Few commonly used ingredients have been as villainized as artificial sweeteners. The collection of too-good-to-be-true sugar substitutes have been mired by a multitude of studies of the years, from indications that they may be more addictive than cocaine, that daily intake may rise risk of developing Type 2 diabetes or that the compounds may impact the gut biome.
With that, a systematic review finding evidence that artificial sweeteners may not only be safe to consume but also beneficial for those living with obesity and/or diabetes — at least in the short-term — has caught interest.
The meta-analysis, published in JAMA Network Open on Monday, looked at 17 clinical trials that replaced sugar-sweetened beverages (SSBs) with either water or low/no-calorie sweetened beverages (LNCSBs). Overall, the authors noted that substituting SSBs with LNCSBs was associated with a reduction in body weight, body fat content and BMI. When studies replaced water with LNCSBs, the outcome was “neutral,” compared to previous studies that found an association between artificial sweeteners and weight gain.
For senior study author Dr. John Sievenpiper, a consultant physician at St. Michael’s Hospital and associate professor in nutritional sciences at the University of Toronto, these findings are a promising channel to assist patients who want to address issues related to body weight or overconsumption of sugar.
“Universally, everyone is recommending a reduction of sugar … What’s the best way to replace it?” Sievenpiper told CNN. “ … you’ve got a choice, and I think that’s important for a lot of people that they have that.”
Switching out sugary beverages for low/no cal drinks or water was not significantly associated with better glycemic control, blood pressure, or “other aspects of the lipid [fat] profile.”
The study looked at medium- and short-term studies, so difficult to say what the long-term effects of a diet pop habit would be. More research will hopefully be underway soon to understand how artificial sweeteners impact health over a course of years.
Please drink responsibly
This study comes at a critical time, as new research indicates that over-consumption of sugar and the resulting health effects put an extra $5 billion burden on Canada’s health care system in 2019. If Canadians cut back their sugar intake to no more than five per cent of daily caloric intake, the rates of type 2 diabetes could be reduced by 44.8 per cent.
While Health Canada approves certain sugar substitutes as safe to eat, the government body also recommends Canadians limit how much they consume each day.
If a doctor has recommended cutting back on unhealthy or sugary foods, experts warn against using diet soda as a reason to indulge. For example, avoid the “’I’m drinking diet soda, so it’s OK to have cake,’” mentality, writes Holly Strawbridge, former editor of Harvard Health.
Sugar substitutes are also hundreds of times sweeter than naturally occurring sugars in fruits and grains, so it may be tempting to get most of a daily calorie intake from sweetened products. Instead, it’s important to develop a diverse diet, full of lightly to unprocessed products that can deliver a range of benefits.
Only eight of the trials specifically mentioned the types of low/no calorie sweeteners that were being compared: seven specifically looked at aspartame, one studied aspartame and acesulfame potassium blend, one for saccharin, one for rebaudioside A, and one for sucralose.
Participants drank a median of 1000 mL of low/no-calorie beverages per day (studies ranged from 250-2000 mL), 1000 mL of sugary drinks per day (studies ranged from 250-1750 mL) and/or 580 mL of water per day (250- 2000 mL).
Four of the seventeen trials reviewed in the analysis were funded by companies or research organizations connected to the food industry, while five others were partially funded by industry.
UPDATE: A previous version of this post classified all sweeteners as artificial. An update has been made to specify they are “Low/no calorie sweeteners.”
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