Are artificial sweeteners safe for weight loss without raising heart disease, diabetes risk?

Artificial sweeteners in foods and beverages helped control the weight in those who underwent rapid weight-loss with low-calorie diets, according to a new study to be presented at an international conference later this year. The researchers said that those using artificial sweeteners reported greater satisfaction, positive moods and lower craving for sweet foods. And, all of this without any added risk of Type-2 diabetes or cardiovascular diseases.

These results are significant as they conflict with and come less than a year after the World Health Organisation (WHO) said that artificial sweeteners can increase the risk of non-communicable diseases. In fact, the WHO recommended against the use of non-sugar sweeteners for weight-loss, stating that in the long run it might actually lead to weight gain.

What does the current study say?

Details of the yet-to-be published study show that subjects who lost weight up to a year with a low calorie diet reported reduced cravings as they substituted sugar with artificial sweeteners. The results are based on data collected from 341 overweight or obese adults from Europe, who were assessed at two, six and 12 months to gather information on diet satisfaction, control overeating, explicit liking and implicit wanting for food, eating behaviour, physical activity, and quality of life. The researchers also looked at biomarkers in the urine of the study participants to assess their risk of diabetes and heart disease.

“The most important thing is that it is a randomised control trial, the best kind of trial to demonstrate that a particular intervention leads to a particular result. The study, however, focusses on satisfaction of the participants and not so much on the weight that is lost. There is still not enough evidence to show that it leads to more weight loss as compared to not taking any sugar at all,” says Dr Anoop Misra, Chairman of Fortis C-Doc Hospital for Diabetes and Allied Sciences.

Dr Ambrish Mithal, Chairman, Endocrinology and Diabetes, Max Healthcare, adds: “The use of biomarkers by the researchers is just an indication and not a hard outcome. It’s an important study but it is unlikely to change the current clinical practice.”

Why, then, is the study significant?

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The lead author of the study, Professor Anne Raben from the University of Copenhagen in Denmark, said: “The findings provide important information to address the controversies about potential adverse health effects. Until now, safety data have generally come from animal studies using sweetener doses far above the usual intake in humans.” This was the biggest concern raised by experts about the WHO recommendations — that it was either based on animal studies or not the most conclusive type of data based on actual human use.

The WHO report said that non-sugar sweeteners — artificial agents that provide the sweet taste with very little or no calories — were associated with a 23 per cent increase in the risk of Type-2 diabetes when consumed in the form of beverages, and 34 per cent increase when added to foods. The higher intake of these sweeteners was also linked to a 32 per cent increase in the risk of cardiovascular disease. Another report from WHO tagged one of the most commonly used sweeteners, aspartame, as possibly carcinogenic to humans.

What do doctors recommend?

Dr Mithal says that artificial sweeteners are mainly recommended for diabetics, especially in tea or coffee, for satiety. “When it comes to weight loss, no sugar is the best. But artificial sweeteners can be used to deal with sugar cravings.”

Dr Misra, on the other hand, says that it is best to stay away from sweeteners. “While this study shows that these promote satisfaction, there are also studies to the contrary that say they lead to increased cravings because they do not trigger the reward pathways in the brain in the manner that sugar does.”

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