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Aug 29, 2023

Bartecchi: World Health Organization hits artificial sweeteners

The WHO recently issued a report advising against using non-sugar sweeteners for

The WHO recently issued a report advising against using non-sugar sweeteners for weight control because of potential health risks. A large French study suggested a potential direct association between artificial sweetener consumption and increased cardiovascular risk (stroke and coronary heart disease).

The WHO points to a review that suggests that non-sugar sweeteners do not provide long term benefit in reducing body fat in adults or children and may also increase Type 2 diabetes in adults. The WHO believes that people should reduce the sweetness of their diet in general, starting early in life. The WHO had already urged people to limit the amount of sugar that they consume and this recommendation is widely accepted.

The previously noted French study mentioned the theory that high intake of sugar-sweetened beverages is associated with weight gain, possibly due to lower satiety and increased blood sugar and insulin levels, leading to insulin resistance.

Low calorie, non-sugar sweetened beverages may also cause weight gain by stimulating appetite and a sweet preference in some people. A recent Harvard report notes that the human brain responds to sweetness with signals to eat more. By producing a sweet taste without any calories, low calorie sweetened beverages may cause us to crave more sweet foods and drinks, which can add up to excess calories, though there is little evidence for this. These and other possibilities are being studies at major medical centers.

People rightly use low calorie sweeteners in place of sugar so as to consume fewer calories or less sugar or to better control their blood sugar if they have diabetes or prediabetes. Many of these sweeteners can be hundreds of times sweeter than sugar. Some of them have been approved by the U.S. FDA and others are nicely described in the March 2023 Nutrition Action magazine which also mentions some concerns about different sweeteners.

Sucralose (Splenda) caused cancer in mice and may boost blood sugar. Stevia Extract is a safe choice. Saccharin (Sweet’N Low, Sweet Twin, Necta Sweet) – is safe for human consumption. Monk Fruit Extract – appears safe but more research is needed. Sugar Alcohols (Swerve), Erythritol is safe. Aspartame (Equal) found in Diet Coke and Diet Pepsi – suggests that it can cause cancer and is being studied. Acesulfame-K (Sunett, Sweet One) may increase cancer risk.

What should be done about all this new information? First of all, kids shouldn't be given low-cal sweeteners as they have not been tested in children. In cutting down on low calorie sweeteners, people should not revert back to sugar, honey, agave or corn syrup. We should cut back on both sugar and non-sugar sweeteners, possibly gradually reducing both with a goal of reaching a diet without as much or even no sweeteners. Moderation is the key, especially for those with Type 2 diabetes or heart disease. Alternatives to low calorie sweeteners can be plain, carbonated or unsweetened, flavored waters.

Artificial sweeteners are commonly found in ultra-processed food. An NIH study showed the problems that can be related to these ultra-processed foods. Food companies are adding these sweeteners to a growing number of packaged foods such as bread, yogurt, oatmeal, muffins, canned soups, salad dressings condiments, snack bars, etc. Such foods are subjected to multiple processing methods that transform their taste, texture and appearance. They contain many additives such as salt, sugar, oils, artificial flavors, colors sweeteners, stabilizers and preservatives, making them what scientists call hyper-palliative and easy to overeat.

The WHO report encourages us to think more carefully about the food products that we buy for our families and the shortcuts that we might take to avoid calories.

Dr. Carl E. Bartecchi, MD, is a Pueblo physician and clinical professor of medicine and the University of Colorado School of Medicine.