" according to a report published in the journal Trends in Endocrinology and Metabolism.6 Research published in Applied Physiology， Nutrition and Metabolism also found aspartame intake is associated with greater glucose intolerance in people with obesity.7
根據發表在《內分泌和代謝趨勢》期刊上的一篇報告，人造甜味劑可透過誘導"代謝紊亂"從而提高體重增加、肥胖、代謝綜合症和其它相關問題(如2型糖尿病)的風險。[6]另一項發表在《應用生理學、營養學及新陳代謝》的研究同時發現，阿斯巴甜的攝入與肥胖者葡萄糖耐受量增加有關。[7]

Glucose intolerance is a condition in which your body loses its ability to cope with high amounts of sugar， and it's a well-known precursor to Type2diabetes.It also plays a role in obesity， because the excess sugar in your blood ends up being stored in your fat cells.This means obese individuals who use aspartame may have higher blood sugar levels， which in turn will raise insulin levels， leading to related weight gain， inflammation and an increased risk of diabetes.
葡萄糖耐受不良是人體失去應對血液裡過高糖分的能力的一種狀況，也是一個眾所週知的罹患2型糖尿病的前兆。它也在肥胖中起作用，因為血液中的多餘糖最終會儲存在你的脂肪細胞中。這意味著攝入阿斯巴甜的肥胖者可能會有更高的血糖水平，反過來會升高胰島素的水平，從而導致相關的體重增加、炎症和罹患糖尿病的風險增加的情況。

Artificial Sweetener in Four Cans of Diet Soda Daily May Increase Fat Production， Inflammation
每天飲用四罐含有人造甜味劑的無糖蘇打水可能會增加脂肪的堆積和炎症

As far as sucralose goes， in April 2017 research presented at ENDO 2017， the Endocrine Society's 99th annual meeting in Orlando， Florida， also found that this artificial sweetener promotes metabolic dysfunction that may promote the accumulation of fat.8
就三氯蔗糖而言，2017年4月在佛羅里達州奧蘭多市內分泌學會第99屆年會上發佈的2017年ENDO研究報告也發現，這種人造甜味劑會促進代謝功能障礙，最終可能促進脂肪的堆累。[8]

Sucralose was tested on stem cells taken from human fat tissue， which revealed that a dose similar to what would be found in the blood of someone who drinks four cans of diet soda a day increased the expression of genes linked to fat production and inflammation， as well as increased fat droplets on cells.9
從人體脂肪組織的幹細胞上對三氯蔗糖進行了測試，結果顯示，當三氯蔗糖的劑量達到相當於一個普通人每天喝四罐無糖汽水的血液中所發現的攝入量時，三氯蔗糖會增加與脂肪產生和炎症相關的基因的表達水平，以及增加細胞上的脂肪滴。[9]

The study's lead author， Dr.Sabyasachi Sen， associate professor of medicine and endocrinology at George Washington University in Washington， D.C.， noted in a press release，"From our study， we believe low-calorie sweeteners promote additional fat formation by allowing more glucose to enter the cells， and promotes inflammation， which may be more detrimental in obese individuals."10
該研究的主要作者，華盛頓喬治華盛頓大學醫學和內分泌學副教授沙布亞莎奇·申(Sabyasachi Sen)博士在一篇新聞稿中指出："從我們的研究中，我們相信低熱量甜味劑透過允許更多的葡萄糖進入細胞從而促進更多脂肪的形成，並促進炎症，這在肥胖的個體中可能更加有害。"[10]

The fact that the artificial sweetener was associated with increased glucose uptake in the cells was particularly concerning， as it could have detrimental effects for people with elevated blood sugar levels， like those with diabetes or prediabetes.11
人造甜味劑與細胞中葡萄糖攝取增加有關的事實特別令人關注，因為它可能對血糖水平升高的人，如糖尿病患者或前驅糖尿病患者非常有害。[11]

Consuming Artificial Sweeteners Alters Gut Flora， Exacerbating Metabolic Disease
攝入人造甜味劑會改變腸道菌群，惡化代謝性疾病

It's a little-known fact that artificial sweeteners have been shown to induce glucose intolerance by altering gut microbiota.12 Research led by Eran Elinav of the Weizmann Institute of Science in Rehovot， Israel， first showed that mice fed artificial sweeteners developed glucose intolerance after 11 weeks.They then revealed that altering the animals"gut bacteria influenced their glucose response.
一個鮮為人知的事實是人造甜味劑已被證明透過改變腸道微生物群來誘導葡萄糖不耐受的症狀出現。[12]由以色列雷霍沃特的維茲曼(Weizmann)科學研究所的埃蘭· 埃林那弗(Eran Elinav)領導的研究首次表明，餵食人造甜味劑的小老鼠在11週後出現葡萄糖不耐受，後續研究表明改變動物的腸道細菌會影響它們的葡萄糖反應。

