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
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.”
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.”
- Gardner C. Circulation. 2012;doi:10.1161/CIR.0b013e31825c42ee.
- 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.