Do Artificial Sweeteners Help You Lose Weight?

Written by Dr. Steve Chaney on . Posted in artificial sweeteners and weight loss, Blood Sugar, Diet Soda and Health

Sucralose and Weight Loss

Author: Dr. Stephen Chaney

 

Do artificial sweeteners help you lose weight?

It’s a puzzle. We are drinking more artificially sweetened foods and sodas than ever. We’ve been told that those artificially sweeteners will help us cut calories and keep us slender. Yet, surprisingly, we’re fatter than ever.

Let me put some numbers to that statement. The number of people consuming calorie free sodas in the US alone increased from 70 million to 260 million between 1987 and 2000. During that same time period, the percentage of overweight adults in this country increased from 52% to 66%; the percentage of obese adults increased from 20% to 32%; and the percentage of obese children increased from 10% to 17%. Clearly something isn’t working.

And, it may just be the artificial sweeteners that aren’t working. A study published in 2007 (R. Dingra et al, Circulation, 116: 480-484, 2007 ) showed that people consuming regular (sugar containing) sodas were 48% more likely to become obese over a four-year period than people who primarily drank water. That wasn’t surprising. The surprising finding from this study was that people who consumed diet sodas were just as likely to become obese as those drinking regular sodas.

Now you may be saying: “Wait a minute. I thought I read that consuming diet sodas actually helps people lose weight.” The answer is that in those studies dietitians rigorously controlled the caloric intake from other foods so that the only caloric difference was between the diet sodas and the regular sodas. Under those conditions the results are fairly obvious. Fewer calories from sodas = weight loss. But those aren’t the results that you see in free living populations where you don’t have a dietitian peering over your shoulder. In those populations people consuming diet sodas tend to take in the same number of total calories overall and gain just as much weight as people drinking regular sodas.

 

Do Artificial Sweeteners Prevent Weight Loss?

 

Obviously, people consuming diet sodas which contain artificial sweeteners must compensate by consuming extra calories from other foods. But, why are they consuming those extra calories? Some experts hypothesize that the answer is physiological. The sweet taste of the diet sodas triggers the release of insulin, which drives down blood sugar levels and makes people hungrier. Other experts hypothesize that the answer is psychological. People simply feel virtuous for consuming the diet sodas and feel they can now splurge somewhere else.

do artificial sweeteners help you lose weightAnimal studies have suggested that the cause may actually be physiological. Those studies have shown that there are “sweetness receptors” in the intestine that respond to the sweetness of sugars and trigger an increase in the level of proteins that transport sugars from the intestine into the bloodstream. That makes great sense from an evolutionary point of view. If we’re eating a low carbohydrate diet we really don’t want to waste a lot of energy producing proteins that transport sugars into our bloodstream. However, whenever we eat foods high in carbohydrates we don’t want to waste that carbohydrate. So, our intestine rapidly breaks the carbohydrates down to simple sugars, and our body responds by increasing our ability to transport those simple sugars into the bloodstream.

This can lead to blood sugar swings and increased food cravings. You’ve heard about the blood sugar swings associated with meals high in simple sugars. When sugars enter the bloodstream very rapidly, blood sugar levels increase, which causes insulin to be secreted. The insulin drives down blood sugar levels, leading to hypoglycemia and increased hunger. That’s a highly simplified scenario, but you get the general idea.

Now the interesting thing is that animal studies have suggested that artificial sweeteners are also recognized by the intestinal “sweetness receptors”. So artificial sweeteners also trigger an increase in the intestinal sugar transporters and prime the body so that blood sugar swings are more likely to occur whenever we eat carbohydrates.

While the results from animal studies have been very consistent with this model, the results from human clinical studies have been mixed. Some studies have suggested that artificial sweeteners do increase the likelihood of blood sugar swings, while other studies have reported that artificial sweeteners have no effect on blood glucose and insulin levels.

With this in mind, do artificial sweeteners help you lose weight?  Let’s continue to investigate.

 

Do Artificial Sweeteners Help You Lose Weight?

