Artificial Sweeteners Might Help Keep Pounds Off But…

But an extensive literature search found sketchy, limited, and often contradictory evidence, researchers concluded in Circulation: Journal of the American Heart Association and Diabetes Care.

Lead author Christopher Gardner, PhD, of Stanford University in Palo Alto California, stated that, "Smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat."

That reduction "could help you attain and maintain a healthy body weight, and thereby lower your risk of heart disease and diabetes," Gardner said in a statement.

But any beneficial effects, the researchers noted, could be undone if people "compensate" for the calorie cuts by eating more high-calorie foods – drinking a diet soda, for example, and then having an extra piece of cake later.

A high intake of dietary sugars has been shown to contribute to cardiovascular disease and obesity, which can lead to the development of diabetes. In 2009, the American Heart Association recommended a population-wide cutback in added sugars in foods, urging that women eat no more than 100 calories a day and men no more than 150 calories daily of added sugars.

For this analysis, the researchers looked at studies of the non-nutritive sweeteners aspartame, acesulfame-K, neotame, saccharin, sucralose, and stevia.

Few studies have looked directly at whether non-nutritive sweeteners can replace added sugars in the diet, the researchers found, although there are data about their effects on such things as obesity and cardiovascular disease.

But those data are inconclusive. In several studies, use of the substances was associated with unwanted outcomes, such as obesity, presumably because of reverse causation – those using the sweeteners were doing so because they already were overweight.

According to co-author Diane Reader, RD, of the International Diabetes Center in Minneapolis, MN, "On the other hand, some people might clearly benefit from drinks and foods that replace sugar with non-nutritive sweeteners." "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." But she cautioned that "just because a food product includes a non-nutritive sweetener" does not mean that it is healthy.

Reader added that non-nutritive sweeteners can be an important part of controlling carbohydrate intake in order to manage weight and control diabetes.

The researchers noted that the effect of non-nutritive sweeteners has to be considered in the context of the overall diet.

"Strategies for reducing calories and added sugars also involves 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 said

• A structured diet can replace sources of added sugars and this substitution may result in modest energy intake reductions and weight loss.
• The American Heart Association (AHA) has previously concluded that limiting added sugars is an important strategy for supporting optimal nutrition and healthy weights.

Gardner G, et al "Nonnutritive sweeteners: Current use and health perspectives: A scientific statement from the American Heart Association and the American Diabetes Association" Circulation 2012; DOI: 10.1161/​CIR.0b013e31825c42ee.