ISA refutes claims made in Suez et al. study

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Brussels, October 10 2014: the International Sweeteners Association (ISA) finds the hypotheses of the study by Suez et al.1 highly questionable. Contrary to the title of the article, these studies do not confirm any conclusions about the consumption of low calorie sweetened food and beverages and an increased risk of obesity or diabetes.

The extrapolation of the results in the study to the low calorie sweeteners aspartame, sucralose and saccharin, misrepresent the work actually carried out. These 3 sweeteners are chemically very different and their physiological behaviour is also distinct; they cannot therefore scientifically lead to the same metabolic effects. As Professor Gérard Pascal, regular member of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and former President of the European Commission’s Scientific Committee on Food, has pointed out:

The authors’ hypothesis is that most sweeteners are not digested and encounter gut microbiota. But this, for example, is completely false in the case of aspartame. In the intestine, the aspartame molecule splits into two amino acids (aspartic acid and phenylalanine) and methanol. The amino acids are then metabolized in the body and do not alter the gut microbiota.

Furthermore, the researchers administered saccharine to only 7 people. The blood sugar rate rose in 4 cases and diminished slightly in 3 cases. The very low sample size makes this study an exploratory work, which would have to be carried out on a much larger group of participants to support any conclusions.

Moreover, the observations raised in the study are very surprising as they contradict numerous recent peer-reviewed studies2-15 which confirm that the consumption of low calorie sweeteners does not lead to insulin secretion or increased glycemia. The authors of this paper have also failed to take into account the numerous peer-reviewed studies showing that by providing sweetness without the calories, low calorie sweeteners can help with weight management and be enjoyed by people with diabetes.

As stated by Professor Marc Fantino, a physician and researcher in human physiology: “It is an established fact that the leading risk factor for Type 2 Diabetes is an imbalance between calorie intake and caloric expenditure and consequent weight gain. The results of several recent studies show that replacing simple sugars with intense sweeteners in food and beverages can actually reduce calorie intake and lead to weight loss.2-4

There is a broad body of scientific evidence that clearly demonstrates that low calorie sweeteners are not associated with an increased risk of obesity and diabetes as they do not have an effect on appetite, blood glucose levels or weight gain. Low calorie foods and beverages make a useful contribution to a healthy, balanced diet.

  1. Artificial sweeteners induce glucose intolerance by altering the gutmicrobiota, Suez et al., doi:10.1038/nature13793.
  2. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Peters JC et al. (2014), Obesity, 22(6), 1415-21.
  3. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies, Perez PE, Miller V (2014), Am J Clin Nutr,100(30):765-77.
  4. Low/No calorie sweetened beverage consumption in the National Weight Control Registry, Catenacci VA et al. (2014), Obesity, 22(10):2244-51.
  5. Non-nutritive sweeteners: no class effect on the glycaemic or appetite responses to ingested glucose, Bryant CE et al. (2014), Eur J Clin Nutr. 2014. doi:10.1038/ejcn.2014.19.
  6. The role of the low-calorie sweeteners in diabetes, Johnston CA et al. (2013), US Endocrinology, 9(1):13–5.
  7. Nonnutritive sweeteners: current use and health perspectives. A scientific statement from the AHA and the ADA, Gardner C et al. (2012), Diabetes Care, 35(8):1798-808.
  8. Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial, Tate et al., Am J Clin Nutr 95:555-63.
  9. Effects of oral ingestion of sucralose on gut hormone response and appetite in healthy normal-weight subjects, Ford HE et al. (2011), Eur J Clin Nutr, 65(4):508-13.
  10. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels, Anton SD et al. (2011), Appetite, 55(1):37-43.
  11. Effect of the artificial sweetener, sucralose, on small intestinal glucose absorption in healthy human subject, Ma J et al. (2010), Br J Nutr 2010, 104(6):803-6.
  12. Sweet-taste receptors, low-energy sweeteners, glucose absorption and insulin release, Renwick AG and Molinary SV. (2010), British Journal of Nutrition. 2010. doi:10.1017/S0007114519992540.
  13. A review of the effectiveness of aspartame in helping with weight control, de la Hunty A et al. (2006), Nutrition Bulletin 2006:31:115-28.
  14. Functional magnetic resonance imaging of human hypothalamic responses to sweet taste and calories, Smeets PA et al. (2005), Am J CLin Nutr, 82(5):1011-6.
  15. The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight, Blackburn et al. (1997), Am J Clin Nutr, 65:409-18