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Sugar Substitutes Can Lead to Weight Loss
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Non-Sugar Sweeteners May Help Control Weight and Blood Sugar -- if You Don't Compensate
By Kathleen Doheny
Reviewed by Laura J. Martin, MD
July 9, 2012 -- Substituting other sweeteners for sugars may help people lose weight and help people with diabetes control blood sugar, according to a new joint statement issued by the American Heart Association and the American Diabetes Association.
"When you use these non-nutritive sweeteners smartly, they will help you cut back on sugar and calories," says Christopher Gardner, PhD, who chaired the writing group for the joint statement.
The key word here is "smartly," says Gardner, associate professor of medicine at Stanford University School of Medicine.
The benefits of the sweeteners only hold if people don't undo them. That happens when they slake their sugar craving with other sugary drinks or foods later in the day -- an all-too-common tendency among people who use artificial sweeteners.
The new scientific statement is published in the journal Circulation.
Sweeteners: Why the Closer Look?
Americans eat too much sugar, the American Heart Association warned in 2009.
The AHA recommends that most women eat no more than 100 calories of added sugars a day and men no more than 150 calories a day. That is about 6 teaspoons for most women, 9 for most men. "Added" sugars means sugar not naturally present in raw vegetables, fruits, and grains. Any sweetened beverage or food adds sugar to the diet.
But the average American's daily intake of added sugars is about 22 teaspoons or about 355 calories, according to 2004 AHA data.
This finding led the AHA to recommend reducing added sugars in the diet. And that raised the question of whether alternative sweeteners might help.
So the association asked a panel of experts to evaluate the role of the non-nutritive sweeteners in controlling weight and diabetes. The catch-all term "non-nutritive sweeteners" includes very low-calorie, no calorie, artificial, and intense sweeteners.
The experts evaluated scientific studies on six of these sweeteners, Gardner says.
"Five of the six are artificial, while stevia is plant-based," he says.
The other five are:
Products with these sweeteners have become much more plentiful. Between 1999 and 2004, according to Gardner, more than 6,000 new products with these sweeteners hit the market.
The experts looked only at whether the alternative sweeteners could help with weight control and blood sugar control. They did not consider whether these products themselves might carry health risks.
"We didn't address safety," Gardner says.
However, the five artificial sweeteners are all regulated by the FDA as food additives. Each had to be approved as safe before being marketed.
Those who market stevia in products do so under a provision of the Food, Drug, and Cosmetic Act. It allows food additives generally recognized as safe (GRAS) to be marketed without specific FDA approval.
After reviewing the evidence, the experts found data insufficient to say for sure that the sweeteners help for weight control and blood sugar control, but they conclude that there is some data that suggests the products appear to help.
The caveat about not overdoing sugary foods later in the day is key, says Kris Voight, RD, a certified diabetes educator and dietitian at Kaiser Permanente Ohio Region, Cleveland.
She reviewed the statement for WebMD.
How common is that?
"I think it depends on the person's motivation [for using the products]," Voight says. "If they are coming in and their diabetes is having an impact on their health, they are on board."
However, some think having a diet soda gives them permission to have a treat later, she says.
To quell sugar cravings, Voight suggests eating a bit more protein to help maintain a feeling of fullness.
Sweeteners: Industry Input
Not surprisingly, the industry group Calorie Control Council likes the AHA and ADA's new stance.
In a statement, Haley Curtis Stevens, PhD, the council president, says: "The Calorie Control Council is pleased that the American Heart Association and the American Diabetes Association have confirmed that substituting non-nutritive sweeteners for sugars may help people reach and maintain a healthy body weight and that for people with diabetes, non-nutritive sweeteners can aid with glucose control."
She, too, cautions that the products are not magic bullets and must be used wisely.
SOURCES: Haley Curtis Stevens, PhD, president, Calorie Control Council, Atlanta. Christopher Gardner, PhD, associate professor of medicine, Stanford University School of Medicine, Stanford, Calif.; chair, writing group for the American Heart Association nutrition committee. Kris Voight, RD, certified diabetes educator, Kaiser Permanente, Ohio Region, Cleveland.