Contrary to Recent Study, Low-Calorie Sweeteners Useful for Diabetes

(ATLANTA) — On October 3, 2019, DiabetesCare published a study entitled, “Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results from Three Large Prospective U.S. Cohorts of Women and Men”. This study reports that increasing consumption of sugary beverages and artificially sweetened beverages (ASB) is associated with a moderately higher risk of type 2 diabetes.  The authors reported that decreasing sugary beverages consumption and replacing them with non-caloric beverages free of artificial sweeteners like water, coffee or tea was associated with a lower risk of diabetes.

However, the research suffered from a few drawbacks, as noted by the Calorie Control Council:

• The likelihood of residual confounding, reverse causation or surveillance bias must be considered. This is particularly necessary in the case of individuals at higher risk of diabetes who intentionally switch from sugar-sweetened beverages to low- and no-calorie sweetened (LNCS) beverages or increase their consumption of LNCS products in an effort to control their weight.
• Given the observational nature of this study, which cannot prove cause and effect, the findings should be interpreted with caution. Though a validated food frequency questionnaire was utilized for this study, it is subject to several biases, including misreporting and recall bias.
• It should also be noted that this study found that changes in ASB consumption were inversely correlated with concurrent weight gain, substantiating previous findings that replacing sugar sweetened beverages with beverages using LNCS is helpful in weight management.  In addition to weight control, these ingredients should been seen as tools in blood glucose management, especially for those with diabetes who are accustomed to sugar-sweetened products.

What the Experts Say

Global health organizations around the world, including The American Heart Association, American Diabetes Association and British Dietetic Association note that the use of LNCS can be helpful for people with diabetes as they do not raise blood glucose or insulin levels, and when used to replace sugar, can help lower carbohydrate intake.

“As a primary care physician, I frequently provide dietary counseling to my patients who are diabetic, overweight or just want to live a healthier lifestyle. Substituting sugar sweetened beverages and snacks with low-calorie sweeteners is one of my tips,” said Keri Peterson, MD and medical advisor of the Calorie Control Council.

According to Robert Rankin, president of the Calorie Control Council, “Millions of Americans are affected by diabetes and obesity, and more develop these conditions every year. For these individuals, nutrition plays a major role in managing disease. LNCS are excellent tools to reduce sugar intake, manage blood glucose levels, and reduce overall calorie intake.”

The following organizations have utilized the most rigorous and extensive testing methods to evaluate LNCS for use in diabetes management, and have concluded:

• For some people with diabetes who are accustomed to sugar-sweetened products, non-nutritive sweeteners may be an acceptable substitute for nutritive sweeteners when consumed in moderation. – American Diabetes Association
• Artificial sweeteners are also safe for people with diabetes when consumed within the ADI and the EFSA Panel concluded that there is sufficient scientific information to support the claims that intense sweeteners lead to lower postprandial blood glucose concentrations if consumed instead of sugars. For people who are accustomed to sugar sweetened products, nonnutritive sweeteners (NNS) have the potential to reduce overall energy and carbohydrate intake and may be preferred to sugar when consumed in moderation and can be a useful strategy for those individuals seeking to control their calorie and manage their weight. – Diabetes UK

For a half a century, The Calorie Control Council has been reviewing science on low calorie sweeteners and diet products. Established in 1966, the Council is an international association representing the low- and reduced-calorie food and beverage industry. Council staff includes experts certified in public health, food and nutrition. More at caloriecontrol.org.