A new study has raised concerns over the safety of artificial sweeteners, warning that sorbitol, a common ingredient in many “sugar-free” products, may pose health risks similar to those associated with regular sugar.
The research, published in Science Signaling by Professor Gary Patti of Washington University in St. Louis, shows that sorbitol can be converted into fructose in the liver, triggering metabolic effects linked to obesity, liver disease and other sugar-related conditions.
“Sorbitol is just one biochemical step away from fructose,” Mr Patti said, noting that the process could expose consumers to the same long-term health problems traditionally associated with sugar intake.
Using zebrafish models, the researchers demonstrated how enzymes in the gut produce sorbitol from dietary sources. The compound is then transported to the liver, where it is metabolised into fructose. According to the study, the amount of fructose the liver receives depends on dietary patterns and the composition of an individual’s gut microbiota.
The findings also highlight the role of gut bacteria in determining whether sorbitol becomes harmful. While certain bacteria, including Aeromonas strains, can break down sorbitol into harmless by-products, the absence of such microbes may allow the compound to accumulate and place stress on liver metabolism.
“If the right bacteria are present, sorbitol may not be a problem,” Mr Patti explained. “But without them, it can become metabolically harmful.”
The study notes that even people without diabetes can produce sorbitol naturally in the gut after meals, especially when blood glucose levels are high. Small amounts, such as those found in whole fruits, are typically processed efficiently. However, excessive intake of glucose or sorbitol, common in processed foods, may overwhelm gut bacteria, increasing the risk of liver dysfunction over time.
Mr Patti warned that modern diets, often containing multiple sweeteners, could amplify these risks. He added that sugar substitutes are not automatically safer alternatives, as their metabolic pathways may still lead to liver damage.
The research builds on earlier studies linking fructose metabolism to serious health conditions, including steatotic liver disease, which affects nearly 30 per cent of adults globally, and the potential promotion of cancer cell growth.
“Sugar alcohols, also known as polyols, are widely believed to be harmless,” Mr Patti said. “But our findings show that sorbitol can spread to tissues throughout the body. There is no free lunch when it comes to sugar substitutes.”
The researchers say the findings underscore the need for further studies into how artificial sweeteners interact with gut bacteria, particularly among individuals with existing metabolic conditions, as debates over the safety of sugar alternatives continue.
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