ISLAMABAD, May 18 (Online): The World Health Organization recommends against using sugar substitutes to help with weight loss, or to reduce the risk of diet-related diseases such as heart disease and diabetes.<\/p>\n
In new guidanceTrusted Source released May 15, the global health body said a review of the available evidence suggests that use of non-sugar sweeteners \u201cdoes not confer any long-term benefit in reducing body fat in adults or children.\u201d<\/p>\n
Non-sugar sweetener does not help with long-term weight loss
\nEvidence from randomized controlled trials included in the review showed that while non-sugar sweeteners may help people lose weight over the short term, the changes are not sustained.<\/p>\n
The review also suggests that there may be \u201cpotential undesirable effects\u201d from long-term use of non-sugar sweeteners, \u201csuch as an increased risk of type 2 diabetes, cardiovascular diseases and mortality in adults.\u201d<\/p>\n
Non-sugar sweeteners are widely used as an ingredient in beverages and prepackaged foods. Consumers can also add them to food and drinks.
\nIn 2015 the WHO issued guidanceTrusted Source on sugar intake, recommending that adults and children reduce their daily intake of added sugars to less than 10% of their total energy intake. Since then, interest in non-sugar sweeteners has increased, the new review said.<\/p>\n
\u201cAs a registered dietitian-nutritionist in practice for more than 40 years, I can certainly attest to the fact that those consuming diet sodas and using sugar substitutes do not necessarily successfully lose excess weight and\/or maintain a healthful weight,\u201d Mindy Haar, assistant dean at New York Institute of Technology\u2019s School of Health Professions, told Healthline.<\/p>\n
\u201cThis [guidance] is a great move,\u201d Samantha M. Coogan, a registered dietitian and program director of the Didactic Program in Nutrition & Dietetics at the University of Nevada, Las Vegas, told Healthline.
\n\u201cMore often than not, [non-sugar sweeteners] have more side effects than benefits,\u201d she said. For example, \u201cthey\u2019re often not well-tolerated in the [gastrointestinal] tract and lead to bloating and diarrhea.\u201d<\/p>\n
In addition, many sugar substitutes are hundreds of times sweeterTrusted Source than table sugar. \u201cThis potentially leads to other sweetened foods tasting more bland,\u201d said Coogan, \u201ccausing people to crave sweeter and sweeter foods for the same satisfaction level.\u201d<\/p>\n
Current guidance excludes people with diabetes
\nThe WHO guidance applies to all people except those with preexisting diabetes.<\/p>\n
\u201cThat does not necessarily mean that [non-sugar sweeteners] do not have any undesirable effects for diabetics,\u201d Abigail Basson, PhD, a registered dietitian and instructor in the School of Medicine at Case Western Reserve University in Cleveland, told Healthline.<\/p>\n
\u201cThe reason why the guidance excludes diabetics is simply because none of the studies in the review [specifically] included people with diabetes,\u201d she said. \u201cTherefore an assessment could not be made\u201d about the risks to this group.<\/p>\n
Higher intake of non-sugar sweetener linked to higher BMI
\nThe reviewTrusted Source identified 283 studies, including both randomized controlled trials \u2014 considered the gold standard for studying therapies and treatments \u2014 and observational studies.<\/p>\n
While observational studies can indicate an association with an outcome, they cannot show direct cause and effect.
\nResults from certain randomized trials showed that use of non-sugar sweeteners resulted in lower body weight and body-mass index (BMI), but most of these studies lasted three months or less. Longer-term studies did not show a sustained effect on body weight.<\/p>\n
In addition, in randomized trials that compared people who used non-sugar sweeteners to those who consumed nothing, an inactive placebo or water, there was no effect on body weight or BMI.<\/p>\n
In addition, observational studies found that higher intake of non-sugar sweeteners was linked to higher BMI and an increased risk of obesity.
\nObservational studies also showed an increased risk of type 2 diabetes, cardiovascular disease, and death from cardiovascular disease or any cause. There was also an increased risk of bladder cancer, particularly among people who used saccharin.<\/p>\n
The findings of the observational studies are of \u201cvery low to low certainty,\u201d due to the limitations of this type of study.<\/p>\n
The WHO said the recommendation is \u201cconditional\u201d because the link between non-sugar sweeteners and disease outcomes is less certain. The results of the studies might also be complicated by other factors such as the characteristics of the study participants and patterns of sweetener use.<\/p>\n
Artificial and \u201cnatural\u201d sweeteners included
\nThe WHO recommendation applies to artificial and naturally-occurring non-sugar sweeteners, such as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives.<\/p>\n
Coogan highlighted that the WHO included not just artificial non-sugar sweeteners in their list, but also naturally-occurring ones such as stevia. \u201cNatural does not necessarily mean healthier,\u201d she said.
\nLow-calorie sugars and sugar alcohols, such as erythritol, are sugars themselves or derived from them, so they are not considered non-sugar sweeteners. As a result, the new guidance did not review research related to them.<\/p>\n
However, a recent studyTrusted Source found that erythritol \u2014 used to add bulk to or sweeten stevia, monk fruit and other keto-friendly reduced-sugar products \u2014 was linked to a higher risk of heart attack, stroke and early death.<\/p>\n
In animal experiments, researchers also found that higher erythritol levels were linked to a higher risk of blood clotting.
