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Low calorie sweeteners: from scientific evidence… to practical use

Author(s): Audrey Aveaux*

Science news from the AFDN conference in France in June, 2018

Highlights:

  • Known for many decades, low calorie sweeteners have a long history of safe use throughout the world. In France, ANSES (the French national food health safety agency) provided a reminder of their safety in a report on the topic in January, 20151.
  • Low calorie sweeteners are non-fermentable and therefore do not cause dental cavities. In 2011, based on a scientific opinion by EFSA (European Food Safety Authority), the European Commission authorised a health claim that confirms that “intense sweeteners maintain tooth mineralisation by decreasing tooth demineralisation if consumed instead of sugars”2.
  • Low calorie sweeteners can be useful in the diet of people with diabetes and, more generally, in helping manage body weight.
  • Thanks to low calorie sweeteners, consumers can find products with reduced sugar content on the market and they can prepare their own recipes with fewer calories.

Introduction

“Low calorie sweeteners’ roles and benefits: scientific news and tasty recipes!”: this is the title of the symposium hosted by the International Sweeteners Association (ISA) in the context of the 56th congress of the AFDN (Association of French dietitians-nutritionists). This symposium was held on 8th June 2018 in Antibes (France).
On this occasion, Audrey Aveaux, a dietitian-nutritionist from Paris, presented the latest research published around the use and roles of low calorie sweeteners. The dietitians and nutritionists who attended this symposium were then able to take part in a tasting session of desserts with reduced sugar content, led by Christian Cottard, pastry chef based in Antibes.

What does the latest scientific information say on low calorie sweeteners’ role in the diet?

Unchanged intestinal function

Two scientific reviews published in 20163,4 addressed this topic, which is very popular at the moment. Both concluded that the consumption of low calorie sweeteners do not seem to impact gut function or to have a negative effect on the gut microbiota in humans. Additionally, these publications support that human studies to date have shown that activation of the gut sweet taste receptor by low calorie sweeteners has no impact on gastric motility, the secretion of gut hormones or on appetitive responses3.

The appetite for sweet taste is not enhanced

A scientific review published in 20155 concluded that there is no cause and effect relationship between the consumption of low calorie sweeteners and the appetite for sweet taste. With regard to beverages in particular, a French study published at the beginning of this year (2018)6 confirmed that diet beverages, compared to water, have no effect neither on food intake nor on the desire for sweets, whether among occasional or regular consumers of low calorie sweeteners.

Confirmed beneficial effect on weight loss

Low calorie sweeteners provide the pleasure of sweet taste, without adding calories. By themselves, they do not lead to weight loss. However, in the context of a low-calorie diet, replacing added sugar with low calorie sweeteners helps to reduce total calorie intake and to achieve greater weight loss. The most thorough review of studies on this topic, published in 20167, concluded that the use of low calorie sweeteners as sugar substitutes leads to a reduction in calorie intake and in body weight. Furthermore, a 2016 randomised controlled trial8 showed that, on some occasions, when used in replacement of their sugar-sweetened versions, diet beverages could even be more effective than water in a weight loss programme and especially during the stabilisation phase. Other studies have shown that, when used ad libitum and with no caloric replacement, beverages with low calorie sweeteners are similar to water in their effects on food and energy intake and on weight loss.6,9.

A little help for people with diabetes who have a sweet tooth

Three systematic reviews including meta-analyses of randomised controlled clinical trials, published in 2016, 2017 and 201810,11,12, concluded that the different low calorie sweeteners do not affect glycaemic parameters such as post-prandial glycaemia, insulin secretion or glycated hemoglobin.
This reaffirms the position of diabetes professionals on this topic. In February 2018, Diabetes UK confirmed that low calorie sweeteners may be recommended for people with diabetes13 in its recommendations for the prevention and management of diabetes.

