Carbonated drinks are the top source of artificial sweeteners in the American diet.
What does the research say?
Research shows that stevia and monk fruit, the natural sugar substitutes, are safe for human consumption. There has been conflicting research about the safety of artificial sweeteners, depending on whether it is the corporations making aspartame who are paying for the research, or research independently funded.
Some studies have suggested that artificial sweeteners could increase the risk of Type 2 diabetes, heart disease, kidney disease and cancer, and may have a negative influence on the microbiome and mental health.
("Microbiome" refers to the microorganisms in a particular environment (including the body or a part of the body). We depend on a vast army of microbes to stay alive: a microbiome that protects us against germs, breaks down food to release energy, and produces vitamins. It is the the combined genetic material of the microorganisms in a particular environment. Understanding the microbiome--human, animal, and environmental--is as important as the human genome.)
Research based on data from 37,716 men from the Health Professional's follow-up study and 80,647 women from the Nurses' Health study published in Circulation revealed that artificially sweetened beverages clearly result in a greater risk of death as well as death from heart disease. The risk was clearly indicated for women consuming 4 servings of artificially sweetened beverages a day. Politely, so as not to offend any corporate sponsors out there, this author states that his findings "need to be confirmed by further research."
Brissette: A review by the nonprofit research foundation Cochrane, conducted for the World Health Organization, examined 56 studies into the effects of sugar substitutes on health. It found that there is no evidence sugar substitutes provide any benefit and many have some risks.
An analysis of U.S. dietary intake from 2003 to 2004 shows that people tend to add artificial sweeteners to their diets rather than replacing sugary foods and beverages with them. The same seems to be true for children. This month, research published in the Pediatric Obesity journal revealed that in U.S. children, drinking artificially sweetened beverages is associated with consuming more calories and sugar.- Advertisement -
Why the difference in advice?
U.S. and Canadian health officials are looking at the same research and have populations with similar health issues. So why the difference in guidelines regarding sugar substitutes?
The new Canadian approach seems to be that if a food or beverage doesn't have a demonstrated health benefit, it doesn't belong in your diet. Their 2019 guidelines suggest that people's taste buds will adapt to less-sweet tastes when they reduce their consumption of sweetened foods and beverages and using high-intensity sweeteners delays that process.
This is a marked change from Canada's last dietary guidelines, released in 2007, which advised the general population to consume sugar substitutes in moderation and to cut back on them if they noticed any digestive symptoms such as gas and bloating.
The new Canadian recommendations might seem tougher, but in fact, are clearer. Further, this latest Canadian Food Guide maintains that whole grains are the only grains to put on your plate, while the U.S. guideline is that at least half of your grains be whole grains. The U.S. view seems to be focused on encouraging health behaviors that are thought to be more achievable. Perhaps that is so with a populace.
Brissette interviewed Alice H. Lichtenstein, professor of nutrition science and policy at Tufts University, who was skeptical of an all-or-nothing approach to sugar substitutes. She also put forth her views in an editorial in Circulation, responding to the study that said consuming artificially sweetened beverages is associated with a greater risk of death.
"To a certain extent, as a community, we can take the high road about beverage recommendations: Drink water (or flavored water) in place of [sugar-sweetened beverages]. However, continuing this simple approach would be disingenuous because we know that it has not worked well in the past and there is little reason to expect that it will work well in the future." Lichtenstein said: "For some people, I suspect the use of high-intensity sweeteners is helpful in avoiding excess energy intake. For others, it might not be helpful."
From my point of view as an all-out ban-aspartame activist, such professorial pronouncements take on the feel of weak academic double-speak and gobbledegook, but we have learned that the preacher must avoid dumping on the choir.
A 2018 advisory from the American Heart Association also takes a more mousy approach to sugar substitutes than Canada's, stating that they can play a role in helping people to reduce the amount of sugar-sweetened beverages they're drinking. Their advisory also says beverages containing low-calorie sweeteners could be especially useful for people who are used to sweetness and find water unappealing at first.