\nThe authors of this study said the results are concerning because non-sugar sweeteners are often marketed to people with type 2 diabetes, obesity and existing cardiovascular disease \u2014 all of whom are at higher risk of future heart attack and stroke.<\/p>\n
Basson highlighted that additional research is needed to better understand the long-term effects of non-sugar sweeteners, including in people with certain diseases such as inflammatory bowel disease, high cardiovascular risk and type 2 diabetes.<\/p>\n
Reducing intake of sugar substitutes
\nRetrain your taste buds
\nBasson said individual preferences for sweetness are influenced by genetic factors. In addition, \u201cregular consumption of [non-sugar sweeteners] may have heightened your sensitivity to sweetness,\u201d she said.
\nAs a result, it can be challenging to adapt to less-sweet tastes, she added, which can affect the enjoyment of certain foods.<\/p>\n
Luckily, said Coogan, you can retrain your taste buds by weaning yourself off sugar substitutes and replacing them with \u201cnatural sugars found in fruits and vegetables, and with unsweetened beverages.\u201d
\nHowever, \u201cindividuals should realize that changing habits is a process and doesn\u2019t happen overnight,\u201d said Haar.<\/p>\n
Wean yourself off slowly
\nIf you want to cut back on your intake of non-sugar sweeteners, Coogan suggests not going \u201ccold turkey.\u201d Otherwise, you risk falling back into your old pattern.<\/p>\n
\u201cThe key is to slowly wean yourself off,\u201d she said. \u201cIf you can avoid altogether, great. But at the very least, use [non-sugar sweeteners] in moderation.\u201d
\nFor example, this might mean cutting back from three diet sodas a day to two a day, and then to one a day.<\/p>\n
\u201cEventually, you can remove them from your daily routine,\u201d said Coogan. \u201cAnd then maybe reserve a sweetened beverage only for when you go out to eat.\u201d
\nBasson said another option is to use unsweetened alternatives to dilute beverages and foods that contain non-sugar sweeteners, increasing the unsweetened amount over time.<\/p>\n
For example, add water to a sweetened beverage, mix plain yogurt in with a sweetened version, or add lightly-sweetened granola to your favorite sweeter cereal.<\/p>\n
Seek tasty alternatives
\nIf you enjoy sweetened beverages or don\u2019t like the taste of plain water, Coogan recommends \u201cspa water,\u201d which is water infused with your favorite fruits.
\n\u201cDifferent fruits have different sugar content,\u201d she said. \u201cso experiment until you find the combo that works best for you.\u201d
\nAnother option is to replace some of your sweetened beverages or desserts with fruit with a high water content, such as watermelon, pineapple or peaches, she said \u2014 in moderation, of course.<\/p>\n
\u201c[Whole fruits] are also more nutrient-dense,\u201d said Coogan, \u201csince they provide antioxidants, vitamins, and minerals, providing more benefit than a [non-sugar sweetener].\u201d
\nHaar said \u201csubstituting fruit \u2013 especially [in summer], with delicious melons and berries available \u2014 is one strategy [for reducing use of sweeteners].\u201d<\/p>\n
\u201cIn the winter, frozen fruit and canned fruit packed in their own juice are both healthful and satisfying,\u201d she added.
\nIn addition, spices and seasonings can be used to add flavor to baked goods, plain yogurt, milk, cereal and other foods without adding non-sugar sweeteners, she said. Some great options are cinnamon, cardamom, nutmeg, vanilla and allspice.<\/p>\n
\u201cDates, raisins, bananas, mashed berries, applesauce and shredded coconut can also provide sweetness to all types of foods,\u201d said Coogan, \u201cand are great thickeners or toppings.\u201d<\/p>\n
Check food labels
\nSweetened beverages and many processed foods like cookies, cakes, pastries and breakfast cereals tend to be high in added sugars or non-sugar sweeteners. These sweeteners also show up in pre-packaged sauces, dressings and condiments.<\/p>\n
Basson recommends checking the ingredient list on packaged foods and beverages to look for non-sugar sweeteners such as aspartame, sucralose or stevia, as well as added sugars such as high fructose corn syrup and cane sugar.<\/p>\n
\u201cOpt for whole, minimally processed foods whenever possible,\u201d she said. And when possible, cook your meals at home, she said. This gives you greater control over the ingredients.
\nIn addition, it helps to keep in mind your overall diet quality.<\/p>\n
\u201cWhile reducing added sugars and [non-sugar sweeteners] is advisable, equal attention should be given to promoting a diet that prioritizes whole, unprocessed foods such as fruits, vegetables, lean proteins and whole grains,\u201d said Basson.<\/p>\n","protected":false},"excerpt":{"rendered":"
ISLAMABAD, May 18 (Online): The World Health Organization recommends against using sugar substitutes to help with weight loss, or to reduce the risk of diet-related diseases such as heart disease and diabetes. In new guidanceTrusted Source released May 15, the global health body said a […]<\/p>\n
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