Added sugar (as opposed to naturally occurring sugars such as those found in fruit) is associated with all sorts of health problems including obesity, heart disease, liver disease, some cancers, diabetes and metabolic syndrome. As such, it would seem sensible to use artificial sweetners such as aspartame, sucralose and stevioside instead of sugar.
Artificial sweetners are everywhere, and you are almost certainly consuming them whether you realize it or not. Artificial sweetners are found in diet soft drinks, juice drinks and sport drinks, yogurt, ketchup, bread, salad dressing, chewing gum, instant oatmeal, canned fruit, dried fruit, and so on. In a recent study blood and urine samples taken from people who reported not consuming artificial sweeteners still found traces of the product.
Artificial sweetners are hundreds, or even thousands, times sweeter than sugar and contain no calories. It would seem that replacing sugar with artificial sweetners would be a positive change in terms of weight management and other issues related to sugar consumption. Is that the case?
A meta-analysis of research on artificial sweetners published this summer in the Canadian Medical Association Journal found that “routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk.” In other words, the studies reviewed found use of sweetners was associated with weight gain and other increased health risks over time. That is a bummer. The study was published by researchers from the University of Manitoba who reviewed 37 studies involving 400,000 people for an average of 10 years and focused on seven of the studies which were randomized controlled trials that followed 1,003 people for an average of six months.
Link to study summary: http://www.cmaj.ca/content/189/28/E929
Why doesn’t use of artificial sweetners help us manage our weight? There are several leading theories:
- Animals, including humans, seek “reward” from food beyond just calories and “food reward” is crucial to feeling satisfied after eating. Sugar-sweetened foods trigger brain chemicals and hormones to be released, part of what is known as the “food reward” pathway. While artificial sweeteners provide sweet taste, studies suggest that the lack of calories prevents complete activation of the food reward pathway and thus consumption of artificial sweetners may actually cause increased appetite and cravings for sugary food.
- A related theory is that the strong sweetness of artificial sweeteners may be causing us to become dependent on sweet flavor. This could increase our desire for sweet foods in general.
- Some researchers speculate that the sweeteners interfere with a person’s microbiome, the trillions of bacteria found in our gut which is crucial for digestion. A recent study from Israel found that artificial sweeteners enhance the populations of gut bacteria that are more efficient at pulling energy from our food and turning that energy into fat. In other words, artificial sweeteners may favor the growth of bacteria that make more calories available to us causing weight gain.
- People may believe that because they haven’t consumed calories, they have license to splurge elsewhere.
More research is needed on artificial sweetners and health. Most importantly, there is a paucity of long-term studies. Advice from experts is to try to limit consumption of artificial sweetened foods. It would be a herculean effort to completely remove artificial sweetners from our diets so that is probably not a realistic goal. Overall, it is best to limit consumption of foods with added sweetness, whether from sugar or artificial sweetners.
Reminder – eating foods such as fruit with high naturally occurring sugars does not appear to be a problem. IFOD on fruit consumption: http://www.theifod.com/is-it-possible-to-eat-too-much-fruit/