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Artificial Sweeteners and Weight Gain

Dear Dietitian – Will Artificial Sweeteners Cause Me to Gain Weight?

As a dietitian and diabetes educator who counsels people who want to lose weight (and keep it off), I often hear concerns about whether using so-called artificial sweeteners cause the side effect of weight gain. Understandably, there’s been plenty of media hype and headlines touting this notion.

Before delving into the research, let me briefly respond to this concern with an emphatic no! Here’s the bottom line: if you use low-calorie sweeteners, whether it’s SPLENDA® Sweetener Products or others, along with carefully counting your calories, selecting healthier foods, slowly changing your eating habits and exercising regularly, using artificial sweeteners can, especially for people with a sweet tooth, offer you an extra edge to lose weight and keep it off.

But, and this is an important but, artificial sweeteners are not a magic bullet for weight loss. You can’t have a large piece of sugar-sweetened cake along with a cup of coffee sweetened with low-calorie sweetener, or a diet beverage, and think your extra pounds will melt away. Not going to happen!

That said, they can be a helpful tool in reasonable strategies for weight loss. So where does the media hype about low calorie sweeteners and weight gain come from?

Let me walk you through the two main types of studies that focus on the effect of artificial sweeteners on weight control. Then I’ll review the conclusions and hopefully put your mind at ease.

Two Types of Studies

The first type is observational studies. They essentially observe vast amounts of food, nutrition, health and/or medical data from a large number of people that has been followed over many years. These studies don’t provide a treatment or intervention, and there is no comparison group. The data collected in these studies can provide information on whether there has ever been any use of certain foods or ingredients in a diet, while simultaneously providing information on measures of health. From there, one can evaluate whether there are any notable associations, like whether use of diet beverages is associated with excess weight.

Over the years, several observational studies have analyzed data from large populations to see if there’s any relationship between the use of diet sodas and/or artificial sweeteners and weight status.

Results of these observational studies1,2,3,4 have varied from a small increase in weight,1,2 to slight decrease in weight3 or both.4 In some ways, this is not surprising, as based on their study design, observational studies can’t determine cause and effect. They can only show associations. Yet, the media has typically chosen to run headlines on the studies that show an association between use of low calorie sweeteners or diet sodas and excess weight. Unfortunately, they have generally not given attention to the ones that show diet sodas can help with weight loss.

Upon further analysis of these observational studies some experts assert that the connection here is because overweight people may be more likely to use larger amounts of diet beverages to help reduce their risks for overweight and related diseases.7 Experts refer to this as “reverse causality.” This hypothesis is supported by new research.8

The second category of studies is randomized controlled trials. These are considered the gold standard to test out a scientific hypothesis or theory. A randomized controlled trial typically provides a treatment, also called intervention, and has two or more treatment groups and one so-called “control group” that receives no treatment. These studies often include a small number of participants due to their cost and the challenge of engaging people for the study duration.

Several randomized controlled trials have recently been conducted to determine if using diet beverages in a weight loss program would help or hinder weight loss – to put findings from the observational studies to the test. Two studies,9,10,11 one a year-long study with a three month weight loss phase9 and nine months of maintenance 10, and the other a six month study,11 showed that using diet beverages to replace water as part of a weight loss program could help a significantly greater percent of participants achieve a five percent weight loss. This amount of weight loss has been shown to be meaningful in terms of preventing or delaying weight related diseases.

A study on long term weight control from the National Weight Control Registry (NWCR) is also worth noting.12 NWCR is a registry that at this point follows over 10,000 individuals who’ve lost over 30 pounds and kept it off for at least one year. A survey conducted by NWCR among its 400+ members, who had kept weight off for seven or more years, showed that over half of them regularly drank diet beverages. Over three-quarters of them noted diet beverages helped them control the number of calories they ate. About 40 percent said these beverages were very important in their quest for weight loss and were helping them keep the weight off.

It’s fair to conclude from all of this research that thoughtful and regular use of artificial sweeteners, from replacing sugar in hot or cold beverages to using diet drinks and replacing added sugars in cooking and baking, can help people eat fewer calories, consume less added sugars and help satisfy one’s sweet tooth.

Now, I’ve got a question for you. With the knowledge that low-calorie sweeteners can assist your weight loss efforts, how will you use them to accomplish your weight control goal?

I have been compensated for my time by Heartland Food Products Group, the maker of SPLENDA® Sweetener Products. All statements and opinions are my own. I have pledged to Blog with Integrity, asserting that the trust of my readers and the blogging community is vitally important to me.


Hope Warshaw, MMSc, RD, CDE, BC-ADM, is a nationally recognized dietitian and diabetes educator who applies more than 35 years of expertise as an author, freelance writer, media spokesperson, consultant and diabetes educator. Hope notes: “Healthy eating today is one tough job! The good news is that simple tweaks in your food choices and how you prepare foods can often set you on a path to healthier eating. Each positive step is a step in the right direction along the path to a long and healthy life.”

References:

  1. Colditz GA, et al. Am J Clin Nutr. Patterns of weight change and their relation to diet in a cohort of healthy women.1990;51(6):1100-5.
  2. Fowler SP, et al. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16:1894–1900.
  3. Mozaffarian D, Hao T, Rimm EB, et al. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364:2392–2404.
  4. de Koning L, Malik VS, Rimm EB, et al. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr. 2011;93:1321–1327.
  5. Miller, PE, et al. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. AJCN 2014; 100:765-777.
  6. Rogers PJ, et al. Does Low-energy Sweetener Consumption Affect Energy Intake and Body Weight? A Systematic Review, including Meta-analyses of the Evidence from Human and Animal Studies. Int J Obesity. 2015;1–14. (e-pub).
  7. Pereira MA. Diet Beverages and the risk of obesity, diabetes and CVD: A review of the evidence. Nutr Rev. 2013;71(7):433-440.
  8. Drewnowski A, et al. The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults. Nutrition & Diabetes (2016) 6, e202; doi:10.1038/nutd.2016.9
  9. Peters JC, et al. The Effects of Water and Non-nutritive Sweetened Beverages on Weight Loss During a 12-week Weight Loss Treatment Program. Obesity. 2014;22(6):1415-21.
  10. Peters JC, et al. The Effects of Water and Non-nutritive Sweetened Beverages on Weight Loss and Weight Maintenance: A Randomized Clinical Trial. Obesity. 2016;24(2):297-304.
  11. Tate D, et al. Replacing Caloric Beverages with Water or Diet Beverages for Weight Loss in Adults: Main Result of the Choose Healthy Options Consciously Everyday (CHOICE) Randomized Control Trial. Am J Clin Nutr. 2012;95:555-563.
  12. Catenacci VA, et al. Low/No Calorie Sweetened Beverage Consumption in National Weight Control Registry (NWCR). Obesity. 2014;22(10):2244-2251.

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