Effect of nutritive and non-nutritive sweeteners on hemodynamic responses to acute stress: a randomized crossover trial in healthy women

Background: The mechanisms by which chronic stress increases the risk of non-communicable diseases remain poorly understood. Chronic stress may increase systemic vascular resistance (SVR) and blood pressure, causing vascular injury and altered myocardial perfusion, and may also promote overconsumption of sugar-containing foods and obesity. Sweet foods are often consumed to alleviate stress responses, yet the effects of nutritive and non-nutritive sweeteners (NNS) on hemodynamic stress responses are largely unknown. Objective/design: This randomized crossover study compared the effects of sucrose-containing and NNS-containing drinks versus unsweetened water on hemodynamic responses to acute stress in twelve healthy women. Acute stress was elicited by a 30-min mental stress (alternating Stroop and mental arithmetic) and a 3-min cold pressor test (CPT), each preceded by a baseline period. Mean arterial pressure was measured repeatedly and cardiac output was continuously monitored via thoracic electrical bioimpedance; SVR was the primary outcome. Results: Across all drink conditions, SVR did not change with mental stress (P = 0.437) but increased with CPT (P = 0.045). Both mental stress and CPT increased mean arterial pressure and heart rate (all P < 0.001). Cardiac output increased with mental stress (P < 0.001) and remained unchanged with CPT (P = 0.252). No significant differences in hemodynamic responses were observed between water, sucrose, and NNS (stress × condition, all P > 0.05). Conclusions: Sucrose and NNS do not alter hemodynamic responses to two standardized acute stress protocols.