The debate
This study may pose a positive outlook for beverage choices for people with weight and diabetes concerns, but there has been a long debate over alternative sweeteners and overall health.
Drinking two or more of any kind of artificially sweetened drinks a day is linked to an increased risk of clot-based strokes, heart attacks and early death in women over 50, a 2019 study found.
Another study the next year found diet soda may be just as bad for your heart as the regular, sugary stuff.
That's despite the fact that artificial sweeteners have been deemed safe by regulatory bodies, said Danielle Smotkin, a spokesperson for the American Beverage Association, a US trade association representing the nonalcoholic beverage industry.
This recent study did not identify increased risk factors, but it couldn't account for long-term impacts and was not able to identify if one low- or no-calorie sweetened beverage was more effective than another, Grim said.
Water is best, experts said, but it can be hard to go cold turkey on sweet drinks, CNN nutrition contributor and registered dietician Lisa Drayer said.
"Cut back by one serving per day until you're down to one drink per day, "Then aim for one every other day until you can phase out soft drinks entirely."
She recommended sparkling water, infusing fruit and a two-week no sugar challenge to help curb cravings.
Your taste buds will adjust to find "natural foods with sugar more satisfying," she said.
In a
meta-analysis published in JAMA Network Open, researchers found replacing sugar-sweetened beverages with low- or no-calorie sweetened beverages (called "LNCSB" by nutrition professionals) was associated with small reductions in weight and cardiometabolic risk factors, the study said.
"Universally, everyone is recommending a reduction of sugar," said senior study author
Dr. John Sievenpiper. "Now the next question is: What's the best way to replace it?
"Some beverages will give you that intended benefit and in a way that's similar to what you would expect from water," said Sievenpiper, consultant physician at St. Michael's Hospital and associate professor in the department of nutritional sciences at the University of Toronto.
The study was set up well and adds evidence "that in the moderate term LNCSBs are a viable alternative to water for those with overweight or obesity," but more evidence is needed to know the long-term impact, said Julie Grim, director of nutrition for the American Diabetes Association, via email. Grim was not involved in the study.
The goal is still to drink water as often as possible, Sievenpiper said, but the results may be good news for people looking to manage weight or diabetes risk.
"You know that you've got a choice, and I think that's important for a lot of people that they have drinks sweetened without sugar may help people at risk for or who have diabetes with weight reduction, but these beverages have some health concerns as well,
Some studies suggest that consuming artificial sweeteners over the long term is likely to make people gain weight. An investigation published in the Canadian Medical Association Journal underwent a review of 37 studies involving more than 400,000 people. It found a link between regular consumption of sweeteners and weight gain, obesity, high blood pressure, diabetes, heart disease and other problems. “Given the increasing use of non-nutritive sweeteners, caution is warranted until the risks and benefits of these products are fully characterised,” the study concluded.
It’s unclear why sweeteners might trigger weight gain. It could be the body becomes confused when it consumes something sweet that has no calories, triggering hunger. Another theory is that sweeteners fuel sugar cravings, or alter our gut bacteria in a way that impairs our ability to control blood sugar levels.
In theory at least, sweeteners don’t raise blood sugar levels the way sugar does, so are considered safe for diabetics. However, a study given to the European Association for the Study of Diabetes last year found that sweeteners can interfere with the way the body processes glucose. The University of Adelaide’s Dr Richard Young, who led the study, says: “High regular consumption of artificial sweeteners may be a path to poorer blood sugar control in humans.” This could cause spikes in blood sugar and increase insulin resistance, which is when the body fails to keep blood glucose levels under control. “This, in turn, could increase the risk of developing type 2 diabetes, obesity and cardiovascular diseases,” Dr Young says. Research is set to continue.
Harvard School of Public Health advises low-calorie drinks are best consumed in small amounts over a short period of time. And because the long-term effects of these sweetened drinks ‘are unknown’, the advice is for children to avoid them.
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