Can low calorie sweeteners help us reduce sugar intake?

Take-home messages from a British Nutrition Foundation (BNF) webinar

Highlights:

• In the current climate, where obesity is a major public health concern, low calorie sweeteners offer a useful tool for reformulation to achieve sugar and calorie reduction in some products.
• Many health authorities note that substitution of sugars for low calorie sweeteners may be helpful in energy reduction and thus in weight management. The European Food Safety Authority has approved health claims for low calorie sweeteners in relation to dental health and post-prandial glucose control.
• From the evidence currently available, it is suggested that exposure to sweet taste may result in a reduction in preference and intake of sweet taste in the short term, but more research is needed for longer-term effects.

In times when policies to help reduce the obesity epidemic are discussed and implemented around Europe, strategies that can contribute to reducing excess energy, fat or sugar intake in the population are of high interest to scientists, health care professionals, public health experts and the food industry. In this context, an online workshop organised by the British Nutrition Foundation (BNF) on 16th May 2018, entitled “A sweet solution: Can low calorie sweeteners help us to reduce sugar intake?”, provided interesting and new scientific information around this topic.

The role of low calorie sweeteners in energy and sugar reduction as well as in weight management was addressed in this webinar by British experts in this scientific area including Sara Stanner, who introduced the webinar on behalf of the BNF, and Prof Peter Rogers, University of Bristol, Dr Duane Mellor, Coventry University and British Dietetic Association, Prof Katherine Appleton, Bournemouth University and Dr Una Masic, University of Liverpool, UK. The key remarks of each talk are summarised in this article.

Low calorie sweeteners can help reduce energy intake

By reducing the calorie content of food and drink products, low calorie sweeteners can be expected to decrease overall calorie intake and thereby decrease body weight. Effects on weight loss depend of course on the extent of calorie reduction in products and can be influenced by the dynamics of weight control. Presenting data from a recent systematic review work, Prof Peter Rogers concluded that evidence to date from controlled human studies clearly indicates that the consumption of low calorie sweeteners in place of sugar can help reduce overall calorie intake, as the “saved” calories from swapping caloric for low calorie sweeteners are not fully compensated. Thus, low calorie sweeteners may also be helpful in weight loss when consumed as part of a weight management programme and a calorie-controlled diet.

Helpful tools towards an overall healthier diet

Presenting the dietetic and more practical approach, Dr Duane Mellor discussed the role of low calorie sweeteners in the context of an overall healthy diet. When it comes to nutrition, looking at the diet quality as a whole rather than focusing on individual ingredients or single swaps is the right approach. So, as part of an overall healthy diet, low calorie sweeteners can provide a means to help reduce energy and especially sugar intake and can be a useful tool to people with weight management problems and to persons living with diabetes. Dr Mellor also highlighted the importance of enjoying the food we eat while aiming for a healthier diet at the same time, and that reducing sugar intake may sometimes go against the first; low calorie sweeteners can help replace some of the sugar while still keeping the enjoyment of sweet taste in the diet, but as with every single food ingredient, they should be consumed alongside an overall healthy diet.

How can repeated exposure to sweet taste affect sweet food intake?

The impact of sweet taste consumption on subsequent generalised sweet taste preference and intake of other sweet-tasting food was addressed by Prof Katherine Appleton, who presented the latest evidence in this area based on a recently published systematic review of the literature. Prof Appleton noted that, while more studies are required around this topic, current evidence from controlled studies suggests that a higher sweet taste exposure tends to lead to reduced preference for sweetness in the shorter term. So, exposure to sweet taste from food with low levels of sugars, for example those sweetened with low calorie sweeteners, may not only replace consumption of sugars, but could also reduce the desire for sweet taste from other sources. While there is a need for more research to confirm this beneficial effect in the longer term, current evidence clearly doesn’t support the notion that exposure to sweetness can lead to habituation to or increased preference for sweet taste or that by reducing exposure to sweet taste we could change our future preference for, or reduce intake of, sweet food.

A topic of high scientific interest

New longer-term research projects exploring the impact of low calorie sweeteners on weight management and on the long term psychological and physiological parameters are on the way and will yield some exciting new results. Dr Una Masic presented the protocol of the ongoing SWITCH study (EffectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss), a 2-year randomised controlled trial that examines the effect of low calorie sweetened beverages on weight loss and long-term weight maintenance compared to water.

Take-home messages

The current evidence supports that low calorie sweeteners can be useful in reducing our daily intake of energy and sugar and may help us satisfy our innate preference for sweet taste. They may also serve as a “stepping stone” towards a healthier diet, which would still offer the enjoyment of sweet taste with less sugar. But of course, in order to contribute to weight loss, they have to be consumed alongside a behavioural weight management programme and in the context of an overall healthy diet. When it comes to our diet, it is our whole dietary choices that can make a difference towards a higher diet quality.