From evidence to practical use

Low calorie sweeteners are used to replace sugar in foods and beverages, enabling consumers to enjoy sweet-tasting products with less sugar. This is the case of some desserts, sweets, jams, ice creams… With low calorie sweeteners, beverages can also be made available with reduced sugar content, including the diet beverages (which usually contain no added sugars and therefore no calories).
There are also table-top sweeteners available on the market (in powder form, in tablets, liquids or even in cubes). These make it possible to replace the sugar added sometimes to hot drinks and dairy products, and they can even be used in home-made recipes, to replace the sugar. Used in very small amounts in recipes because of their very high sweetening power, low calorie sweeteners can replace the sweet taste from sugar in mousses, creams, whipped cream, custards and all related desserts (puddings, clafoutis, Bavarian creams, charlottes, cupcakes…). They do not replace the volume and texture usually provided by sugar in baked goods though.

 

During the ISA symposium in Antibes, pastry chef Christian Cottard led a tasting session for four different desserts without added sugar: a verrine of vanilla-strawberry mousses, a lemon-raspberry millefeuille, a chocolate-whipped cream choux bun and a fine intense chocolate tart with a creamy coffee dome. These tasty recipes with no after-taste were greatly appreciated by the attendees.

Conclusions

Low calorie sweeteners provide sweet taste with no sugar; they also don’t cause dental caries, provide no calories and have no impact on blood glucose, which make them even more relevant in the context of today’s nutritional recommendations. The latest scientific publications confirm that even if they are not indispensable, they can be very useful in helping manage diabetes and overweight-related issues, without enhancing the appetite for sweet taste. Their consumption as part of a balanced diet and overall healthy lifestyle may make it possible to reconcile pleasure and health on a daily basis.

* By Audrey Aveaux, dietitian-nutritionist

  1. ANSES, Evaluation des bénéfices et des risques nutritionnels des édulcorants intenses, January 2015.
  2. EFSA NDA. Scientific opinion on the substantiation of health claims related to intense sweeteners and contribution to the maintenance or achievement of a normal body weight, reduction of post-prandial glycaemic responses, maintenance of normal blood glucose concentrations, and maintenance of tooth mineralisation by decreasing tooth demineralisation pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA 2011 Journal 9: 2229.
  3. Bryant C et al. Low calorie sweeteners: Evidence remains lacking for effects on human gut function. Physiology and Behaviour 2016; 164(Pt B): 482-5.
  4. Magnuson BA et al. Biological fate of low calorie sweeteners. Nutrition reviews, 2016; 74(11): 670-689.
  5. Bellisle F. Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management. Curr Obes Rep. 2015; 4(1): 106-10. Doi: 10.1007/s13679-014-0133-8.
  6. Fantino M et al. Beverages containing low energy sweeteners do not differ from water in their effects on appetite, energy intake and food choices in healthy, non-obese French adults. Appetite 2018; Mar 8. pii: S0195-6663(18)30066-7. doi: 10.1016/j.appet.2018.03.007. [Epub ahead of print]
  7. Rogers PJ et al. Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes 2016; 40(3): 381-394.
  8. Peters JC et al. The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: a randomized clinical trial. Obesity (2016) 24, 297-304.
  9. Higgins KA, Considine RV, and Mattes RD. Aspartame Consumption for 12 Weeks Does Not Affect Glycemia, Appetite, or Body Weight of Healthy, Lean Adults in a Randomized Controlled Trial. J Nutr 2018;148:650–657
  10. Romo-Romo A et al. Effects of the Non-Nutritive Sweeteners on Glucose Metabolism and Appetite Regulating Hormones: Systematic Review of Observational Prospective Studies and Clinical Trials. PLos ONE 2016; 11(8): e0161264.
  11. Tucker RM et al. Do non-nutritive sweeteners influence acute glucose homeostasis in humans? A systematic review. Physiology & Behavior, 1 December 2017, Volume 182, Pages 17-26.
  12. Nichol AD et al. Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Nutr 2018; 72: 796-804.
  13. 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.