Low Calorie Sweeteners

I started the reading for this newsletter quite a few months ago. I was catapulted in many different directions as I have always had a concern over the consumption of artificial low-calorie sweeteners. There is conflicting evidence for and against the long-term impact of consumption of low calorie sweeteners. What I did find interesting was the number of studies which were challenging the use of low-calorie sweeteners as a way to lose weight. 

Obesity – the scale of the problem

Obesity is a complex issue. In England, one in three children are overweight or obese by the time they leave primary school and this rises to two in three in adulthood. Not only does this impact on the individual and their health and wellbeing, it also impacts our society.

After smoking, obesity is the leading cause of heart disease, some cancers and Type 2 diabetes. It is estimated that the UK cost of obesity to the NHS stands at £6.1 billion a year and the cost to the wider economy is £27 billion annually.

Excess calorie consumption is the root cause of the obesity crisis. Overweight or obese children consume up to 500 extra calories per day, depending on their age and sex, while adults consume between 200 and 300 calories too many. To help tackle this, Public health have challenged the food industry to reduce calories in their most popular products as part of our calorie reduction programme. One such programme is the sugar reduction programme which challenges the food industry – retailers, manufacturers, restaurants, cafés, takeaways, pubs, entertainment chains and delivery services – to reduce sugar in their most popular products commonly consumed by children.

The challenge set is to reduce sugar in these products by 20% by 2020.

These products cover ten categories: breakfast cereals, chocolate confectionary, sweet confectionary, yogurts and fromage frais, ice cream, lollies and sorbets, sweet spreads and sauces, cakes, biscuits, puddings, and morning goods such as croissants and buns.

If this action is successful, 200,000 tonnes of sugar could be removed from the UK market per year by 2020.

One such way that the food and drinks industry is targeting this reduction is replacing sugar with low calorie artificial sweeteners. I have spent a considerable amount of time reading labels in supermarkets and now it is actually quite difficult to find foods or soft drink that are targeted towards young children that does not contain an artificial low-calorie sweetener.

Low Calorie Sweeteners

  • Low-calorie sweeteners are among the most thoroughly researched ingredients worldwide
  • Sweeteners have been approved by all leading health authorities around the world, as well as Cancer Research UK and Diabetes UK
  • Public Health England endorses the use of low-calorie sweeteners in calorie reduction and weight management

What are low-calorie sweeteners (LCS)?

Low- and no-calorie sweeteners are used by food and drinks producers as a substitute for sugar.

There are several types of LCS, from artificial and natural sources. They are used in a range of food and drink products including chewing gum, tomato ketchup, ice cream, soft drinks and cough syrups. Some well-known sweeteners include aspartame, acesulfame K, sucralose, and stevia. Each LCS has its own unique taste profile, characteristics and benefit.

Rising demand for low- and no-calorie products has led to an increase in the use of LCS, but they have been safely used all over the world for decades.

What is the difference between natural and artificial sweeteners?

A natural sweetener is derived from a natural source whereas a synthetic (artificial) sweetener has been developed to sweeten food and drinks in place of sugar. All low- and no-calorie sweeteners, whether natural or synthetic, can only be used after approval has been obtained from the European Food Safety Authority (EFSA) based on the authority’s vigorous assessment. A consumer benefit must also be shown before a sweetener is added to the permitted list of sweeteners.

Are LCS safe?

LCS are among the most thoroughly researched ingredients worldwide. They can only be used after approval has been obtained from the European Food Safety Authority (EFSA) based on the authority’s vigorous assessment. A consumer benefit must also be shown before a sweetener is added to the permitted list of sweeteners.

Do they work as a good substitute for sugar?

“Sugar substitutes like aspartame are designed to promote weight loss and decrease the incidence of metabolic syndrome, but a number of clinical and epidemiologic studies have suggested that these products don’t work very well and may actually make things worse.”1

The very first artificial sweeteners were created way back in the 1870s, some were banned in the 1960s and then strangely re-instated, and now artificial sweeteners such as aspartame and sucralose are everywhere.

In a bid to avoid sugar, many people choose ‘sugar-free’ versions of their favourite foods and drinks, most of which are packed with artificial sweeteners instead.  With zero calories and an intense sweetness (NutraSweet is 7,000 times sweeter than normal white table sugar!) they may seem like the obvious choice whilst the ‘sugar is bad’ message reigns supreme. 

