July 9th, 2012

AHA and ADA Cautiously Endorse Non-Nutritive Sweeteners

In a newly released scientific statement, the American Heart Association and the American Diabetes Association offer a cautious endorsement of the use of non-nutritive sweeteners in the diet. But the statement notes that the products are not “magic bullets” and that there is no strong evidence demonstrating their beneficial effects.

Sugar in the diet has been linked repeatedly to obesity, type 2 diabetes, and cardiovascular disease, leading to recommendations that sugar intake be limited. However, the evidence to date is “inconclusive” that non-nutritive sweeteners (including aspartame, acesulfame-K, neotame, saccharin, sucralose, and stevia) can reduce caloric intake, lower body weight, or help prevent diabetes or cardiovascular disease.

“Determining the potential benefits from non-nutritive sweeteners is complicated and depends on where foods or drinks containing them fit within the context of everything you eat during the day,” sad Christopher Gardner, one of the authors of the report, in an AHA press release. “For example, if you choose a beverage sweetened with non-nutritive sweeteners instead of a 150-calorie soft drink, but then reward yourself with a 300-calorie slice of cake or cookies later in the day, non-nutritive sweeteners are not going to help you control your weight because you added more calories to your day than you subtracted.”

“However, if you substitute the beverage with non-nutritive sweeteners for a 150-calorie sugar-sweetened soft drink, and don’t compensate with additional calories, that substitution could help you manage your weight because you would be eating fewer calories,” said Gardner.

The following text is taken from the summary and recommendations of the report:

At this time, there are insufficient data to determine conclusively whether the use of NNS [non-nutritive sweeteners] to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors…. There are some data to suggest that NNS 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. Successful reduction in energy intake requires that there is incomplete compensation of energy reduction from the use of NNS containing beverages and/or foods. The impact of incorporating NNS and NNS-containing beverages and foods on overall diet quality should be included in assessing the overall balance of benefits and risks.

Addressing the negative perception of non-nutritive sweeteners that many people have developed,  weight loss expert and blogger Yoni Freedhoff sent the following comment to CardioBrief:

Likely consequent to the natural fallacy many readily assume that the consumption of NNS carries risk, included among them a risk towards increased consumption and weight gain.  It’s refreshing then to see the analysis of actual evidence on the use of NNS in people rather than animal models concludes that if anything there’s a suggestion of benefit to weight management, rather than risk, with the consumption of NNS.  Given the complexity of weight regulation and human behavior, no intervention will work in a vacuum and my clinical experience definitely suggests a synergy between their use and true caloric literacy and may help to explain the lackluster results.  Hopefully future studies will shine more conclusive light on the situation.”

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