health

Low- and No-Calorie Sweeteners No Better Than Sugar for Weight Loss

How are alternative no-calorie and low-calorie sweeteners used?

The Food and Drug Administration considers alternative sweeteners to be safe if consumed within acceptable daily intake (ADI) levels. Thus, food makers commonly add them to diet drinks, baked goods, frozen desserts, candy, light yogurt, and chewing gum.

Conversely, Dr. Merbol says, “Based on current evidence, we also cannot definitively rule out negative health effects. Since there is no convincing evidence for health benefits, people need to ask themselves whether they want to consume non-sugar sweeteners, particularly in large amounts. big “.

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The potential health benefits of using sweeteners that contain no sugar

Meerpohl and colleagues from the nonprofit Cochrane Research Group conducted the research to support the guidelines on non-sugar sweeteners developed by the World Health Organization (WHO).

The study authors based their analysis on a review of 56 studies that measured how consumption of non-sugar sweeteners affected a wide range of health outcomes in adults and children. These outcomes included weight, blood sugar control, heart disease and cancer.

Overall, the scientists found that sweeteners did not significantly reduce participants’ weight or appear to affect disease risk, but study results suggested a small improvement in body mass index (BMI) and fasting glucose. Fasting glucose levels are measured after a patient has stopped eating for at least eight hours and is a measure used to diagnose diabetes. The researchers also found that people who tended to eat fewer non-sugar sweeteners gained less weight than those who ate higher amounts of these sweeteners.

In children, the researchers observed a smaller increase in BMI among those who ate the non-sugar sweeteners versus sugar, but there was no difference in body weight. BMI is a measure of body fat based on the ratio of weight to height.

The authors note that most of the studies analyzed had a small number of participants, were of short duration, and had limited methodological and reporting quality. Therefore, confidence in the reported results is limited, the authors wrote.

Related: Why the BMI is flawed and the history behind how the scale came to define obesity

Weigh the pros and cons of low- and low-calorie sweeteners

While this study found no noticeable positive or negative effects from choosing alternative sweeteners instead of sugar, other studies have found that they may be harmful.

For example, a review published in November 2017 in the journal Current Gastroenterology Reports He stated that, “Although artificial sweeteners have been developed as an alternative to sugar to help reduce insulin resistance and obesity, data in both animal models and humans suggest that the effects of artificial sweeteners may contribute to the metabolic syndrome and obesity epidemic.”

Insulin is a hormone that helps cells use glucose (blood sugar) for energy, while insulin resistance refers to the body’s cells not being able to use insulin effectively. Insulin resistance is a hallmark of type 2 diabetes, which causes a build-up of sugar in the blood (called hyperglycemia), which increases the risk of health complications such as kidney damage, nerve damage and blindness.

According to the American Diabetes AssociationArtificial sweeteners may be a good choice for diabetics because they contain fewer calories and carbohydrates. People with diabetes need to count carbohydrates to help keep blood sugar levels stable.

Related: How to Build a Healthy Diet If You’re Managing Type 2 Diabetes

Artificial sweeteners are less likely to raise blood sugar than regular sugar, and some of her patients have switched from sugary drinks to diet drinks, says Betul Hatipoglu, an endocrinologist at the Cleveland Clinic in Ohio who was not involved in the study. They lost up to 30 lbs.

“I tell patients as far as we know, you can use artificial sweeteners; just make sure you don’t overdo it,” Dr. Hatipoglu says. “Like anything, you need moderation.”

Hatipoglu says the best ways to reduce your intake of sugar or a sweetener without sugar is to drink more water. “I tell patients if they want to make the water more flavorful, they can supply it with natural ingredients — I like the combination of strawberry and lemon with basil,” she says.

Osama Hamdi, MD, PhDMD, medical director of the Clinical Obesity Program and Director of the Inpatient Diabetes Program at the Joslin Diabetes Center at Harvard Medical School, adds, “If you asked me which one to use—sugar or no-sugar sweeteners, my answer would be the no-sugar sweeteners. But if You asked me if there was any benefit beyond a little weight loss due to calorie reduction, my answer would be that I see no convincing evidence for any other benefit.”

RELATED: 5 Good Sugar Alternatives for Type 2 Diabetes

How does the body respond to sugar and artificial sweeteners?

Dr. Hamdi, who was not involved in the new study, says that sugar is quickly absorbed and metabolized, which leads to a sudden spike in blood glucose and a strong stimulation of insulin secretion. Insulin promotes fat storage and thus increases body weight.

“All of these effects are weaker or dulled in sweeteners that don’t contain sugar,” he says. As the American Diabetes Association explains, many of these sweeteners pass through the body without being digested, so they don’t provide additional calories.

So why do some patients who choose these sweeteners over sugar continue to gain weight or fail to lose weight? Hamdi says one theory is that sweeteners alter the gut flora (the bacteria in the gut) in a way that may promote weight gain, while another idea is that the brain reacts the same way to sugar and sweeteners in terms of controlling body weight.

Although the study authors did not examine why or how alternative sweeteners affect weight, mirbol speculates that they may increase appetite, causing people to overeat after eating them.

While Hamdi, Hatipoglu and Mirbol all say that rigorous methods of data analysis were applied in the study and the results may be useful, they also agree that more research is needed to better understand how non-sugar sweeteners affect an individual’s health. Merbol says his group is currently working on a review to assess the effects of these sweeteners on people with diabetes.

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