In this latest report, (not the first to link artificial sweeteners to weight gain), a team of researchers at Massachusetts General Hospital have identified a likely mechanism linking artificial sweeteners to weight gain. 

The report was published in Applied Physiology, Nutrition and Metabolism and the researchers have found that mice given drinking water with added aspartame gained more weight and developed other symptoms of metabolic syndrome (glucose intolerance and systemic inflammation) than animals fed a similar diet but without aspartame.  When the researchers looked into this more closely they found that aspartame actually interferes with an enzyme known to prevent metabolic syndrome.

Senior author of the study, Richard Hodin MD commented on the findings,

“We found that aspartame blocks a gut enzyme called intestinal alkaline phosphatase (IAP) that we previously showed can prevent obesity, diabetes and metabolic syndrome, so we think that aspartame might not work because, even as it is substituting for sugar, it blocks the beneficial aspects of IAP.”

“People do not really understand why these artificial sweeteners don’t work.  There has been some evidence that they actually can make you more hungry and may be associated with increased calorie consumption.  Our findings regarding aspartame’s inhibition of IAP may help explain why the use of aspartame is counterproductive.”

Consumption of Low-calorie Sweetened Beverages is Associated with Higher Total Energy and Sugar Intake Among Children, NHANES 2011-2016

Current data taken from a study which used 24‐hour dietary recalls from 7026 children enrolled in the National Health and Nutrition Examination Survey (NHANES) 2011 to 2016 to assess energy and macronutrient intake reports that consumption of Low-calorie Sweetened Beverages is Associated with Higher Total Energy and Sugar Intake Among Children, NHANES 2011-2016, This study reports that children who enjoy sweetened soft drinks consume more total calories and sugar compared with their water- and milk-drinking peers.

In this study, the researchers compared children ages 2-17 who drank unsweetened beverages (milk and water) with those who drank only sugary drinks (soft drinks and 100 percent juices), those who drank beverages that contained low calorie sweeteners (diet soft drinks), and to those who drank both sugary and artificially-sweetened drinks.

The data suggest that instead of using diet soft drinks as substitutes for sugary beverages, children may actually be adding them to their normal sugar intake. The researchers reported high intakes of sugar and sugar substitutes are problematic, because they groom children’s’ palates to expect that foods are supposed to taste incredibly sweet.

One theory in psychology called classical conditioning might explain how sugar substitutes could promote greater consumption of sugar. Classical conditioning is a type of learning in which the body pairs sensory input, such as taste, with a corresponding biological response.

With sugar, the sweet taste activates the body’s metabolic functions so that it can more efficiently process the incoming energy. With artificial sweeteners, the sweet taste occurs but the energy doesn’t arrive. This may lead the body to stop responding to the sweet taste stimulus even when real sugar arrives. This is one-way artificial sweeteners may cause a slower metabolism, which could lead to weight gain or health complications, like Type 2 diabetes.

 Studies like this current one in children provide evidence for the fact that consuming artificial sweeteners doesn’t always produce the decreases in energy intake you would predict.

The food and beverage industry have funded some studies reporting the opposite: Artificially sweetened beverages are related to reduced sugar consumption and, therefore, weight.

With the focus on artificial sweeteners’ effect on weight, the industry pushes this public health crisis onto individuals’ food choices without recognizing it’s already difficult, expensive and time-consuming for consumers to get access to healthy food. For example, industry-funded studies which compare diet soft drinkers to water consumers actually included people who drink regular soft drinks in the “water” group. This misleads consumers into thinking that diet soft drinks are better choice than water. The data just don’t support that kind of conclusion.

This distortion could confuse consumers about their healthiest food options. The influence could become limiting for consumers further constrained by economic boundaries.

We consume way too much sweetener whether actual sugar or a substitute. It’s not a healthy pattern to drink a sweetened beverage every day. No evidence supports that health risks like diabetes or high blood pressure are lessened by artificial sugars. It is definitely possible for a regular or diet soft drinks to be a part of a healthy diet, but as an occasional indulgence not as a regular, daily choice.”

My advice with sugar is don’t try to replace it.  Wean yourself off slowly instead.  If you get used to a diet that is less sweet in general, your taste buds will soon become accustomed and you will find that you enjoy the full array of tastes in food again, not just sweet.  ed soft drink