Low calorie sweeteners are safe and can bring benefits in weight and glucose control


Posted: 27 September 2018

Science news from FELANPE 2018 Congress


Highlights:

  • The safety of low calorie sweeteners has been thoroughly studied and consistently confirmed by numerous regulatory food safety authorities at a national and international level.
  • The use of low calorie sweeteners in place of sugar and as part of a weight management programme may favour weight loss and maintenance.
  • People with diabetes may use low calorie sweeteners as part of a healthy diet without adverse effects on blood glucose control. In fact, low calorie sweeteners have no impact on glycaemic control, insulin secretion or on insulin sensitivity in humans.

In times when people are seeking for effective dietary strategies to help them reduce their sugar intake, in line with recent nutritional recommendation to limit the consumption of free sugars in the diet, there is an increased interest in the use and health effects of low calorie sweeteners. With the aim to address this heightened interest in low calorie sweeteners among healthcare professionals, the International Sweeteners Association (ISA) organised a scientific symposium in the context of the FELANPE 2018 Congress by inviting well-renowned experts on this field to talk about the safety and role of low calorie sweeteners in weight management and glucose control.

The FELANPE - XVI Latin American Congress of Clinical Nutrition, Nutrition Therapy and Metabolism, which took place in the city of Guadalajara in Mexico, from 22th to 25th of September 2018, is one of the most important scientific events on clinical nutrition in Latin America that brings together a wide community of health professionals from all Iberoamerica and academics from different continents and with different expertise. On this occasion, Dr Hugo Laviada-Molina, Marist University of Merida, Mexico, Dr Susana Socolovsky, President of the Argentine Association of Food Technologists, Argentina, and Dr Pilar Riobó Serván, Universidad Autónoma de Madrid, Spain, presented the latest evidence around low calorie sweeteners in an ISA Symposium entitled: “Low calorie sweeteners: safety, use and benefits in the diet”.

How can consumers be reassured about the safety of low calorie sweeteners?

In a talk about the safety and regulation of low calorie sweeteners, Dr Susana Socolovsky, President of the Argentine Association of Food Technologists, described the thorough, strict and long process of scientific risk assessment that is conducted by the competent food safety bodies before low calorie sweeteners are approved for use in foods and beverages. To decide upon the safety of a food additive, such as a low calorie sweeteners, the authorities thoroughly review and assess data on the chemistry, kinetics and metabolism of the substance, the proposed uses and exposure assessment, as well as extensive toxicological studies. Dr Socolovsky concluded that low calorie sweeteners are amongst the most thoroughly studied ingredients worldwide and, based on strong evidence, regulatory food safety agencies around the world consistently confirm their safety.

At an international level, the Joint Expert Scientific Committee on Food Additives (JECFA) of the United Nations Food & Agriculture Organization (FAO) and the World Health Organization (WHO) is responsible for the evaluation of the safety of all food additives, including low calorie sweeteners. JECFA serves as an independent scientific committee which performs safety assessments and provides advice to the Codex Alimentarius, a body of the FAO-WHO, and to the member countries of these organisations. Countries rely on national or international governing bodies and expert scientific committees, such as JECFA, to evaluate the safety of food additives, including low calorie sweeteners, or have their own regulatory bodies for food safety assessment. For example, many countries in Latin America approve the use of low calorie sweeteners based on JECFA’s safety assessment and the Codex Alimentarius provisions.

Reasons to opt for low calorie sweeteners in place of sugar

Presenting the latest evidence on hot topics around the benefits of low calorie sweeteners, Dr Hugo Laviada-Molina, Marist University of Merida, Mexico, and Dr Pilar Riobó Serván, Universidad Autónoma de Madrid, Spain, concluded that low calorie sweeteners can be a helpful dietary tool in weight management and in glucose control, when used in place of sugar and in the context of a balanced diet and healthy lifestyle. Dr Laviada-Molina presented data from published systematic reviews of observational and clinical studies and stressed out that the results of randomised controlled trials (RCT), the “gold standard” study design to evaluate cause and effect relationships, demonstrate that the use low calorie sweeteners in place of sugar can help in achieving a decreased overall energy intake and thus may facilitate weight loss in dieters or help maintain the lost body weight following a diet. The benefits in terms of weight loss are modest, although significant. Notably, there is no RCT showing that the use of low calorie sweeteners when used in place of sugar can lead to weight gain, contrary to what some observational studies have suggested. Taken together, results from observational studies about low calorie sweeteners and risk of obesity are inconsistent. Importantly, observational studies are difficult to interpret as associations may be due to confounding or reverse causality.

Talking about the role of low calorie sweeteners in glucose control and in diabetes management, Dr Pilar Riobó Serván, Universidad Autónoma de Madrid, Spain, concluded that using low calorie sweeteners in place of sugars can be helpful to persons with diabetes in improving compliance to their diet, as low calorie sweeteners can help them satisfy their cravings for sweet taste without contributing to raised blood glucose levels or increased insulin needs. In line with strong scientific evidence, several health organisations around the world, including the American Diabetes Association, the Diabetes Uk and the Mexican Federation of Diabetes, have issued guidelines for the nutritional management of diabetes, which support the use of low calorie sweeteners instead of sugars and of sugar-sweetened foods or drinks.

Take-home messages

Low calorie sweeteners are safe food ingredients that are used in very small amounts to replace sugars in foods and drinks while maintaining sweet taste with fewer or no calories. While there should be no expectation that low calorie sweeteners, by themselves, would magically cause weight loss or decrease blood glucose levels, they can certainly be a useful dietary strategy to reduce overall calorie and sugars intakes, and thus, help in weight management and in glucose control in people with diabetes.

References

  1. American Diabetes Association. 4. Lifestyle management: Standards of Medical Care in Diabetes – 2018. Diabetes Care 2018;41(Suppl. 1):S38–S50
  2. Dyson PA., et al. Diabetes UK Position Statements. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med. 2018;35:541-547
  3. Nichol AD, Holle MJ, An R. Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Nutr 2018; 72: 796-804
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