Specifically， when they transplanted feces from glucose-intolerant mice consuming saccharin to mice with sterile intestines， the latter group developed glucose intolerance，"indicating that saccharin was causing the microbiome to become unhealthy，" Scientific American reported.13Perhaps the most revealing part of the experiments came when the researchers tested artificial sweeteners on people.Scientific American continued:14
具體來說，他們將餵食糖精導致葡萄糖不耐受的小老鼠的糞便移植到無菌腸的小老鼠體內後，後一組產生了葡萄糖不耐受性，"這表明糖精導致腸道微生物變得不健康，"《科學美國人》刊登到，[13]可能這些實驗最驚人的發現是研究人員把人造甜味劑在人體上進行試驗之後的發現。《科學美國人》的後文：[14]

"[Elinav's] team recruited seven lean and healthy volunteers， who did not normally use artificial sweeteners， for a small prospective study.The recruits consumed the maximum acceptable daily dose of artificial sweeteners for a week.Four became glucose intolerant， and their gut microbiomes shifted towards a balance already known to be associated with susceptibility to metabolic diseases."
"[埃林那弗(Elinav)的]團隊招募了7名體型偏瘦健康的志願者進行了一項小型的前瞻性研究，這些志願者通常不吃含有人造甜味劑的食物。實驗中志願者們連續一週每天攝入了人造甜味劑最大可接受的攝取量，一週之後四個志願者已經出現了葡萄糖不耐症，他們的腸道微生物群已經轉向已知的與代謝疾病易感性相關的生存狀態。

Splenda has also been found to reduce the amount of beneficial bacteria in rat intestines by 50 percent15 and depending on which ones are affected it could certainly affect your diabetes risk.Studies have found that the microbial composition in diabetics differ from nondiabetics.16
三氯蔗糖(商標名為Splenda)也被發現可以將大老鼠腸道中的有益細菌數量減少50%[15]，並且受到影響的細菌肯定會影響人體患糖尿病風險。研究發現，糖尿病患者體內的微生物組成與非糖尿病患者有所不同。[16]

In particular， diabetics tend to have fewer firmicutes and more plentiful amounts of bacteroidetes and proteobacteria compared to nondiabetics.A positive correlation for the ratios of bacteroidetes to firmicutes and reduced glucose tolerance has also been found.
特別是與非糖尿病患者相比，糖尿病患者趨向於具有更少的硬壁菌和更多的擬桿菌和變形桿菌，研究也已經發現擬桿菌與硬壁菌的比值和降低的葡萄糖耐量呈現正相關性。

A researcher in Amsterdam， Dr.Max Nieuwdorp， has published a number of studies looking at changes in the microbiome that are characteristic of Type2diabetes.17 In one trial， he was able to reverse Type2diabetes in all of the 250 study participants by doing fecal transplantations on them.Remarkable as it may sound， by changing the makeup of the gut bacteria， the diabetes was resolved， so it's not a stretch to think that the opposite could also hold true.
阿姆斯特丹的一位研究人員馬克斯· 紐多普(Max Nieuwdorp)博士發表了許多關於2型糖尿病特徵性微生物組變化的研究。[17]在一項試驗中，他能夠在所有250名研究參與者中透過對他們進行糞便移植逆轉2型糖尿病。這可能聽起來很明顯，透過改變腸道細菌的構成，糖尿病就得到了解決，所以這個規律是顯而易見的。

Diet Drinks May Trigger a Greater Metabolic Response Than Sugary Drinks
無糖飲料可能比含糖飲料能引發更強的代謝反應

Part of the problem with artificial sweeteners is that the sweet taste they provide(in many cases even hundreds of times sweeter-tasting than sugar) does not match up with the energy(or calories) the food provides.
人造甜味劑的其中一個問題是它們所提供的甜味(在許多情況下甚至比糖更甜幾百倍)與食物提供的能量(或卡路里)不匹配。

Your body， however， is designed to relate the two， and a recent study by Yale University School of Medicine researchers revealed that the mismatch that occurs when consuming artificially sweetened foods and beverages leads to disruptions to metabolism.18，19 In a Yale University press release， senior author and psychiatry professor Dana Small said:20
然而，你的身體被基因設定為將這甜味和能量相連起來，耶魯大學醫學院最近的一項研究顯示，食用含有人造甜味劑的食物和飲料時發生的與攝入的能量不匹配，會導致新陳代謝紊亂。[18，19]在一個耶魯大學的新聞發佈會上，資深作家和精神病學教授達納·斯莫爾說：[20]

