‘Striking’ rise in consumption of no- and low-calorie sweeteners stokes debate about their health impact

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A “striking” increase in the consumption of no- and low-calorie sweeteners over 13 years combined with conflicting data on their connection to obesity, diabetes and other health issues escalates the need for more research on their chronic health effects, according to a study published this month in the Journal of the Academy of Nutrition and Dietetics.

Between 2009 and 2012, a “conservative” estimate of the number of children who regularly consume no- and low-calorie sweeteners, such as aspartame sucralose and saccharin, climbed 200% and the number of adults rose 54%, researchers at the National Institute of Diabetes and Digestive and Kidney Disease, Emory University and George Washington University report in the study

This increase translates to a quarter of children in the US and 41.4% of adults consuming sweeteners that the study described as low-calorie sweeteners but which included a list of no-calorie sweetners. Of these consumers, 80% of the children and 56% of the adults say they do so daily, according to the study.

The frequency of consumption, however, increases with body weight in adults, and is higher in obese individuals compared to over- and normal-weight individuals, according to the study. Specifically, it found 19.2% of obese adults consumed low-calorie sweeteners three or more times a day compared to 13.4% of normal weight adults.

Drivers of low-calorie sweetener consumption

“The continued shift toward increasing LCS consumption may be a result of recent obesity-prevention campaigns focusing on reducing intake of added sugars and calories,” according to the study. “Other factors may be the increased availability of LCSs in the food supply, due in part to recent developments in blending several LCSs to enhance palatability of LCS-containing products and in combining LCSs with caloric sugars, and because of the continued reduction in the cost of LCSs.”

An uptick in type 2 diabetes also might have contributed to the increased consumption as these consumers look for safer ways to enjoy sweet foods.

Finally, the researchers suggest that the increase could be due partly to parents unintentionally giving their children more products with low-calorie sweeteners even though “most parents have negative attitudes toward LCS consumption by their children.”

They explain: “This study raised the possibility that parents may preferentially select products with nutrient content claims, such as ‘no sugar added’ or ‘light,’ in an effort to provide healthier options to their children, without realizing that these sugar-modified products often contain LCSs.”

It adds: “The presence of LCSs in foods commonly consumed by children, such as canned fruit, ice cream, flavored oatmeal and snack bars, combined with strong marketing and promotion of products deemed to be healthier alternatives, may be driving LCS food intake in children.”

Do low-calorie sweeteners help or hurt health?

Whether or not low-calorie sweetened options are healthy is at the heart of debate about the increased use of these ingredients.

The researchers carefully walk a tightrope over the debate and do not come down on either side of the issue other than to say there is no scientific consensus on the health impacts of low-calorie sweeteners and the more research is needed.

They note some studies suggest low-calorie sweetened food can help with weight-loss, and other suggest they can lead to weight gain because they trigger a craving for more intensely sweet food or because people who consume low-calorie sweetened products may think they saved enough calories to justify second servings.

Given the ambiguous health impact of low-calorie sweeteners and the rising consumption of them, the researchers conclude that additional research is necessary on how low-calorie sweeteners might impact weight management and chronic health disease.  

ISA argues Low-calorie sweeteners are useful weight management tool

This conclusion, however, rankled some low-calorie sweetener stakeholders, including the International Sweeteners Association which said the authors’ comments “seem to ignore the wide body of research that already exists.”

For example, the association points to studies demonstrating the dental health benefit of low-calorie sweeteners and the “important and significant aid to people with diabetes.”

The ISA goes on to criticize the authors for “seeking to scare people about safe, effective low calorie sweeteners,” noting that “in times when overweight and obesity levels are increasing, the use of low calorie sweetened products, when used in place of their full-calorie sugary versions and as part of a balanced diet and healthy lifestyle, can help in reducing overall daily energy intake and therefore be a useful tool in weight management, based on an overwhelmin

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