Association Between Nonnutritive Sweeteners and Appetite

Data show that nonnutritive sweeteners likely do not change appetite or cause diabetes and may actually help with weight loss.

There is no evidence demonstrating that nonnutritive sweeteners cause diabetes or some other metabolic problems, according to 2 presenters. In fact, they noted that evidence shows that nonnutritive sweeteners may help with weight loss.

“This is important to endocrinologists so that they can provide evidence-based answers to their patients’ questions and provide practical advice,” said Claudia Shwide-Slavin, MS, RD, CDE, a clinical diabetes specialist at Tandem Diabetes, New York, New York.

She and her colleague, Alan Barclay, PhD, RD, from Sydney, Australia, discussed this topic at the American Association of Diabetes Educators (AADE) 2016 Annual Meeting. She told diabetes educators that understanding the information on nutrition fact labels is the first step to making healthier choices. The updated labels now offer greater help for patients with diabetes when it comes to added sugars.

“There is some research [showing] that there is a gap between the body of scientific evidence on a topic and what health care providers recommend about nutrition and weight loss to their patients. This talk is important to prevent them from falling into the same trap,” Shwide-Slavin told Endocrinology Advisor.

Nonnutritive sweeteners are defined as zero-calorie or low-calorie alternatives to nutritive sweeteners like table sugar. They are much sweeter than sugar, so only small amounts are required. However, Shwide-Slavin said both the excess dietary intake of foods and beverages with added sugars and the safety of nonnutritive sweeteners are a global public health concern.

The 2015 Dietary Guidelines for Americans examined the evidence on safety as well as the associated risks of obesity, cardiovascular disease, and type 2 diabetes with the use of nonnutritive sweeteners. Many patients with diabetes are not completely sure how best to include nutritive and nonnutritive sweeteners as part of healthy dietary patterns. Therefore, clinicians need to empower their patients with the tools to make smart decisions, Dr Barclay said.

He noted that the World Health Organization (WHO) recommends reducing the intake of free sugars to less than 10% of total energy intake in both adults and children, which many Americans are not achieving. Soda is one of the biggest contributors of sugar in the American diet, while another is sugar added during processing of foods and syrups.

“The evidence shows reducing nutritive sweeteners reduces certain health risks. The evidence does not prove that nonnutritive sweeteners cause diabetes, weight gain, or changes in appetite. The evidence does show nonnutritive sweeteners help weight loss if other calories eaten don’t make up for calories saved,” Dr Barclay told Endocrinology Advisor.       

Many people report that they consume many more calories if they drink a nonnutritive-sweetened beverage with their meal compared with drinking water. Nevertheless, Dr Barclay said a review of observational studies, experimental laboratory studies, randomized controlled trials, and brain imaging studies concluded there is no consistent association between nonnutritive sweeteners and an increased appetite for sugar or sweet products. In addition, intervention studies suggest that the use of nonnutritive sweeteners may reduce intake of foods made with sugar.

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  1. Barclay A, Schwide-Slavin C. D14 – Hot Topics in Nutritive and Nonnutritive Sweeteners. Presented at: AADE 2016; August 12-15, 2016; San Diego, CA.

This article originally appeared on Endocrinology Advisor