Action Points
·
The American Heart
Association (AHA) has previously concluded that limiting added sugars is an
important strategy for supporting optimal nutrition and healthy weights.
·
This new statement
from the AHA and the American Diabetes Association (ADA) indicates that there
are some data to suggest that noncaloric sweeteners may be used in a structured
diet to replace sources of added sugars and that this substitution may result
in modest energy intake reductions and weight loss.
Can artificial sweeteners help people reach
and maintain a healthy body weight?
Maybe,
according to two major medical societies:
A scientific statement issued by the American
Heart Association and the American Diabetes Association concluded that using
non-nutritive sweeteners could cut down on added sugars and therefore lead to
beneficial effects.
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.
"Smart use of non-nutritive sweeteners
could help you reduce added sugars in your diet, therefore lowering the number
of calories you eat," said lead author Christopher Gardner, PhD, of
Stanford University in Palo Alto, Calif.
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.
On the other hand, some people might clearly
benefit from drinks and foods that replace sugar with non-nutritive sweeteners,
according to co-author Diane Reader, RD, of the International Diabetes Center
in Minneapolis, Minn.
"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 said in a
statement.
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 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 said.
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