"The assumption that more calories trigger greater metabolic and brain response is wrong.Calories are only half of the equation; sweet taste perception is the other half …Our bodies evolved to efficiently use the energy sources available in nature.Our modern food environment is characterized by energy sources our bodies have never seen before."
"更多的卡路里引發更強烈的代謝和大腦反應的假設是錯誤的。卡路里只是方程的一半，甜味的感覺是方程的另一半…我們的身體進化到可以高效地利用自然界的能量。我們現代的飲食結構特點是我們的身體從未遇到過的。"

The study found that an artificially sweetened， lower-calorie drink that tastes sweet can trigger a greater metabolic response than a drink with a higher number of calories.21 Your body uses the drink's sweetness to help determine how it should be metabolized.When sweetness matches up with the calories， your brain's reward circuits are duly satisfied.However， when the sweet taste is not followed by the expected calories， your brain doesn't get the same satisfying message.22
這項研究發現，一種含有人造甜味劑的、低熱量的、嘗起來比較甜的飲料，會比另一種具有更高熱量的飲料引發更大的代謝反應。[21]你的身體透過飲料的甜味來幫助確定它應該如何代謝。當甜味與卡路里相匹配時，你的大腦獎勵神經網路就會得到滿足。然而，當甜味沒有跟隨預期的熱量時，你的大腦得不到同樣的令它滿意的訊號。[22]

This may explain why diet foods and drinks have been linked to increased appetite and cravings， as well as an increased risk of diabetes and other metabolic diseases.23，24 When you eat something sweet， your brain releases dopamine， which activates your brain's reward center.The appetite-regulating hormone leptin is also released， which eventually informs your brain that you are"full" once a certain amount of calories have been ingested.
這也許可以解釋為什麼無糖食物和飲料與食慾的增加以及糖尿病和其它代謝疾病的風險增加有關[23，24]。當你吃甜的東西時，你的大腦會釋放多巴胺，啟動你的大腦的獎勵中心。調節食慾的激素瘦蛋白也被釋放出來，一旦攝入了一定量的卡路里，這些分泌的激素就會告訴你的大腦你已經"吃飽"了。

However， when you consume something that tastes sweet but doesn't contain any calories， your brain's pleasure pathway still gets activated by the sweet taste， but there's nothing to deactivate it， since the calories never arrive.Artificial sweeteners basically trick your body into thinking that it's going to receive sugar(calories)， but when the sugar doesn't come， your body continues to signal that it needs more， which results in carb cravings.
然而，當你吃的東西味道很甜卻不含任何卡路里，你的大腦的快樂神經傳導網路仍然處於被甜味啟動的狀態，但沒有什麼可以讓它失活，因為卡路里一直沒得到供應。人造甜味劑基本上欺騙你的身體認為它會接受糖(卡路里)，但是當糖不來時，你的身體會表示它繼續需要更多的食物，這就導致了對碳水化合物的食慾。

Yale Cardiologist—and Ex-Diet Soda Fiend—Speaks Out Against Them
耶魯心臟病學家—曾經無糖蘇打水的忠實消費者—現在大聲疾呼抵制無糖汽水

Dr.Harlan Krumholz is a cardiologist at Yale University School of Medicine who openly states，"I used to pound down diet drinks."25 Like so many Americans， he believed the low-calorie， sugar-free drinks to be a guilt-free source of caffeine that helped him keep his weight down.Now he feels betrayed， and he's speaking out against them.Krumholz cited a recent systematic review and meta-analysis of randomized controlled trials(RCTs)—the gold standard of research—which found:26
哈倫·克魯姆霍爾茨(Harlan Krumholz)博士是耶魯大學醫學院的一名心臟病專家，他公開聲明："我曾經很喜歡喝無糖飲料。"[25]像許多美國人一樣，他相信低熱量的無糖飲料是零負擔的咖啡因的來源，幫助他降低體重。現在他有一種被背叛了的感覺，他現在正大聲疾呼抵制無糖飲料。克魯姆霍爾茨引用了最近的系統評估和薈萃分析(研究的黃金標準)- 隨機對照試驗(RCTs)，發現：[26]

"Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management， and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI [body mass index]and cardiometabolic risk."
"來自隨機對照試驗的證據並沒有明確支持非營養型甜味劑在體重管理的預期益處，觀察性數據表明，長期攝入非營養型甜味劑可能與體重指數(BMI)和心臟代謝風險增加有關。

