Artificial Sweeteners – Better Choice for Weight Loss or Diabetes?

Artificial sweeteners are always a hot topic for debate among nutrition scientists. Widely found in several beverages to aid people targeting weight loss or control blood glucose, artificial sweeteners produce more harm than help as is reported by many literature. On the other hand, many believe that these are safe and can be better choices to avoid white sugar consumption. This article discusses the pros and cons of using artificial sweeteners by evidence-based literature.

Artificial sweeteners are found in diet soda, fruit juices, sports drinks or protein bars. Sometimes, these are also used in bakery, sweets, and condiments. With almost zero calorie content, artificial sweeteners are apparently considered as ‘healthy’. Latest research provides compelling evidence that strengthens the argument against the health benefit claims of popular artificial sweeteners found across the globe. However, there is evidence supporting the claim that these sweeteners may offer some benefits to people with metabolic syndrome such as obesity and diabetes type 2.

More Hunger and Calorie Intake?

Diet soda and cold drinks containing artificial sweeteners are extremely popular among people trying to lose weight. Some believe that artificial sweeteners trigger more hunger than usual as they provide empty calories and zero nutrients that may bring satiety. A small study involving seven female participants with calorie restrictions found that replacing sugar-sweetened beverages for diet drinks leads to a higher intake of calories. Another study reported increased hunger in 20 participants who consumed aspartame containing chewing gums.

On the contrary, one study with 318 participants found that substitution of sweetened beverages with diet beverages as a weight-loss strategy leads to average weight losses of 2% to 2.5%. Another study in 19 healthy men didn’t support the more calorie or increased hunger claim from artificial sweeteners, instead the report said stevia significantly lowered postprandial glucose levels among the participants.

Weight Loss or Weight Gain?

Some observational studies reported a link between consuming artificial and weight gain. A large data involving approximately 5000 participants who were consuming artificially sweetened beverages for a long time reported the risk of obesity to be doubled among 2,000 individuals in the same cohort.

However, some reports suggest otherwise with instances of more weight loss, loss of fat mass and waist circumference. A study analyzing 15 Randomized Control Trials reported otherwise. The authors have concluded that low-calorie sweeteners were not associated with weight gain among participants rather they had a decent weight loss. Another study reported that replacing sugary soft drinks with sugar-free versions could reduce the body mass index by 1.7 points.

Diabetes and Insulin Resistance?

Studies found that drinking diet soda was related to a greater risk of developing diabetes. A review involving almost 66,000 women found that both sugar sweetened beverages and artificially sweetened beverages consumption were associated with increased type 2 diabetes risk.

On the other hand, a controlled study concluded that sucralose, an artificial sweetener, had no effect on blood sugar or insulin level.

Elevated Risk of Stroke?

Multiple studies have reported the link between consumption of artificial sweeteners and stroke. A study with 2888 participants found that those who consumed one artificially sweetened drink per day had up to three times the risk of stroke, compared to people who drank less than one drink per week. However, most of the studies were observational and uncontrolled to determine any definitive conclusion.

That said, as these studies produce mixed opinions regarding the benefits of artificial sweeteners in people trying to lose weight or controlling blood glucose, effects of artificial sweeteners on other parameters like gut health can be looked at.

Gut Health

Some scientists found that use of artificial sweeteners may damage the gut microbiota, which can lead to metabolic syndromes. A study suggested non-caloric artificial sweeteners like saccharin, sucralose and aspartame could induce glucose intolerance by altering the gut microbiota and ultimately cause diabetes type 2. A study on mice found that 6 commonly used artificial sweeteners approved by the Food and Drug Administration were toxic to the digestive tract.

These evidence conclude artificial sweeteners may or may not be beneficial for weight loss or managing diabetes and may be harmful to the gut. However, a safe and calculated quantity of certain sweeteners of natural origin may be taken occasionally without getting any adverse effects. Additionally, the intake must be discussed with an expert like a doctor or a nutritionist.

Which Sweeteners and How Much? There are 4 natural sweeteners that can be considered to replace white sugar occasionally.

Stevia: A very popular natural sweetener with zero calories found to be beneficial in reducing the blood pressure and blood sugar in a randomized control trial.

Erythritol: A low calorie sweetener that is found naturally in certain fruits reported no increase in the level of blood sugar, cholesterol, or triglyceride. In addition, Erythritol found to be effective in lowering oxidative stress damage. However, this natural sweetener might cause gastric issues or diarrhea according to a scientific review.

Xylitol: This is a sugar alcohol reported to reduce the risk of cavities and dental decay. It was found that this didn’t elevate blood sugar or insulin levels, however, like erythritol, it may cause diarrhea or gastric issues if taken in high dosage.

Monk Fruit Sweetener: This sweetener has zero calories and carbohydrates that may help in better blood sugar management. Monk fruit contains an antioxidant compound called mogrosides that found to reduce inflammation.

When it comes to the safe amount, the daily dosage varies from one sweetener to the other and is calculated according to one’s body weight. So, there is no blanket recommendation on the amount of sweeteners and it’s best to customize the intake after discussing with a nutrition expert.

Bottomline

As the evidence produces both benefits and ill effects of popular sweeteners and artificially sweetened drinks, it’s important to adopt a lifestyle to gradually overcome the sugar craving instead of replacing the white sugar with the alternatives. Occasionally the natural sweeteners can be taken after discussing with an expert.

--Subhasree Ray, Doctoral Scholar, Clinical and Public Health Nutritionist, Certified Diabetes Educator. roysubhoshree@gmail.com, Twitter: @DrSubhasree

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