Use of no-calorie sweeteners may be a helpful addition to strategies for healthy living, as evidenced by some of the studies below.
This 2016 report by Gibson, et al.1 observed associations in diet quality based on data from 4-day dietary records in 1,590 adults (16 years and older) who participated in the UK National Diet and Nutrition Survey (NDNS) between 2008 and 2011. Beverage consumption at any time over the 4 days was divided into 4 groups: sugar-sweetened beverages (SSB), low-calorie sweetened beverages (LCB), non-consumers of soft drinks (NC) and consumers of both beverages (BB). Similar to the U.S.-based National Health and Nutrition Examination Survey (NHANES), the NDNS is the most authoritative source of dietary habits and nutrient intake of the UK population.
The researchers concluded that non-consumers (NC) of sugar-sweetened beverages and low-calorie beverage (LCB) consumers had a higher diet quality compared to sugar-sweetened beverage (SSB) consumers as well as adults who consumed both SSB and LCB . Diets of higher quality were defined as those that included higher consumption of fruits and vegetables, fish, whole grains, low fat dairy, and lower consumption of fat- and sugar-containing foods.
The results showed LCB consumers had a significantly lower energy intake (1719 kcal/day) compared to SSB consumers (1958 kcal/day) and BB consumers (1986 kcal/day). LCB consumers had the same mean total energy intake (1719 kcal/ day) as non-consumers (1718 kcal/day). Researchers also found that LCB and NC consumers do not consume more sugary foods or calories to compensate for their lower calorie consumption from beverages
1. Gibson SA, Horgan GW, Francis LE, Gibson AA, Stephen AM. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults. Nutrients. 2016; http://www.mdpi.com/2072-6643/8/1/9
Journal of the Academy of Nutrition and Dietetics. Zheng M, Allman-Farinelli M, et al. Substitution of sugar-sweetened beverages with other beverage alternatives: a review of long-term health outcomes. 2015;767-779.
This systematic review, authored by nutrition and obesity experts from several universities in Australia and Denmark, culled studies from six literature databases through November 2013 to identify all prospective cohort studies (PCS) and randomized controlled trials (RCTs) in children and adults four months or longer duration. The main search terms used were: sugar-sweetened beverages (SSBs) and substitution. Cohort studies were included if they documented the effect of replacing SSBs with at least one beverage alternative on a long-term health outcome. RCTs were included if they provided alternative beverages to displace SSBs on long-term health outcome. Six cohort studies and 4 RCTs were determined to have a quality of acceptable to high and therefore included in the analyses. Evidence from both the cohort studies and RCTs showed that substitution of SSBs with various lower calorie beverage alternatives (including, for example water, coffee, tea, and/or beverages with low calorie sweetener), was associated with lower energy intake and weight gain. While studies included in the assessment were considered sparse, the conclusion was the available evidence suggests a beneficial effect of substitution of SSBs with low-calorie beverage alternatives. The study also highlights the importance of using age-appropriate low/no calorie beverage substitutions. For example, use of coffee/tea with children may not achieve the calorie reduction expected. The level of evidence for assessment of health outcomes other than energy intake or effect on body weight, such as type 2 diabetes and cardiometabolic risk factors, was considered insufficient for conclusions to be drawn. Further studies were determines warranted for additional insight into these areas.
Maersk M, Belza A, Stødkilde-Jørgensen H, et al. Am J Clin Nutr. 2012;95(2): 283-289.
This study indicates how low-calorie sweeteners may be useful in managing a healthy diet, contrasting the effects of consumption of sucrose (sugar)-sweetened beverages to that of consumption of diet cola and water. Study abstract: "The consumption of sucrose-sweetened soft drinks (SSSDs) has been associated with obesity, the metabolic syndrome, and cardiovascular disorders in observational and short-term intervention studies. Too few long-term intervention studies in humans have examined the effects of soft drinks. We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition (in liver and muscle tissue). Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk, diet cola, and water. Thus, daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases."
Sigman-Grant M, and Hsieh G. Journal of Food Science. 2005;70(1),S42-S46.
In this study, the overall diet quality of low-calorie, sugar-free food and beverage users was compared to that of nonusers, based on national dietary survey data. The results suggest that the diets of people who regularly use low- and no-calorie sweeteners may be healthier, with fewer overall calories, more vitamins and minerals, and overall better nutritional quality.
Raben A, Møller BK, Flint A, Vasilaris TH, Christina Møller A, Juul Holst J, Astrup A. Food Nutr Res. 2011;55.
The importance of exchanging sucrose for artificial sweeteners on risk factors for developing diabetes and cardiovascular diseases is not yet clear. To investigate the effects of a diet high in sucrose versus a diet high in artificial sweeteners, healthy overweight subjects were randomised to consume drinks and foods sweetened with either sucrose (~2 g/kg body weight) (n = 12) or artificial sweeteners (n = 11) as supplements to their usual diet, and fasting and postprandial metabolic profiles were observed after 10 weeks. Supplements were similar on the two diets and consisted of beverages (~80 weight%) and solid foods (yoghurts, marmalade, ice cream, stewed fruits). The rest of the diet was free of choice and ad libitum. Before (week 0) and after the intervention (week 10) fasting blood samples were drawn and in week 10, postprandial blood was sampled during an 8-hour meal test (breakfast and lunch). After 10 weeks postprandial glucose, insulin, lactate, triglyceride, leptin, glucagon, and GLP-1 were all significantly higher in the sucrose compared with the sweetener group. After adjusting for differences in body weight changes and fasting values (week 10), postprandial glucose, lactate, insulin, GIP, and GLP-1 were significantly higher and after further adjusting for differences in energy and sucrose intake, postprandial lactate, insulin, GIP, and GLP-1 levels were still significantly higher on the sucrose-rich diet. The study concluded that a sucrose-rich diet consumed for 10 weeks resulted in significant elevations of postprandial glycaemia, insulinemia, and lipidemia compared to a diet rich in artificial sweeteners in slightly overweight healthy subjects.
Mandel ID, Grotz VL. J Clin Dent. 2002;13(3):116-118.
Dental caries is commonly mediated by oral bacteria that digest fermentable carbohydrates, such as sucrose, glucose, and fructose. When these oral bacteria digest these carbohydrates, they secrete acidic by-products and decrease plaque pH. These changes help to cause microscopic demineralization of tooth enamel, with the formation of subsurface carious lesions. With further mineral loss, bacteria penetrate the tooth and cause cavities. The potential for sucralose to be used by oral bacteria as an energy source or to cause dental cavities has been thoroughly investigated, in "Dental Considerations in Sucralose Use." The FDA and other regulatory agencies agree that sucralose is non-cariogenic.
Read answers to commonly asked questions about SPLENDA® Sweetener Products, usage, effect of sucralose on blood glucose levels, and comparison with other sweeteners.
Randomized clinical trials, a meta-analysis and scientific statements further confirm the safety and efficacious use of nonnutritive sweeteners as part of a healthy eating plan for weight loss and maintenance.