Long-term low calorie sweeteners’ intake does not affect insulin resistance, a new clinical trial suggests

An interview with Sara Engel and Anne Raben, University of Copenhagen, Denmark, about the findings of their new study

In times when type 2 diabetes is increasing globally, and the role of nutrition is recognised as key in diabetes management, the publication of new studies exploring the effect of different foods and drinks in risk markers of type 2 diabetes is critical. Within this context, the International Sweeteners Association (ISA) is keenly pleased to present in this article an interview with MSc., Ph.D.-student Sara Engel and Prof Ph.D. Anne Raben, Department of Nutrition, Exercise, and Sports, SCIENCE, University of Copenhagen, Denmark, first and last author, respectively, of a recently published study in the European Journal of Clinical Nutrition, entitled ‘Effect of high milk and sugar-sweetened and non-caloric soft drink intake on insulin sensitivity after 6 months in overweight and obese adults: a randomized controlled trial’1.

To find out more about this new trial, which examined the effects of high daily consumption of different beverages (milk, sugar-sweetened beverage, low calorie sweetened beverage and water) for 6 months on insulin sensitivity and risk markers of type 2 diabetes, please read below the interview with Sara Engel and Anne Raben explaining the outcomes of this new study.

ISA: What motivated you to study the effects of different beverage intake on insulin sensitivity?
Sara Engel: Type 2 diabetes is on the rise worldwide and as an MSc and PhD student in Human Nutrition I’m especially occupied with studying the effect of what we eat on development of type 2 diabetes. Additionally, it motivated me that the study makes a comparison between beverages consumed every day by many people which give a high level of practical relevance and applicability to the consumers.

ISA: What would be the 3 key remarks that health professionals could take out of your study?
Sara Engel:

  • 6-months intake of semi-skimmed milk did not differ in effect on insulin sensitivity compared to sugar-sweetened soft drinks, non-caloric-sweetened soft drinks and water.
  • In comparison to non-caloric-sweetened soft drinks consumption of sugar-sweetened soft drinks increased total cholesterol and triacylglycerol concentration significantly after 6 months.
  • The study results suggest that semi-skimmed milk is beneficial compared to sugar-sweetened soft drinks regarding effect on risk markers of CVD.

 

ISA: What do your outcomes mean in relation to the consumption of low calorie sweetened drinks?
Sara Engel: Our results suggest that consumption of low calorie sweetened drinks is beneficial compared to sugar sweetened drinks, which showed adverse effect on risk markers of CVD. Further, the results suggest that the consumption of low calorie sweetened drinks does not affect insulin sensitivity differently than milk, water and sugar-sweetened soft drinks after 6 months’ intake.

ISA: How does this study complement the findings of a previous publication of your team by Maersk et al?
Sara Engel/Anne Raben: Our team showed earlier that 6-months’ consumption of sugar-sweetened soft drinks increased ectopic fat storage compared to the other beverages2, but unexpectedly, this did not also reflect in an adverse effect on insulin sensitivity in this group of overweight and obese adults. Interestingly, there were also no differences in changes in total body weight.

ISA: Taken all available evidence together, what does the science support with regards to low calorie sweeteners’ use?
Anne Raben: Currently, there is no evidence that the use of low-calorie sweeteners has any detrimental effects with regard to appetite or body weight regulation, metabolic health or risk of CVD and T2D. On the contrary, the compiling evidence points toward beneficial effects compared with sucrose and in some cases even with water.

  1. Engel S, Tholstrup T, Bruun JM, Astrup A, Richelsen B, and Raben A. Effect of high milk and sugar-sweetened and non-caloric soft drink intake on insulin sensitivity after 6 months in overweight and obese adults: a randomized controlled trial. Eur J Clin Nutr 2017; doi:10.1038/s41430-017-0006-9
  2. Maersk M, Belza A, Stødkilde-Jørgensen H, Ringgaard S, Chabanova E, Thomsen H et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr 2012; 95: 283–289