Sugar substitutes aid weight loss without raising heart disease, diabetes risk

ISLAMABAD, MARCH 23 (ONLINE): New research suggests replacing sugar with low or no-calorie sweeteners could aid weight management after rapid weight loss without increasing the risk of diabetes or heart disease.
The 1-year trial found that adults who used sweeteners had greater diet satisfaction, improved mood, and reduced cravings for sweet foods.

Despite the promising results, the findings conflict with other studies about the health effects of sugar substitutes, and more research is needed.A new study suggests swapping sugar-sweetened foods and beverages with low or no-calorie sweeteners could aid weight management following rapid weight loss in adults without increasing the risk of or cardiovascular disease.The research, which is being presented at the annual European Congress on Obesity (ECO) May 14–16, 2024, in Venice, Italy, indicates that weight management continued for at least one year.

The study, aptly named the SWEET project, also found that consuming sweeteners and sweetness enhancers (S&SE) correlated with heightened diet satisfaction, improved mood, reduced cravings, and decreased explicit preference for sweet foods among adults.Clarissa Dakin, co-lead author of the SWEET project and PhD student in the Appetite Control and Energy Balance Research Group at the University of Leeds, United Kingdom, explained the key findings to Medical News Today:

“This study was a large randomized controlled trial comparing how including or avoiding sweeteners and sugar substitutes as part of a low-sugar weight maintenance diet affects people’s mood, food craving, and satisfaction with their diet.”How do sweeteners affect weight loss?The SWEET project involved a one-year trial to see if using sweeteners as part of a healthy, low-sugar diet could promote weight management following rapid weight loss.

The researchers recruited 341 adults with overweight or obesity and 38 children who were overweight from Denmark, Spain, Greece, and The Netherlands.During the first two months of the study, adults followed a low calorie diet with a goal of losing at least 5% of their weight, while children were advised to maintain their weight.For the next 10 months, participants were split into two groups:

Group A: Subjects followed a healthy diet with less than 10% of calories from added sugar and were allowed to consume foods and drinks with sweeteners.Group B: Subjects followed the same healthy diet but without sweeteners.Throughout the study, participants completed questionnaires about their diet, eating habits, physical activity and quality of life.Their weight, body measurements, and markers for diabetes and heart disease were also measured at the start and after 2, 6, and 12 months.

“We found after 6 months of the intervention, that the group who included sweeteners and sugar substitutes had greater diet satisfaction, more positive mood and fewer cravings for sweet foods,” Dakin explained.“Whereas after 12 months, the group who avoided sweeteners and sugar substitutes showed an increased liking for other calorie-containing sweet foods,” Dakin noted.In addition, the group using sweeteners had slightly better weight maintenance after one year than the group without sweeteners.

“We also found that participants who included sweeteners during the study tended to view them more positively for health outcomes by the end. Conversely, those avoiding sweeteners became less positive about artificial sweeteners and somewhat more positive about the safety of sugar.”

— Clarissa Dakin, co-lead study author

Additionally, researchers found no significant differences in markers for diabetes and heart disease between the two groups.

However, more research with a larger number of children would be needed to determine the effects of sweeteners on younger individuals.

Should you use sugar alternatives for weight loss?
Natural and artificial sweeteners, such as aspartame, stevia, and saccharin, are widely used by the food and beverage industry to lower sugar content and are present in various products like soft drinks, desserts, and breakfast foods.

Sweeteners are consumed by millions of people globally on a daily basis, particularly those seeking low calorie alternatives to regular sugar.

Many experts suggest replacing sugar with low or no-calorie sweeteners to promote weight loss and weight management among adults with overweight or obesity.

However, there is ongoing debate about the safety of sweeteners for human health and their effects on appetite, weight management, and obesity.

The present study suggests that incorporating sweeteners into a healthy, low-sugar diet could help with weight management without increasing the risk of diabetes and heart disease, conflicting with other research in this area.

Conversely, a systematic reviewTrusted Source conducted by the World Health Organization (WHO) suggests that replacing sugar with non-sugar sweeteners might not effectively aid long-term weight control and could potentially increase the risk of various health issues, including diabetes and heart disease.

However, the WHO report acknowledged there’s a lack of evidence linking sweeteners to disease outcomes, and more studies are still needed.

Moreover, the WHO recently declared a common artificial sweetener, aspartame, as a potential human carcinogen but maintains that further research on the potential cancer risk in humans is warranted.

Successful weight loss may depend on satisfaction
While further research on the long-term health effects of sweeteners is still needed, Dakin noted the study’s positive findings on sweeteners and sugar substitutes could promote overall diet satisfaction, positive mood, and feelings of control over food cravings.

These qualities, Dakin explained, could help with weight maintenance.

“This knowledge may help patients and the public understand some of the benefits of sweeteners for supporting long-term weight maintenance after weight loss,” Dakin said.

Courtney Pelitera, a registered dietitian at Top Nutrition Coaching, who was not involved in this study, told MNT the new research on using sweeteners for weight management is exciting and applicable to the patient population. She noted the following to MNT:

“This study increases my assurance as a healthcare professional when recommending foods that contain sweeteners as sugar replacements. The standout information is the increase in diet satisfaction with the sweetener group. Those of us working with clients on improving healthy eating habits in the long term know that satisfaction with the diet is imperative. A healthy diet is ineffective if a person can not follow and maintain the practices throughout their life.”