 

A recent study (M.Y. Pepinoet al, Diabetes Care, 36: 2530-2535, 2013 ) provides a possible explanation for these conflicting results. This study was similar to many of the previous studies in that obese adults were given either sucralose (an artificial sweetener) or water 10 min before being given a fixed amount of glucose, and blood sugar and insulin levels were followed over the next five hours. What made this study unique was that overweight participants were selected who did not normally consume artificially sweetened beverages or foods (Those people are hard to find in the overweight US population).

artificial sweetenersAnd the results were fairly clear-cut. The participants consuming sucralose prior to the glucose load had a 20% greater increase in blood sugar levels, a 20% greater increase in the amount of insulin produced, and significantly lower blood sugar levels three hours after the glucose load than participants consuming water prior to the glucose load. In the words of the authors: “These data suggest that sucralose ingestion is not physiologically inert but affects the glycemic [blood sugar] response to oral glucose load and potentiates glucose stimulated insulin secretion in obese people.” Basically, what they are saying is that sucralose primes their bodies so that they are more likely to experience blood sugar swings when they subsequently consume carbohydrates. [And that can lead to food cravings and weight gain.]

The authors hypothesized that some previous studies had not found an effect of artificial sweeteners on blood sugar and insulin levels because most of the people in those studies were already consuming artificially sweetened beverages on a regular basis and their intestinal sugar transport proteins were already maximally stimulated. Basically, what they are saying is that when someone is regularly consuming artificial sweeteners the damage has already been done (sugar transport is already maximal), and a single dose of an artificial sweetener will not have any significant additional effect.

So, do artificial sweeteners help you lose weight?  I think you know.

 

The Bottom Line

 

It has become clear in recent years that artificially-sweetened diet sodas and diet foods are not effective at preventing weight gain, and may, in fact, contribute to weight gain. There is also increasing evidence that artificially-sweetened diet sodas may be harmful to our health. In fact, an international consortium of obesity experts recently concluded: “The absence of evidence to support the role of artificially sweetened beverages in preventing weight gain and the lack of studies on their long-term effects on health strengthen the position that artificially-sweetened beverages should not be promoted as part of a healthy diet.”

 

However, the reason why diet sodas appear to promote obesity rather than prevent it has remained elusive.

  • A recent study suggests that sucralose (and presumably other artificial sweeteners) triggers a complex serious of metabolic responses that lead to increased appetite and food cravings.
  • However, this is just one small study. Many more studies will be required before we understand why artificial sweeteners promote obesity, rather than prevent it.
  • However, it is clear that artificial sweeteners are not the simple, magical solutions for weight control that food manufacturers and advertisers would have you believe.
    • There are unresolved safety issues with all the artificial sweeteners – but that’s another subject for another day.
    • There is no convincing evidence that artificial sweeteners actually help you lose weight unless you are very carefully controlling the calories from all the other foods you’re eating – and if you’re doing that successfully, you probably don’t need artificial sweeteners in the first place.
    • There is some evidence that artificial sweeteners may actually cause blood sugar swings and make you hungrier, thus making it harder – not easier – to control your weight.
  • The best solution to weight control is always true lifestyle change that includes exercise, healthy foods, and reduced caloric intake and is not based on gimmicks or artificial ingredients.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Trackback from your site.

Comments (1)

  • Merlena Cushing

    |

    Great article, as always. I appreciate so much your diligence in research and willingness to share your wisdom. You and Suzanne are a blessing to us in the field. Am looking forward to the Product Talk Call on the new Performance line tonight. Have the flyers, but thought sending a link to the call might be helpful to some of our customers.

    Reply

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

Should We Use Supplements For Cardiovascular Health?

Posted July 10, 2018 by Dr. Steve Chaney

Are You Just Wasting Your Money On Supplements?

Author: Dr. Stephen Chaney

 

supplements for cardiovascular health wast moneyYou’ve seen the headlines. “Recent Study Finds Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.”  You are being told that supplements are of no benefit to you. They are a waste of money. You should follow a healthy diet instead. Is all of this true?

If I were like most bloggers, I would give you a simple yes or no answer that would be only partially correct. Instead, I am going to put the study behind these headlines into perspective. I am going to give you a deeper understanding of supplementation, so you can make better choices for your health.

 Should we use supplements for cardiovascular health?

In today’s article I will give you a brief overview of the subject. Here are the topics I will cover today:

  • Is this fake news?
  • Did the study ask the right questions?
  • Is this a question of “Garbage In – Garbage Out?
  • Reducing Heart Disease Risk. What you need to know.

