Artificial sweeteners are not the answer to childhood obesity

Swithers, Susan E.

doi:10.1016/j.appet.2015.03.027

Cited by 77 publications

(69 citation statements)

References 82 publications

(83 reference statements)

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“…of sweetener use among products with sugar claims were among the categories with at least 50% fewer products with excess free sugar levels (i.e., canned fruit, pudding and gelatin, pies and tarts, soft drinks, and yogurt). The use of sweeteners may be a worthwhile method of reformulation to achieve caloric and sugar reductions in some subcategories, but the potential for sweeteners to encourage energy and sugar compensation at subsequent meals needs to be considered (Mennella 2014;Mwatsama and Landon 2014;Swithers 2015), along with the unknown long-term health effects of higher intakes and acceptability of increased sweetener use by consumers. In a 2013 study, 54% of Canadian consumers reported that the use of sweeteners influenced their food choices (Canadian Foundation for Dietetic Research 2013).…”

Section: Discussionmentioning

confidence: 99%

“…This is especially concerning since nutrition marketing is commonly found on foods that are high in calories and other "nutrients to limit" (i.e., sodium, sugar, fat) (Colby et al 2010;Schermel et al 2016), and many Canadians rely on NCC alone and do not check the more detailed nutrition information available on the NFt (Reid and Hendricks 1994). Other concerns about products with sugar claims include the replacement of sugar with low-or no-calorie sweeteners (van Raaij et al 2009), of which the long-term health effects remain inconclusive (Gardner et al 2012;Mennella 2014;Mwatsama and Landon 2014;Swithers 2015; United States Department of Agriculture 2015).…”

Section: Introductionmentioning

confidence: 99%

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Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims

Bernstein

Franco-Arellano

Schermel

et al. 2017

Appl. Physiol. Nutr. Metab.

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Abstract:The objective of this study was to evaluate differences in calories, nutrient content, overall healthfulness, and use of sweetener ingredients between products with and without sugar claims. Consumers assume products with sugar claims are healthier and lower in calories. It is therefore important claims be found on comparatively healthier items. This study is a cross-sectional analysis of the University of Toronto's 2013 Food Label Database. Subcategories where at least 5% of products (and n ≥ 5) carried a sugar claim were included (n = 3048). Differences in median calorie content, nutrient content, and overall healthfulness, using the Food Standards Australia/New Zealand Nutrient Profiling Scoring criterion, between products with and without sugar claims, were determined. Proportion of products with and without claims that had excess free sugar levels (≥10% of calories from free sugar) and that contained sweeteners was also determined. Almost half (48%) of products with sugar claims contained excess free sugar, and a greater proportion contained sweeteners than products without such claims (30% vs 5%, 2 = 338.6, p < 0.0001). Overall, products with sugar claims were "healthier" and had lower median calorie, free sugar, total sugar, and sodium contents than products without claims. At the subcategory level, reductions in free sugar contents were not always met with similar reductions in calorie contents. This study highlights concerns with regards to the nutritional composition of products bearing sugar claims. Findings can support educational messaging to assist consumer interpretation of sugar claims and can inform changes in nutrition policies, for example, permitting sugar claims only on products with calorie reductions and without excess free sugar.Key words: sugars, nutrition marketing, food labelling, sugar claims, nutrient composition, free sugar, food policy, sugar claims. Résumé :Évaluer les différences sur le plan des calories, de la teneur en éléments nutritifs, de la valeur sanitaire globale et de l'utilisation d'édulcorants, et ce, avec ou sans allégations relatives au sucre. Les consommateurs croient que les produits présentant des allégations relatives au sucre sont meilleurs pour la santé et plus faibles en calories. On devrait donc retrouver des allégations sur des produits relativement plus sains. Analyse transversale de la Base de données 2013 de l'étiquetage des aliments de l'Université de Toronto. Les sous-catégories avec au moins 5 % des produits (et n ≥ 5) présentant une allégation relative au sucre sont incluses (n = 3048). Au moyen des critères de notation des profils nutritionnels basés sur les normes alimentaires de l'Australie/Nouvelle-Zélande, on calcule les différences entre les médianes du contenu calorique, de la teneur en éléments nutritifs et de la valeur sanitaire globale des produits avec et sans allégation relative au sucre. On détermine aussi la proportion des produits avec et sans allégation d'une trop haute teneur en sucre libre (≥10 % des calories provenant du su...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims

Bernstein

Franco-Arellano

Schermel

et al. 2017

Appl. Physiol. Nutr. Metab.

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“…Consumption of artificially sweetened beverages is positively associated with BMI and percentage of body fat increase in children [16] . Current evidence is controversial [17] , but suggests that reducing the intake of any sweetener, whether high or low calorie, is a better strategy for limiting metabolic disorders than using artificial sweeteners [18] . In our study, the magnitudes of the observed associations were only moderately decreased after controlling for the main T2D risk factors, suggesting an independent association with artificial sweeteners.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that the use of artificial sweeteners could lead to overeating, diminished release of hormones such as GLP-1, impaired blood glucose regulation [18] and therefore could ultimately lead to T2D. A high consumption of artificial sweeteners can also activate sweet taste receptors T1R2 and T1R3, which may be involved in the regulation of metabolic processes such as sugar sensing, glucose homeostasis, and satiety hormone release [19] .…”

Section: Biological Pathwaysmentioning

confidence: 99%

Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study

et al. 2017

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Background: The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary. Methods: We used data from 61,440 women in the prospective E3N-European Prospective Investigation into Cancer and Nutrition study, conducted between 1993 and 2011. We estimated hazards ratios (HRs) and 95% CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets. Results: Compared to “never or rare” consumers of artificial sweeteners, those using them “always or almost always” had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI). Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users (HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively). Conclusions: Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity. A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes.

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“…Consuming high amounts of fat and alcohol leads to the accumulation of visceral fat and boosters the development of fatty liver disease. Consuming soft drinks with artificial sweeteners may influence gut microbiota and thus increase glucose intolerance (49). Changes in dietary habits are effective in preventing T2D if started early and performed in a sustained manner.…”

Section: Pathophysiologymentioning

confidence: 99%

Preventing Diabetes: Early Versus Late Preventive Interventions

Tuomilehto

Schwarz

2016

Diabetes Care

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There are a number of arguments in support of early measures for the prevention of type 2 diabetes (T2D), as well as for concepts and strategies at later intervention stages. Diabetes prevention is achievable when implemented in a sustainable manner. Sustainability within a T2D prevention program is more important than the actual point in time or disease process at which prevention activities may start. The quality of intervention, as well as its intensity, should vary with the degree of the identified T2D risk. Nevertheless, preventive interventions should start as early as possible in order to allow a wide variety of relatively low- and moderate-intensity programs. The later the disease risk is identified, the more intensive the intervention should be. Public health interventions for diabetes prevention represent an optimal model for early intervention. Late interventions will be targeted at people who already have significant pathophysiological derangements that can be considered steps leading to the development of T2D. These derangements may be difficult to reverse, but the worsening of dysglycemia may be halted, and thus the clinical onset of T2D can be delayed.

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Artificial sweeteners are not the answer to childhood obesity

Cited by 77 publications

References 82 publications

Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims

Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims

Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study

Preventing Diabetes: Early Versus Late Preventive Interventions

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