This week the World Health Organization (WHO) He advised “Non-sugar desserts should not be used to control weight or reduce the risk of non-communicable diseases such as diabetes and heart disease.”
Artificial sweeteners are – and are – natural compounds or synthetic compounds that taste sweet like sugar. Up to 400 times Sweeter by weight – but provide no or negligible energy. For comparison, sugar has 17kj (or four calories) per gram, so one teaspoon of sugar has 85kJ.
There are many types of artificial sweeteners It is used in Australia. Some are synthetic, others are derived from foods such as monk fruit and the stevia plant.
So what does the new WHO guidance mean for people who have turned to artificial sweeteners for health reasons? Just go back to sugar?
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Introduced for weight loss
In the year As a practicing clinical dietitian in the 1990s, I remember when artificial sweeteners began to appear in processed foods. They are promoted as a way to replace sugar in food products that can lead to weight loss.
A can of sugar-sweetened soft drink costs an average of 500 kilos. In theory, replacing one can of sugar-sweetened soft drink with an artificially sweetened can each day will reduce your weight by 1 kg per month.
But research over the past few decades has shown that this has not stopped.
What is the new advice based on?
The WHO recommendations are based on a systematic review. held. The aim was to provide evidence-based guidance on the use of artificial sweeteners in weight management and disease prevention.
Weight management Importantly, obesity increases the risk of diseases such as diabetes and certain types of cancer leading factor Global mortality.
of WHO systematic review It includes data from different types of studies that provide us with different information.
50 randomized controlled trials (when scientists intervene and make changes – in this case in diet – while holding everything constant, to see the effect of that change)
97 were prospective cohort studies (when scientists look at the risk in a large group over a period of time to see how it affects the outcome – without intervening or changing anything).
There were 47 case-control studies (another type of observational study that compares two groups of otherwise matched people without risk of interest).
Randomized controlled trials provide causal information, which allows us to say whether the intervention caused the change we observed.
The standby team and case control only provide us with associations or links. We can’t prove that risk factors made a difference in the outcome — in this case, weight — because other risk factors that scientists haven’t considered may be responsible. But they do give a good indication of what might be going on, especially if we can’t test whether it’s unethical or unsafe to give or withhold specific treatments.
A WHO systematic review looked at obesity, non-communicable diseases and mortality.
For body fat, the randomized controlled trial found that people who ate a lot of artificial sweeteners weighed slightly less than those who ate little or no artificial sweeteners – an average of 0.71 kg.
But cohort studies found that high intakes of artificial sweeteners were associated with a higher BMI or body mass index (0.14 kg/m2) and a 76 percent higher risk of obesity.
The prospective cohort studies showed that drinking high amounts of artificially sweetened beverages was associated with a 23 percent increased risk of type 2 diabetes. Artificial sweeteners such as tableware (if the user adds them to foods and drinks) increase the risk of diabetes by 34%.
Artificial sweeteners did not improve or worsen any clinical markers of diabetes in people with diabetes, such as fasting blood sugar or insulin levels.
High intakes of artificial sweeteners increased the risk of type 2 diabetes, cardiovascular disease and death in participants for an average of 13 years in long-term prospective observational studies.
But artificial sweeteners were not associated with overall cancer rates or premature cancer deaths.
Overall, randomized controlled trials suggest slightly more weight loss in people who consume artificial sweeteners, but observational studies show that this group tends to be more likely to be obese and have poorer health outcomes.
Does the review have flaws?
World Health Organization recommendations. Some criticisms Because although small randomized controlled trials have shown some weight loss benefits for using artificial sweeteners.
However, the WHO has made it clear that its recommendations are based on multiple research designs, not just randomized controlled trials.
In addition, the WHO rated the quality of the studies in the review as “low or very low certainty”.
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Are you not well?
This advice is not to suggest that artificial sweeteners are unsafe or should be banned. The World Health Organization’s scientific review was not on chemicals or safety issues.
So should we have sugar instead?
The answer is no.
It was released by the World Health Organization in 2015 Guidelines on the amount of added sugar To reduce the risk of overweight and obesity. Added sugar is found in processed and highly processed foods and drinks such as soft drinks, fruit drinks, sports drinks, chocolate and sweets, flavored yoghurt and muesli bars.
It is recommended that people consume no more than 50 grams (ten teaspoons) of sugar per day, making up no more than 10% of total energy intake for an adult who needs 8,700kj per day.
The recommendation of the World Health Organization Australian Dietary Guidelines, which recommends more than three hearty meals a day if you need extra energy. But it’s best to get more energy from the main food groups (grains, vegetables, fruits, dairy and protein groups).
Leer más: 8 everyday foods that you didn’t know were highly processed and how to identify them
So what do I drink now?
So, if artificial and sugary drinks are not recommended for weight loss, what can you drink?
Some options include water, kombucha without added sugar, tea or coffee. Soda and mineral water are good substitutes for your favorite fruit juice in small amounts.
Milk is a good alternative, especially if you are currently not meeting your calcium needs.