All these topics are covered in much more detail (with references) in my book “Slaying The Supplement Myths”, which will be published this fall.

 

How Was This Study Done?

supplements for cardiovascular healthThis study (D.J.A. Jenkins et al, Journal of the American College Of Cardiology, 71: 2540-2584, 2018 ) was a meta-analysis. Simply put, that means the authors combined the results of many previous studies into a single database to increase the statistical power of their conclusions. This study included 127 randomized control trials published between 2012 and December 2017. These were all studies that included supplementation and looked at cardiovascular end points, cancer end points or overall mortality.

Before looking at the results, it is instructive to look at the strengths and weaknesses of the study. Rather than giving you my interpretation, let me summarize what the authors said about strengths and weaknesses of their own study.

The strengths are obvious. Randomized control trials are considered the gold standard of evidence-based medicine, but they have their weaknesses. Here is what the authors said about the limitations of their study:

  • “Randomized control trials are of shorter duration, whereas longer duration studies might be required to fully capture chronic disease risk.”
  • “Dose-response data were not usually available [from the randomized control studies included in their analysis]. However, larger studies would allow the effect of dose to be assessed.”

There are some other limitations of this study, which I will point out below.

Is This Fake News?

supplements for cardiovascular health fake newsWhen I talk about “fake news” I am referring to the headlines, not to the study behind the headlines. The headlines were definitive: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” However, when you read the study the reality is quite different:

  • In contrast to the negative headlines, the study reported:
    • Folic acid supplementation decreased stroke risk by 20% and overall heart disease risk by 17%.
    • B complex supplements containing folic acid, B6, and B12 decreased stroke risk by 10%.
    • That’s a big deal, but somehow the headlines forgot to mention it.
  • The supplements that had no significant effect on heart disease risk (multivitamins, vitamin D, calcium, and vitamin C) were ones that would not be expected to lower heart disease risk. There was little evidence from previous studies of decreased risk. Furthermore, there is no plausible mechanism for supposing they might decrease heart disease risk.
  • The study did not include vitamin E or omega-3 supplements, which are the ones most likely to prove effective in decreasing heart disease risk when the studies are done properly (see below).

Did The Study Ask The Right Question?

Most of the studies included in this meta-analysis were asking whether a supplement decreased heart disease risk or mortality for everyone. Simply put, the studies started with a group of generally healthy Americans and asked whether supplementation had a significant effect on disease risk for everyone in that population.

That is the wrong question. We should not expect supplementation to benefit everyone equally. Instead, we should be asking who is most likely to benefit from supplementation and design our clinical studies to test whether those people benefit from supplementation.

supplements for cardiovascular health diagramI have created the graphic on the right as a guide to help answer the question of “Who is most likely to benefit from supplementation?”. Let me summarize each of the points using folic acid as the example.

 

Poor Diet: It only makes sense that those people who are deficient in folate from foods are the most likely to benefit from folic acid supplementation. Think about it for a minute. Would you really expect people who are already getting plenty of folate from their diet to obtain additional benefits from folic acid supplementation?

The NIH estimates that around 20% of US women of childbearing age are deficient in folic acid. For other segments of our population, dietary folate insufficiency ranges from 5-10%. Yet, most studies of folic acid supplementation lump everyone together – even though 80-95% of the US population is already getting enough folate through foods, food fortification, and supplementation. It is no wonder most studies fail to find a beneficial effect of folic acid supplementation.

The authors of the meta-analysis I discussed above said that the beneficial effects of folic acid they saw might have been influenced by a very large Chinese study, because a much higher percentage of Chinese are deficient in folic acid. They went on to say that the Chinese study needed to be repeated in this country.

In fact, the US study has already been done. A large study called “The Heart Outcomes Prevention Evaluation (HOPE)” study reported that folic acid supplementation did not reduce heart disease risk in the whole population. However, when the study focused on the subgroup of subjects who were folate-deficient at the beginning of the study, folic acid supplementation significantly decreased their risk of heart attack and cardiovascular death.  This would seem to suggest using supplements for cardiovascular health is a good idea.

