Sleuthing for Cause and Cure of IBD

Could an artificial sweetener be the link that will solve the mystery?

As in the classic game of Clue®, one researcher has used the investigative tool of deduction to come up with what might be one of the most important risk factors for inflammatory bowel disease (Crohn’s disease and ulcerative colitis).

The culprit – gut mucosa disruption caused by dietary chemicals;

The room – developed countries like Canada where people have a taste for sweets; and

The smoking gun– sucralose.

Key to Dr. Xiaofa Qin’s hypothesis, recently reported in The Canadian Journal of Gastroenterology,1 is the related mystery of why Canada has the highest reported incidence of inflammatory bowel disease (IBD) in the world. IBD is far more prevalent in developed countries, but since the early 1990s, Canada has seen a dramatic increase in the prevalence of Crohn’s disease and ulcerative colitis, greater even than other developed countries, such as the United States and England. What is so different about Canada? The answer, Qin suggests, is the long-term, widespread use of sucralose in this country.

Sucralose is an artificial sweetener (it’s 600 times sweeter than sugar) that has become a common ingredient during the past two decades in thousands of food products, including tabletop sweeteners (e.g., Splenda®), desserts, candies, breakfast cereals, salad dressings, alcoholic beverages, and countless others. There is also increasing evidence that regular consumption of sucralose has significant adverse effects on the gut, such as suppressing beneficial bacteria and altering microbial composition.2 Qin believes that this sustained disruption of the gut mucosa caused by dietary chemicals can result in IBD.3

Nearly ten years ago, Qin argued that saccharin, an earlier artificial sweetener that has a similar effect on the gut as sucralose, might be one of the most important risk factors for IBD.3 Qin tracked the use of saccharin over different time durations and locations. In the United States, for example, the consumption of saccharin skyrocketed from the 1950s to the peak of its popularity in the 1960s and early 1970s. Similarly, the incidence of IBD increased dramatically during that period. When saccharin consumption declined in the 1980s, with the introduction of new US Food and Drug Administration (FDA) rules restricting its use (due to its cancer-causing properties), the incidence of IBD also decreased.

In 1995, even with restrictions on its use in foods, Americans consumed 4,500 tonnes of saccharin, those in Western Europe consumed 4,100 tonnes, and the population of Japan consumed a mere 140-150 tonnes of the sweetener. Supporting Qin’s hypothesis, the incidence of IBD in those three regions is proportional to their consumption of saccharin. Many studies have pointed to sugar as a consistent dietary risk factor for IBD, but Qin suggested that it might not be sugar itself but the demand for more sweet things in the diet and, specifically, an increased consumption of saccharin that is the real risk factor for IBD.

What that earlier paper could not explain, however, was the significantly greater incidence of IBD in Canada than anywhere else in the world, especially since Canada has had more stringent saccharin-restricting rules during the past three decades than most other countries. If saccharin is the major risk factor that Qin proposed, shouldn’t Canada’s incidence of IBD be lower than in other developed countries?

In this latest hypothesis, Qin now follows the trail to sucralose for clues. Sucralose, which has been widely used in Canada longer than in any other country, is twice as sweet as saccharin. Extrapolating from recent research, Qin contends that sucralose is likely even more destructive than saccharin to the gut. Canada was the very first country to approve the use of sucralose in the early 1990s – shortly before the incidence of Crohn’s disease and ulcerative colitis in this country began to grow at an unprecedented rate.

A coincidence?

Stacked against all of the other evidence, Qin certainly doesn’t think so. Sucralose is beginning to look very guilty indeed. Qin urges the scientific community to conduct specific investigations to determine if there is a definite link between sucralose and inflammatory bowel disease, “before it is too late.” Until further evidence accumulates, take a minute to think about what you’re using to sweeten your food and beverages.

First published in the Inside Tract® newsletter issue 180 – 2011
1. Qin X. What made Canada become a country with the highest incidence of inflammatory bowel disease: Could sucralose be the culprit? The Canadian Journal of Gastroenterology. 2011;25(9):511.
2. Mohamed B et al. Splenda Alters Gut Microflora and Increases Intestinal P-Glycoprotein and Cytochrome P-450 in Male Rats. Journal of Toxicology and Environmental Health, Part A. 2008;71(21):1415-29.
3. Qin X. Impaired inactivation of digestive proteases by deconjugated bilirubin: The possible mechanism for inflammatory bowel disease. Medical Hypotheses. 2002;59(2):159-63.
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