(CNN) Don’t use sugar substitutes if you’re trying to lose weight, according to new guidelines from the World Health Organization.
The global health body said a systematic review of the available evidence suggests that the use of non-sugar sweeteners, or NSSs, confers no long-term benefit in reducing body fat in adults or children.
Replacing free sugars with non-sugar sweeteners doesn’t help people control their weight in the long term, said Francesco Branca, director of WHO’s department for nutrition and food safety. We have seen a slight reduction in body weight in the short term, but it will not be sustained.
The guidance applies to all people except those with preexisting diabetes, Branca said. Why? Simply because none of the studies in the review included people with diabetes and an assessment could not be made, she said.
The review also indicated that there may be potential side effects from long-term use of sugar substitutes, such as a slightly increased risk of type 2 diabetes and cardiovascular disease.
However, this recommendation is not intended to comment on the safety of consumption, Branca said. What this guideline says is that whether we’re looking for obesity reduction, weight control, or NCD risk, that’s sadly something science hasn’t been able to prove, she said. It will not produce the positive health effects that some people may be looking for.
Non-sugar sweeteners are widely used as an ingredient in prepackaged foods and beverages, and are also sometimes added to foods and beverages directly by consumers. WHO released guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. As a result of that recommendation, interest in sugar alternatives has intensified, the review says.
This new guideline is based on a thorough evaluation of the latest scientific literature and points out that the use of artificial sweeteners is not a good strategy for achieving weight loss by reducing dietary energy intake, said nutrition researcher Ian Johnson. researcher emeritus at Quadram Institute Bioscience, formerly the Institute of Food Research, in Norwich, UK.
However, this shouldn’t be interpreted as an indication that sugar intake has no relevance to weight control, Johnson said in a statement.
Instead, you should reduce your use of sugary drinks and try to use raw or lightly processed fruit as a source of sweetness, Johnson added.
Dr Keith Ayoob, scientific adviser to the Calorie Control Council, an international association representing the low-calorie food and beverage industry, told CNN by email that WHO’s insistence on focusing only on prevention of unhealthy weight gain and non-communicable diseases is at best misleading.
Robert Rankin, chairman of the Calorie Control Council, said low-calorie and no-calorie sweeteners are a vital tool that can help consumers manage body weight and reduce the risk of NCDs.
The guide is intended for governmental health organizations in countries that may want to use scientific analysis to implement policy changes for their citizens, Branca said.
That will likely depend on how sweeteners are consumed in a specific country, he said. For example, in a country where consumption patterns are high, those countries may decide to act one way or another.
A total of 283 studies were included in the review. Both randomized controlled trials, considered the gold standard of research, and observational studies were included. Observational studies can only show an association, not direct cause and effect.
Results from randomized trials found that the use of nonsugar sweeteners had a low impact on body weight reduction and calorie intake compared with sugar and no changes in intermediate markers of diabetes such as glucose and insulin, according to the report.
Observational studies have also found a low impact on body weight and fat tissue, but no change in calorie intake. However, these studies found a small increased risk of type 2 diabetes, high blood pressure, stroke, heart disease and death from heart disease, the report noted. A very low risk has also been found for bladder cancer and an early death from any cause.
WHO said the recommendation was conditional because the identified link between sweeteners and disease outcomes could be confounded by complicated patterns of sweetener use and characteristics of study participants.
In an emailed statement, the International Sweeteners Association, an industry association, said it did a disservice to fail to recognize the public health benefits of low-calorie sweeteners and was disappointed that the findings of the ‘WHO are largely based on low-certainty evidence from observational studies, which are at high risk of reverse causation.
Still, observational studies that follow people over time are important, Branca said. A long-term study is needed to prove that overweight people can reduce their body weight. And we didn’t see that impact from the research that we have.
The recommendation included low- or no-calorie synthetic sweeteners and natural extracts, which may or may not be chemically modified, such as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives, and monkfruit, he says. the report.
Stevia and monkfruit are newer sweeteners, so there’s less research published in the scientific literature, Branca said. However they probably act in the body with a physiological mechanism similar to that of other sweeteners. We cannot say that they are different from the others based on the data we have that they play the same role.
Many people consider stevia products to be more natural, as they are derived from the stevia plant. Some natural and artificial sweeteners add bulk sugars to their products to reduce their sweetness and add bulk to the product for baking.
A recent study by researchers at the US-based Cleveland Clinic found that erythritol used to bulk or sweeten stevia, monkfruit and reduced-sugar keto products was linked to blood clotting, stroke, heart attack and premature death. .
People with existing risk factors for heart disease, such as diabetes, were twice as likely to suffer a heart attack or stroke if they had the highest levels of erythritol in their blood, the study found.
Just as many people have learned to eat and cook without salt, they can learn to reduce their reliance on free sugars and non-nutritive sweeteners, Branca said.
We need to target young children, he said. For example, why do parents typically use sweeteners as a reward for children and after almost every meal? We must advise parents to avoid building that sweet interest in young children which is a very important action to take.
Even if you’re a real sugar addict, the good news is you can tame your sweet tooth, said registered dietitian Lisa Drayer in an article for CNN. It provides the following steps:
Train your taste buds. If you gradually cut back on sugar including artificial sweeteners and include more protein- and fiber-rich foods in your diet, that can help you crave less sugar, Drayer said.
When we consume protein and fiber, it slows down the rise in blood sugar if we consume it with a food containing sugar. It can help keep us satisfied and even help us reduce our sugar intake, he said in a previous interview.
Choose foods with no added sugar and avoid all sugary drinks. For example, choose whole grain cereals or sweetened-free Greek yogurt. Sugary drinks to cross off your grocery list should include sodas, energy drinks, sports drinks, and fruit punch. Choose water instead.
If you like sweet sodas, add a splash of cranberry or orange juice to your seltzer, or try flavored seltzers. You can also flavor your waters with fruit slices for a natural sweetness or try fruit teas, Drayer said.
Drink coffee and tea with no or less sugar. Be careful of the bars, Drayer suggested. All those lattes and flavored coffees can have as much sugar as a can of soda, or more.
Enjoy fruit for dessert. Try cinnamon-baked apples, berries or grilled peaches instead of cookies, cakes, ice cream, pastries and other desserts, Drayer said.
Watch out for hidden sugars. Added sugars are often found in foods you might not consider sweet, such as sauces, breads, relishes and salad dressings, Drayer said.
Prepackaged sauces like ketchup, barbecue sauce and tomato sauce tend to be some of the biggest culprits of hidden added sugar in the diet, Kristi King, senior pediatric dietitian at Texas Childrens Hospital and national spokesperson for the Academy of Nutrition and Dietetics Drayer said in a previous interview.
Check the nutrition facts labels. All foods and beverages must list the amount and type of sugar on the label.
Added sugars may have other names such as agave, brown sugar, corn sweetener, corn syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrate, fruit nectar, glucose, high sugar corn syrup. fructose, honey, invert sugar, lactose, malt syrup, maltose, molasses, maple syrups, raw sugar, sucrose, trehalose and turbinado sugar, Drayer said.
The higher up these added sugars are on the ingredients list, the more added sugar is in the product, she said.
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