Increased Need: There are many factors that increase the need for certain nutrients. However, for the sake of simplicity, let’s only focus on medications. Medications that interfere with folic acid metabolism include anticonvulsants, metformin (used to treat diabetes), methotrexate and sulfasalazine (used to treat severe inflammation), birth control pills, and some diuretics. Use of these medications is not a concern when the diet is adequate. However, when you combine medication use with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial.

Genetic Predisposition: The best known genetic defect affecting folic acid metabolism is MTHFR. MTHFR deficiency does not mean you have a specific need for methylfolate. However, it does increase your need for folic acid. Again, this is not a concern when the diet is adequate. However, when you combine MTHFR deficiency with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial. I cover this topic in great detail in my upcoming book, “Slaying The Supplement Myths”. In the meantime, you might wish to view my video, “The Truth About Methyl Folate.”

Diseases: An underlying disease or predisposition to disease often increases the need for one or more nutrients that help reduce disease risk. The best examples of this are two major studies on the effect of vitamin E on heart disease risk in women. Both studies found no effect of vitamin E on heart disease risk in the whole population. However, one study reported that vitamin E reduced heart disease risk in the subgroup of women who were post-menopausal (when the risk of heart disease skyrockets). The other study found that vitamin E reduced heart attack risk in the subgroup of women who had pre-existing heart disease at the beginning of the study.

Finally, if you look at the diagram closely, you will notice a red circle in the middle. When two or three of these factors overlap, that is the “sweet spot” where supplementation is almost certain to make a difference and it may be a good idea to use supplements for cardiovascular health.

Is This A Question Of “Garbage In, Garbage Out”?

supplements for cardiovascular health garbage in outUnfortunately, most clinical studies focus on the “Does everyone benefit from supplementation question?” rather than the “Who benefits from supplementation?” question.

In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.

Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.

 

Should We Use Supplements For Cardiovascular Health?

 

If you want to know whether supplements decrease heart disease risk for everyone, this meta-analysis is clear. Folic acid may decrease the risk of stroke and heart disease. A B complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but the analysis did not include vitamin E and/or omega-3s.

However, if you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.

I would be remiss, however, if I failed to point out that we know healthy diets can decrease heart disease risk. In the words of the authors: “The recent science-based report of the U.S. Dietary Guidelines Advisory Committee, also concerned with [heart disease] risk reduction, recommended 3 dietary patterns: 1) a healthy American diet low in saturated fat, trans fat, and meat, but high in fruits and vegetables; 2) a Mediterranean diet; and 3) a vegetarian diet. These diets, with their accompanying recommendations, continue the move towards more plant-based diets…” I cover the effect of diet on heart disease risk in detail in my book, “Slaying The Food Myths”.

 

The Bottom Line

 

You have probably seen the recent headlines proclaiming: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” The study behind the headlines was a meta-analysis of 127 randomized control trials looking at the effect of supplementation on heart disease risk and mortality.

  • The headlines qualify as “fake news” because:
    • The study found that folic acid decreased stroke and heart disease risk, and B vitamins decreased stroke risk. Somehow the headlines forgot to mention that.
    • The study found that multivitamins, vitamin D, calcium, and vitamin C had no effect on heart disease risk. These are nutrients that were unlikely to decrease heart disease risk to begin with.
    • The study did not include vitamin E and omega-3s. These are nutrients that are likely to decrease heart disease risk when the studies are done properly.
  • The authors of the study stated that a major weakness of their study was that that randomized control studies included in their analysis were short term, whereas longer duration studies might be required to fully capture chronic disease risk.
  • The study behind the headlines is of little use for you as an individual because it asked the wrong question.
  • Most clinical studies focus on the “Does everyone benefit from supplementation question?” That is the wrong question. Instead we need more clinical studies focused on the “Who benefits from supplementation?” question. I discuss that question in more detail in the article above.
  • In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.
  • Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.
  • If you want to know whether supplements decrease heart disease risk for everyone, this study is clear. Folic acid may decrease the risk of stroke and heart disease. A B-complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but they did not include vitamin E and/or omega-3s in their analysis.
  • If you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.
  • However, we do know that healthy, plant-based diets can decrease heart disease risk. I cover heart healthy diets in detail in my book, “Slaying The Food Myths.”

 

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

UA-43257393-1