Artificial sweeteners have gone a long way in improving the life of diabetic patients - diabetics can now eat sweetened foods without worry.
Artificial sweeteners have also been aggressively marketed as a means to avoid sugar in non-diabetics as well. Manufacturers claim that they reduce the total calorie intake and play a role in maintaining fitness and reducing obesity. However, to achieve this, artificial sweeteners should also be accompanied by reduced calorie intake from other sources as well as exercise and other methods to increase caloric expenditure. Non-caloric sweeteners do not have an ability to suppress appetite and reduce motivation to eat more.
AdvertisementA variety of sweeteners are available in the market. These include:
Non caloric sweeteners like acesulfame-K, aspartame, cyclamate, saccharin and sucralose
Sugar alcohols like hydrogenated starch hydrosylate, lycasin, maltitol and sorbitol. Sugar alcohols provide fewer calories as compared to saccharides, but they cause some digestive tract disturbances.
Saccharides like fructooligosaccharides, fructose, glucose, high fructose corn syrup, honey, isomaltulose, maltose, sucromalt, sucrose, tagatose and trehalose. Fructooligosaccharides give half the amount of calories per gram compared to sucrose, fructose or glucose.
Which sweeteners could possibly help in controlling blood glucose? Do sweeteners play any role in reducing obesity, as they are claimed to be? Which sweeteners provide better health benefits? A review of published clinical trials evaluating the use of sweeteners in healthy people, diabetics and obese or overweight people was recently published.
A total of 53 studies were included in the review. Most of the studies were of a short duration, with only 13 trials lasting for a week or more and the longest trial lasting for 10 weeks. Unfortunately, trials carried out for such short durations are unable to establish the benefits of using non-caloric sweeteners in daily life.
Forty included trials studied the effect of sweeteners on 2-hour blood glucose. Fructose appeared to reduce 2-hour blood sugar as compared to glucose in diabetics. Studies comparing the effect of hypocaloric sweeteners to sucrose or high-fructose corn syrup were unable to reach any conclusions with regards to 2-hour blood glucose concentrations.
Twelve included studies were conducted on diabetic people, five studied overweight or obese people and thirty-five were conducted on healthy individuals.
Two trials indicated that non-caloric sweeteners reduced total energy intake compared to sucrose by approximately 250- 500 kcal/day.
One trial indicated that body mass index is reduced in people taking non-caloric sweeteners compared to sucrose.
It is unclear whether any short-term benefits of non-caloric sweeteners will have any long-term impact on obesity. In addition, artificial sweeteners should be used with caution since some are associated with adverse effects. For example, high corn fructose syrup has been associated with hypertriglyceridemia (though this was not found in any of the studies included in the review). Some sweeteners have been associated with certain cancers in animal studies. Further and longer term studies are required to establish the benefits of artificial sweeteners in conditions like obesity.
1. Natasha Wiebe et al. A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes. BMC Medicine 2011, 9:123