AHA/ADA: Appropriate use of artificial sweeteners may have limited health benefits

Although substituting non-nutritive sweeteners for added sugars in foods and beverages has the potential to improve body weight and glucose control, the American Diabetes Association and American Heart Association said in a scientific statement that evidence supporting their long-term benefits in cutting caloric and added sugar intake is limited.

“At this time, there are insufficient data to determine conclusively whether the use of [non-nutritive sweeteners] to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors,” AHA and ADA researchers wrote in the scientific statement.

Christopher Gardner, PhD, one of the statement’s authors and associate professor of medicine at Stanford University in California, and colleagues examined data on six non-nutritive sweeteners: aspartame; acesulfame-K; neotame; saccharin; sucralose; and plant-derived stevia. They determined that “smart use” of non-nutritive sweeteners can help patients reduce added sugars in their diet, thus lowering the number of calories they eat.

“But there are caveats,” Gardner said in a press release. “Determining the potential benefits from non-nutritive sweeteners is complicated and depends on where foods or drinks containing them fit within the context of everything you eat during the day.”

Christopher Gardner

One possible issue is compensatory energy intake. If a person consumes a beverage sweetened with non-nutritive sweetener compared with a 150-calorie soft drink, but rewards this choice with a 300-calorie slice of cake or cookies later in the day, Gardner said the non-nutritive sweeteners are not going to assist in weight loss because more calories were added than removed from the diet.

When focusing more specifically on added sugars, non-nutritive sweeteners can also have benefits beyond decreased caloric intake for people with diabetes, according to Diane Reader, RD, CDE, one of the statement authors on behalf of the ADA.

“For example, soft drinks sweetened with non-nutritive sweeteners do not increase blood glucose levels, and thus can provide a sweet option for those with diabetes,” Reader, who is manager of professional training at the International Diabetes Center in Minneapolis, said in the release.

Still, she cautioned against viewing foods containing these sweeteners as “free” or healthy.

“The use of non-nutritive sweeteners may be used in a carbohydrate-controlled food plan, to potentially reduce carbohydrate intake, which may aid in weight management and diabetes control,” she said.

The statement concludes that current evidence suggests that non-nutritive sweeteners may positively affect metabolic parameters, but compensatory caloric intake can impede these benefits.

“For anyone trying to monitor or reduce their intake of calories or added sugars, the potential impact of choosing ‘diet products’ with non-nutritive sweeteners needs to be considered within the context of the overall diet,” Gardner said. “Strategies for reducing calories and added sugars also involve choosing foods which have no added sugars or non-nutritive sweeteners — such as vegetables, fruits, high-fiber whole grains, and non– or low–fat dairy.”

 

Reference:
  • Gardner C. Circulation. 2012;doi:10.1161/CIR.0b013e31825c42ee.
Disclosures:
  • Judith Wylie-Rosett, EdD, RD, reports receiving a research grant from Kraft and speakers’ bureau/honoraria from Unilever. Rachel K. Johnson, PhD, MPH, RD, reports research grants from Dairy Management Inc.; New England Dairy Promotion Board and Vermont Dairy Production Council, and is a member of the Dairy Management Inc. National Research Scientific Advisory Committee and the Milk Processor Education Program Medical Advisory Board.

Although substituting non-nutritive sweeteners for added sugars in foods and beverages has the potential to improve body weight and glucose control, the American Diabetes Association and American Heart Association said in a scientific statement that evidence supporting their long-term benefits in cutting caloric and added sugar intake is limited.

“At this time, there are insufficient data to determine conclusively whether the use of [non-nutritive sweeteners] to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors,” AHA and ADA researchers wrote in the scientific statement.

Christopher Gardner, PhD, one of the statement’s authors and associate professor of medicine at Stanford University in California, and colleagues examined data on six non-nutritive sweeteners: aspartame; acesulfame-K; neotame; saccharin; sucralose; and plant-derived stevia. They determined that “smart use” of non-nutritive sweeteners can help patients reduce added sugars in their diet, thus lowering the number of calories they eat.

“But there are caveats,” Gardner said in a press release. “Determining the potential benefits from non-nutritive sweeteners is complicated and depends on where foods or drinks containing them fit within the context of everything you eat during the day.”

Christopher Gardner

One possible issue is compensatory energy intake. If a person consumes a beverage sweetened with non-nutritive sweetener compared with a 150-calorie soft drink, but rewards this choice with a 300-calorie slice of cake or cookies later in the day, Gardner said the non-nutritive sweeteners are not going to assist in weight loss because more calories were added than removed from the diet.

When focusing more specifically on added sugars, non-nutritive sweeteners can also have benefits beyond decreased caloric intake for people with diabetes, according to Diane Reader, RD, CDE, one of the statement authors on behalf of the ADA.

“For example, soft drinks sweetened with non-nutritive sweeteners do not increase blood glucose levels, and thus can provide a sweet option for those with diabetes,” Reader, who is manager of professional training at the International Diabetes Center in Minneapolis, said in the release.

Still, she cautioned against viewing foods containing these sweeteners as “free” or healthy.

“The use of non-nutritive sweeteners may be used in a carbohydrate-controlled food plan, to potentially reduce carbohydrate intake, which may aid in weight management and diabetes control,” she said.

The statement concludes that current evidence suggests that non-nutritive sweeteners may positively affect metabolic parameters, but compensatory caloric intake can impede these benefits.

“For anyone trying to monitor or reduce their intake of calories or added sugars, the potential impact of choosing ‘diet products’ with non-nutritive sweeteners needs to be considered within the context of the overall diet,” Gardner said. “Strategies for reducing calories and added sugars also involve choosing foods which have no added sugars or non-nutritive sweeteners — such as vegetables, fruits, high-fiber whole grains, and non– or low–fat dairy.”

 

Reference:
  • Gardner C. Circulation. 2012;doi:10.1161/CIR.0b013e31825c42ee.
Disclosures:
  • Judith Wylie-Rosett, EdD, RD, reports receiving a research grant from Kraft and speakers’ bureau/honoraria from Unilever. Rachel K. Johnson, PhD, MPH, RD, reports research grants from Dairy Management Inc.; New England Dairy Promotion Board and Vermont Dairy Production Council, and is a member of the Dairy Management Inc. National Research Scientific Advisory Committee and the Milk Processor Education Program Medical Advisory Board.