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Sunday
Sep062009

Non-Calorie Sweeteners: Do they support weight loss?

Written by Tom Nikkola - Director of Nutrition & Weight Management

Last week, we looked at whether nonnutritive sweeteners (NNS) affect hunger. As we saw, research shows an increase only in some individuals, and only when the NNS are consumed in sweet beverages on their own, without the consumption of any calorie containing foods. For the most part, NNS do not affect hunger, but do they actually support weight loss? We'll take a look at this today.

NNS and Energy Consumption

In order to affect weight loss, the use of NNS would have to reduce overall energy intake. Short-term studies on the use of NNS provide mixed results, with some studies showing a short-term increase in calories with the use of NNS, and others showing no change or a reduced calorie intake. Long-term use studies have shown either no change, or a reduction in calories. From a practical standpoint, if NNS is used in place of sugar, and calories are reduced, it should lead to a reduction in weight, providing overall calories consumed are less than the calories burned in a day.

NNS use in "Free-Living" Conditions

This is where some of the confusion about NNS and weight loss comes from. Nonnutritive sweeteners would be effective in weight management only if they lead to a reduction in overall calories. However, many of the studies done on NNS are not designed to create a caloric deficit. "Free-living" means those who are part of the study group are not held to a certain calorie level in their diet. They are usually designed in a way to strictly measure weight loss of those who use NNS and those who do not. Simply choosing diet soda will not ensure a reduction in calories, so studies like these are not likely to show a significant difference in weight loss.

Another common research model for NNS use, is to look at a large population and compare the soft drink and diet soft drink use for those who are at a normal weight, overweight, and obese. Often, the results show that those who are overweight or obese consume higher amounts of both regular and diet sodas. Does this mean that diet sodas cause weight gain? No. It simply means that those who consume a diet that leads to weight gain may be more likely to drink regular or diet soft drinks. It may appear that either one - regular or diet soft drinks - can lead to added weight. However, it does not show us what the rest of the diet looks like that leads to the added weight.

As an example, I was eating lunch at Moe's in the Cincinnati airport on Friday. I ordered a cob salad with chicken and a diet soda. For me, I drink an occasional diet soda with a meal for something different than my usual water. I was not concerned at all about the Diet Coke I ordered affecting my body composition. However, the three extra servings of salad dressing and the bacon I left on my plate (pictured to the right) surely could have affected my calorie total for the day, which is why I chose not to eat them.

While at the restaraunt, a gentleman, who was about 30-40 pounds overweight, sat down at a table to my left. He also ordered a diet soda and a few minutes later ordered the Jumbo Moe's Smoked Meat Sandwich, which also included half a plate of fries. Did he order the diet soda because he was trying to cut back on calories? I didn't ask him, but it was not likely based on the meal he ordered. Maybe he just preferred the taste of diet soda. The point is, NNS are only effective at supporting weight management if it leads to a reduction in calories.

NNS use in a Structured Nutrition Plan

As mentioned, NNS use can lead to weight loss only as part of an appropriate nutrition plan. If NNS are used to reduce overall calories, or are added into an already-reduced calorie plan. In the past, I met many people who would drink 4-6 regular sodas during the day. By replacing them with non-calorie soft drinks, it would quickly reduce their daily calorie consumption by 600-900 calories per day. A switch from sugar-containing to sugar-free soft drinks could be a reasonable first step for someone, with a longer-term goal of moving toward water and unsweetened tea as the main choice of fluids.

In addition, if foods containing NNS provide satisfying meals and snacks, while controlling for calorie content, they can also be effective for weight management. In this case, NNS can be used to create a food or powder formulation that helps support a good nutrition plan.

For people consuming an appropriate nutrition plan, the use of NNS would have little, if any, impact on their ability to lose weight.

Summary

To determine the effect of NNS on weight loss, there are a few different frames of reference to look at. One is looking at the use of NNS in soft drinks to determine whether their use affects weight loss or weight gain. The other is the use of NNS in calorie-containing foods.

When making a judgement on NNS use in soft drinks, based on the studies that have been done, it is unlikely that the use of diet soft drinks by themselves could contribute to weight gain. A more likely scenario is that people who consume higher levels of diet soft drinks are less likely to consume a healthier diet, like the example of the gentleman at Moe's. On the other hand, for someone eating a properly balanced, reduced-calorie nutrition plan, diet soft drinks should not lead to weight gain.

Nonnutritive sweeteners used in calorie-containing foods can be beneficial by adding to the flavor of the food without adding additional calories. If the NNS-containing food or food mix provides a good taste and helps an individual manage calorie intake, the NNS-containing food should be able to help in weight management or weight reduction.

In summary, NNS use will not cause a reduction in weight by themselves. In the context of a properly-designed nutrition plan, NNS can provide additional, pleasurable foods to add variety in a reduced-calorie nutrition plan. Nonnutritive sweeteners should be used in moderation, especially in the form of diet soft drinks. Drinking too many diet drinks every day replaces the amount of pure water consumed. Occasional use would not negatively affect a weight-loss plan. As an ingredient in a food or meal replacement, it can be a beneficial way to manage calorie and nutrient consumption. Within a mostly whole-food, appropriate nutrition plan, NNS can be used to provide additional flavor and variety to support daily nutrient goals.

Next week we'll look at potential negative effects from consuming too much nonnutritive sweeteners.

Go to: Non-Calorie Sweeteners: Do they increase appetite?

Go to: Non-Calorie Sweeteners: Pros and Cons

References:

Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 2009;89:1-14

Aragon A. Artificial sweetener use: current controversies. Alan Aragon Research Review. April 2009

Lutsey P, Steffen L, Stevens J. Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Communitites Study. Circulation 2008;117:754-761

Vartanian L, Schwartz M, Brownell K. Effects of Soft Drink Consumption on Nutrition and Health: A Systematic Review and Meta-Analysis. Am J Public Health. 2007;97:667-675

Nettleton J, Lutsey P, Wang Y, Lima J, Michos E, Jacobs D. Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Mult-Ethnic Study of Atherosclerosis. Diabetes Care. 32:688-694, 2009

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

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