Sugar substitutes, as a large category of sweet, but low-calorie (or even zero-calorie) sweeteners, meet the ambivalence of human beings who want to eat and are afraid of fat, and have become the hottest health food labels in recent years.
But the latest announcement from the World Health Organization (WHO) has poured some cold water on sugar substitutes.
On May 14, the WHO published the latest version of its Guidelines for Non-Sugar Sweeteners (NSS) and advises to stop using non-sugar sweeteners (NSS) to control weight loss.
Source: Screenshot of the World Health Organization public account
First of all, it should be emphasized that the WHO bulletin does not talk about all sugar substitutes, but the "non-sugar sweeteners" among them.
Sugar substitutes refer to a large class of food additives that have sweet taste but no calories or are relatively low in calories, and there are two common categories:
Non-sugar sweeteners: no nutrients, including natural and synthetic, common such as aspartame, acesulfame potassium, etc.;
Sugar alcohols: can provide part of the energy, common such as erythritol, xylitol, etc.;
To help you understand simply, let's draw a picture:
The WHO guidelines remind that "no more non-sugar sweeteners (NSS) are used to control weight loss" and do not include sugar alcohols.
Common non-sugar sweeteners mainly include: acesulfame potassium, aspartame, edwardame, cyclamate, neotame, saccharin, sucralose, stevia and stevia derivatives.
For weight loss
Sugar substitutes are not as perfect as they might seem
Recall what sugar substitutes are in all the information you've heard: sweet taste experiences, no calories, and little effect on blood sugar fluctuations.
Now, at least in the matter of weight loss, the era of "sugar substitute perfection" should come to an end.
First, want to lose weight through this type of sugar substitute? In the long run, it won't work.
In theory, if we replace the sugar we usually eat with sugar substitutes without calories (or very low calories), it means that the overall calories in the diet decrease, which means that we can create an energy difference and make us lose weight.
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With the advent of sugar substitute foods, there are more and more research related to sugar substitutes and weight loss.
WHO has analysed a large number of studies and found that: sugar substitutes may contribute to short-term weight loss; But in the long run, it will not continue to lose weight.
Evidence from some prospective observational studies, as well as up to 10 years of follow-up, suggests that more intake of sugar substitutes (non-sugar sweeteners) is associated with a higher BMI and an increased risk of obesity.
Second, drinking this type of sugar substitute may still be fat.
Scientists at Purdue University did a classic clinical trial, published in the American Journal of Clinical Nutrition.
The researchers found 154 volunteers, randomly assigned them to 5 groups, and asked to drink 1.25~1.75 liters of special sweet drinks (equivalent to a large cup of milk tea + 1 bottle of Coke) every day for the next 12 weeks, and other diets were not restricted.
In order to make the volunteers unable to taste what they drank, the drinks used in the experiment were the same from color to taste, and the only difference between the five groups was the different sweet components in the drink, namely: sucrose, saccharin, aspartame, steviol glycosides, sucralose.
After 12 weeks, all four groups except sucralose, whether real sugar, saccharin, aspartame, and steviolin, were fatter.
Sugar substitutes may have fooled the tongue
But did not deceive the brain
In recent years, some reports have found that non-sugar sweeteners may affect the regulation of energy metabolism, satiety, and hunger in the human body through a variety of mechanisms.
It can fool your taste buds and make you feel sweet, but it doesn't fool your brain, and it may even make your brain more savvy.
Some of this type of sugar substitute will make it harder for you to feel full and thus potentially eat more.
Researchers believe that the brain can find that the sweetness is false through feedback from various receptors throughout the body, so it gradually learns to fool the sweet signal in the mouth.
Even after eating real sugar, the brain is no longer so active in physiological preparation for digestion, and the response to "eat enough" is weaker and slower. So sweet things may become harder and harder to satisfy your appetite.
Some may also activate the brain's reward center like real sugar, although it will be much weaker than real sugar, but it may still make you want to eat more sugar.
Others can reach the colon, affect the intestinal flora, and then affect the body's metabolism.
Although these phenomena are still some preliminary findings, they can help explain the observation in previous clinical trial studies to some extent.
Sugar substitutes first appeared to help everyone quit sugar that harms health, but more and more studies tell us that in the matter of weight loss, it may not only have a relatively small effect, but may even cause new problems.
Can you still eat sugar substitute food?
At one time, the scientific community also thought that sugar substitutes would be a healthy and perfect alternative to sugar.
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Carefully recall, are there more and more sugar-free products around you, and is the probability of you choosing "sugar-free" foods getting higher and higher?
Even because of the emergence of sugar substitutes, some people who originally wanted to eat less sugar and quit sugar began to re-cultivate their sweet preferences, including children who are in the sweet growth period.
This is probably the real reason why WHO has to jump out of the "reminder". Sugar substitutes are not a perfect substitute for eating presumptuously.
If you want to say whether you can eat it, of course.
The harm of added sugar to the body is clear, if you must choose, based on the available scientific evidence, this order is still the same: do not eat sugar>>>> sugar substitutes > real sugar.
The safety of sugar substitutes is recognized, and we cannot deny the value of sugar substitutes, which are currently considered to be an effective intervention in short-term weight loss, and it is still a means of stabilizing blood sugar for patients with diabetes.
WHO has only raised the issue of non-sugar sweeteners at the moment, and we have nutritional sweeteners to choose from. And "recommended not to eat" does not mean "no eating".
This announcement is not a warning, more like a reminder: those who want to lose weight, control weight or prevent diseases (such as cardiovascular disease) through sweeteners, advise you to think about eating again, don't be too presumptuous!
In front of this "can eat", for now, we want to add some qualifiers:
If you can, eat less and eat less;
If you can, don't start the habit of sweetening for your child, including sugar substitutes;
If you can, start trying to quit sweetness slowly, no alternative is perfect.
The essence of weight loss is to change our overall lifestyle, control the total energy of the diet, and don't put hope on any single product or method. Weight loss, there are no shortcuts.
Co-expert of this paper: Kelly Weaver, Ph.D. student in epidemiology and health statistics, Peking Union Medical College/Fuwai Hospital
Acknowledgements: This article has been professionally reviewed by Ruan Quangfeng, Director of the Communication Department of Kexin Food and Health Information Exchange Center, and Liu Suiqian, Clinical Dietitian of Beijing United Family Hospital
This article was first published in Dr. Lilac, curated: Murphy|Executive Producer: Feidi|Title Image Source: Tuworm Creative
Bibliography:
[1]https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline
[2] Kelly A Higgins, Richard D Mattes,A randomized controlled trial contrasting the effects of 4 low-calorie sweeteners and sucrose on body weight in adults with overweight or obesity. Am J Clin Nutr. 2019 May 1;109(5):1288-1301.
[3] Stephanie R. Hunter,Evan J. Reister,Eunjin Cheon,Richard D. Mattes,Low Calorie Sweeteners Differ in Their Physiological Effects in Humans.Nutrients. 2019 Nov; 11(11): 2717.