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Low-Calorie Sweeteners May Help With Weight Loss

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Low-Calorie Sweeteners May Help With Weight Loss

Replacing sugar-sweetened beverages with alternative beverages containing low-calorie sweeteners — a category that includes both artificial sweeteners and certain plant-based sweeteners, like stevia — may result in improvements in body weight and metabolic health, according to a new analysis published in the journal JAMA Network Open.

There is a long-running debate about the potential risks and benefits of using low-calorie sweeteners, especially within the diabetes community. While these sweeteners don’t contain glucose and can’t directly raise your blood glucose level, that doesn’t mean they’re necessarily harmless — and they might not lead to the benefits that people hope they will. One analysis from a few years ago found that across seven different clinical trials, consuming low-calorie sweeteners had no meaningful effect on weight loss, waist circumference, or body-mass index (a measure of body weight that takes height into account). Another study showed that both sugar and artificial sweeteners may cause harmful changes in the cells that line our blood vessels, potentially contributing to cardiovascular disease over time. But despite the lack of clear health benefits and potential risks linked to low-calorie sweeteners, many people with diabetes consume them — possibly in part based on the idea that they’re at least not as bad as sugar when it comes to satisfying a craving for something sweet.

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Now, it looks like people who turn to low-calorie sweeteners over sugar might have the right idea, after all, at least when it comes to weight management. The latest analysis involved looking at 17 different clinical trials in which some participants were assigned to replace certain beverages in their diet with other beverages. These trials included a total of 1,733 participants with an average age of 33 — most of whom were women, and all of whom were overweight or obese and considered at high risk for diabetes. In 12 of the trials, some participants were assigned to replace sugar-sweetened beverages with beverages containing low-calorie sweeteners. In nine of the trials, some participants were assigned to replace water with beverages containing low-calorie sweeteners. And in three trials, some participants were assigned to replace sugar-sweetened beverages with water. As these numbers show, some trials involved more than one group making different substitutions in their diet.

Replacing sugar-sweetened beverages with low-calorie sweeteners in beverages linked to weight loss

The researchers found that overall, replacing sugar-sweetened beverages with beverages containing low-calorie sweeteners was linked to an average body weight loss of 1.06 kilograms (2.34 pounds) and an average drop in body-mass index (BMI) of 0.32. Replacing sugar-sweetened beverages with water, on the other hand, was not linked to any changed outcomes. Replacing water with beverages containing low-calorie sweeteners wasn’t linked to any body weight changes, but it was linked to a slight average increase in A1C (a measure of long-term blood glucose control) of 0.21%, and a slight average drop in systolic blood pressure (the “top number” measured during heartbeats) of 2.63 mm Hg. Since there was more overall data on replacing sugar-sweetened beverages with beverages containing low-calorie sweeteners than for any of the other substitutions, the researchers considered this evidence to be of “moderate” certainty, while the link (or lack of link) to weight differences from the other substitutions was considered to be of “low” certainty.

The researchers concluded that replacing sugar-sweetened beverages with beverages containing low-calorie sweeteners “was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution.” The evidence, they wrote, supports the benefits of using these sweeteners “over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.” But the long-term health effects of using low-calorie sweeteners are still uncertain, which is why many health experts still advise drinking water — or other unsweetened beverages like herbal tea — whenever possible.

Want to learn more about weight management? Read “Tried and True Weight-Loss Techniques,” “Losing Weight Without Feeling Hungry: Eight Tips,” and “Seven Ways to Lose Weight.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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