He also mentioned other concerning studies， like one that found artificial sweeteners activate different areas in the brain than regular sugar，27 which could ultimately influence feelings of hunger and reward pathways.
他還提到其它的有關研究，如發現人造甜味劑與普通的糖相比會啟動大腦不同的區域，[27]這最終會影響飢餓感和獎勵神經網路的傳導機制。

Another， conducted by his Yale University colleagues， found artificial sweeteners"are not physiologically inert compounds" and may"impact energy balance and metabolic function， including actions on oral and extra-oral sweet taste receptors， and effects on metabolic hormone secretion， cognitive processes(e.g.， reward learning， memory， and taste perception)， and gut microbiota."28 Krumholz wrote in The Wall Street Journal that he's stopped his daily diet drinks and is removing them from the rest of his diet as well.
除此以外，他的耶魯大學的同事們發現人造甜味劑"不是生理惰性化合物"，可能"影響能量平衡和代謝功能，包括對口腔和口腔外甜味受體的作用，對代謝激素分泌的影響，認知過程(例如獎勵學習，記憶和口味感知)以及腸道微生物群。"[28]克魯姆霍爾茨在《華爾街日報》中寫道，他已經不再喝他過去常喝的無糖飲料，並不再吃無糖的食物。

"It is reasonable to ask why these substances were not evaluated as drugs in the first place，" he says."Millions of people are exposed to them every day， and yet their long-term effect is uncertain.Could they be actually causing the health problems they were intended to prevent? I don't know the answer at this point， but it seems to me that the burden of proof is on the manufacturers to show benefit and demonstrate safety through clinical trials …
他說："有足夠的理由去問為什麼這些物質一開始不被評估為藥物，每天有數以百萬計的人會食用這些人造甜味劑的食物，但它們的長期效果是不確定的。它們是否真的會造成它們本來打算要預防的健康問題呢？在這一點上我不知道答案，但在我看來，舉證的責任在於人造甜味劑的製造商要進行臨床試驗來證明人造甜味劑的對人體的益處和安全性…

If， in the end， we discover that large-scale consumption of diet drinks and foods helped fuel the obesity epidemic， it would be more than ironic.It would be tragic."29
如果最後我們發現無糖飲料和飲食的大規模普及反而導致了肥胖的流行的話，那這就不僅僅是諷刺了，這將是悲劇。"[29]

Are You Ready to Ditch "Diet"Foods From Your Diet?
你準備好從你的飲食中去除無糖食物了嗎？

I would not recommend waiting for public health agencies to catch up to the science and change their stance on artificial sweeteners before making changes to your diet.If you"re currently an artificial sweetener fanatic， or even if you consume them in moderation， ditching them from your diet is a smart move for your health.Be aware that they"re found not only in diet sodas but also in many low-calorie and reduced-calorie foods， from yogurt and ice cream to bread and salad dressing.
我不建議你一直等到公共衛生機構跟上最新科學的研究並改變對人造甜味劑的立場之後你才開始改變自己的飲食結構。如果你現在食用含有人造甜味劑的食物很瘋狂的話，或者即使你適量的食用它們，那麼今後從你的飲食結構中拋棄它們，這對你的健康而言是一個很明智的選擇。要知道，人造甜味劑不僅存在於無糖汽水中，而且存在於許多低熱量和人為降低熱量的食物中，比如優酪乳、冰淇淋、麵包和沙拉醬等。

Stevia is an acceptable replacement， but I also suggest curbing your sweet cravings by eating fermented vegetables or drinking water with lemon or lime juice added—the sour taste helps reduce cravings， as does organic black coffee.30，31 To learn more， my book"Sweet Deception" has the details about why artificial sweeteners are so hazardous for your health as well as common artificial sweetener-related side effects to watch out for.
甜葉菊是一種健康的可以接受的糖類替代品，但是我也建議透過食用發酵蔬菜或飲用檸檬水或酸橙汁來降低你對甜味的慾望—酸味和有機黑咖啡有助於減少對甜味的慾望。[30，31]如果你想瞭解更多相關內容的話，在我寫的書《甜蜜的欺騙》中詳細的解釋了為什麼人造甜味劑對人體的健康有害，並列舉了常見的需要警惕的與人造甜味劑相關的副作用。

約瑟夫·麥考拉博士撰寫
原文：http://www.theeventchronicle.com/health/new-study-shows-artificial-sweeteners-lead-diabetes/
翻譯:人才
出處:https://www.golden-ages.org/2017/12/06/20171206-01
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