Why you should avoid sweeteners if you want to stay healthy

Obesity is a current global pandemic, estimated to effect 700 million people or over 37% of men and women worldwide and to be the cause of almost 3.4 million deaths in 2010 alone. Obesity has many detrimental health implications, such as Type 2 diabetes and cardiovascular disease, and we are now seeing the development of these issues in a much younger generation than ever before.  The exact causes of obesity are controversial, and the approaches to combat the issue are diverse, with many different studies providing inconclusive and varied evidence.  One approach taken by the food industry is to replace sugar, a high energy sweetener comprising mainly sucrose, with alternative zero or low calorie sweeteners in food and beverages, in order to reduce overall calorie intake in individuals.  There is evidence to suggest, however, that this tactic may be counterintuitive, and could actually be amplifying the problem.

There are a variety of low-energy sweeteners consumed globally with the intention of sweetening foods and beverages whilst contributing only a few or no calories.   Like any ingredient that is added to food, sweeteners must be safe for consumption and so the particular sweeteners that may be utilised are regulated.   Sweeteners that are approved for use in the European Union are listed under Directive 94/35/EC and given their own E-number: acesulfame K (E950), aspartame (E951), saccharin (E954) and sucralose (E955). Six high-intensity sweeteners are FDA-approved as food additives in the United States, specifically saccharin, aspartame, acesulfame potassium (Ace-K), sucralose,  neotame, and advantame. Information is available from their website (U.S. Food and Drug Administration, 2014).

When considering the relationship between sweeteners and obesity, an acknowledgment has to be given to the fact that the growth in use of sweeteners by the food industry has curiously coincided with a dramatic increase in worldwide obesity and diabetes epidemics. This poses the question of whether or not there may be an underlying link between the consumption of sweeteners and the effect on the metabolic system, which may result in weight gain and ultimately obesity.

A recent scholarly review explored the interaction between sweeteners and enteroendocrine cells (special cells of the gastrointestinal tract and pancreas) and the consequences for glucose (sugar) absorption and insulin release. The authors found that sweeteners can impact on the body’s natural metabolic responses.  As a result, the ingestion of food and beverages containing sweeteners may act via intestinal mechanisms to increase obesity due to a loss between taste receptor activation, nutrient assimilation and appetite. 

In a further review, the association between sugar, sweetened beverages and Type 2 diabetes was examined.  In this study, they found that higher consumption of sweetened beverages, by just one serving per day, was positively associated with a 25% greater incidence of Type 2 diabetes.  Also, 90% of adults with Type 2 diabetes are either overweight or obese and so a positive association between the two can be concluded.

Additional research provides evidence to suggest sweeteners interfere with learned responses that typically contribute to glucose and energy stability, which could then bring on metabolic problems.  Ultimately what this suggests is that individuals who frequently consume sugar substitutes in the form of sweeteners may be at risk of excessive weight gain, metabolic syndrome, Type 2 diabetes and cardiovascular disease.

Another study examined the impact of sweeteners on glucose metabolism (how the body breaks down and absorbs sugars) and gut microbiota (the health of the gut).  They note that most sweeteners are not ingested in the gastrointestinal tract and that they will lead to a predisposition to metabolic syndrome.  The investigation observed the consequences of consumption of saccharin, sucralose and aspartame on the microbiota of mice, and delivered conclusive proof that sweeteners facilitated the development of glucose intolerance through adverse metabolic effects. 

There is also the argument that sweeteners don’t satisfy and so they result in immediate or delayed energy compensation.  Sweeteners, as a substitute for sugar, may support energy intake reduction, thus promoting glycemic control and weight management in theory, but the viability of the evidence surrounding this may well be questionable as any potential benefits may be reduced, or even negated by compensatory eating habits.  Observational data suggests that sweeteners may promote weight gain through poorly understood mechanisms of cravings, reward phenomenon, and addictive behaviour.  Diet soda may also enhance appetite and consumers of diet soda may use the reduced energy intake as a rationale for consuming other higher-calorie foods, inevitably leading to weight gain.

We have been lead to believe that fat is the cause of a lot of problems when it comes to obesity and so the understanding of the impact of sugar has been swept aside.  Wholesome foods can contain lots of heart healthy fats, and have an unjust bad reputation because of this – such as nuts, seeds and avocados, but really we might be missing the point.  Sugar can, and does, play a huge role in the obesity epidemic.  Replacing sugar with sweeteners is an artificial approach and not in a healthy approach to tackle the issue.  A balanced diet that has minimal use of either sweeteners of sugar would seem to be the most beneficial in the long term in combatting the obesity epidemic.