Good news for diabetics
By UNIVERSITY OF LEEDS
Replacing sugar with artificial and natural
sweeteners in foods does not make people hungrier – and also helps to reduce
blood sugar levels, a significant new study has found.
Photo by Sarah Pack
The double-blind randomized controlled trial
found that consuming food containing sweeteners produced a similar reduction in
appetite sensations and appetite-related hormone responses as sugary foods –
and provides some benefits such as lowering blood sugar, which may be
particularly important in people at risk of developing type 2 diabetes.
The use of sweeteners in place of sugar in
foods can be controversial due to conflicting reports about their potential to
increase appetite. Previous studies have been carried out but did not provide
robust evidence.
However, the researchers say their study,
which meets the gold standard level of proof in scientific investigation,
provides very strong evidence that sweeteners and sweetness enhancers do not
negatively impact appetite and are beneficial for reducing sugar intake.
The trial was led by the University of Leeds in collaboration with the The Rhône-Alpes Research Center for Human Nutrition. It is the latest study to be published by the SWEET consortium of 29 European research, consumer, and industry partners which is working to develop and review evidence on long term benefits and potential risks involved in switching over to sweeteners and sweetness enhancers in the context of public health and safety, obesity, and sustainability. It was funded by Horizon Europe.
Research Insights and Public Health Implications
Lead author Catherine Gibbons, Associate
Professor in the University of Leeds’ School of Psychology, said: “Reducing
sugar consumption has become a key public health target in the fight to reduce
the rising burden of obesity-related metabolic diseases such as type 2
diabetes.
“Simply restricting sugar from foods without
substitution may negatively impact its taste or increase sweet cravings,
resulting in difficulties sticking to a low-sugar diet. Replacing sugars with
sweeteners and sweetness enhancers in food products is one of the most widely
used dietary and food manufacturing strategies to reduce sugar intake and
improve the nutritional profile of commercial foods and beverages.”
Principal investigator Graham Finlayson,
Professor of Psychobiology in the University of Leeds’ School of Psychology,
said: “The use of sweeteners and sweetness enhancers has received a lot of
negative attention, including high profile publications linking their
consumption with impaired glycaemic response, toxicological damage to DNA and increased risk of heart attack and stroke.
These reports contribute to the current befuddlement concerning the safety of
sweeteners and sweetness enhancers among the general public especially people
at risk of metabolic diseases.
“Our study provides crucial evidence
supporting the day-to-day use of sweeteners and sweetness enhancers for body
weight and blood sugar control.”
Methodology and Participant Details
The study, which is the first of its kind,
looked at the effects of consuming biscuits containing either sugar or two
types of food sweetener: natural sugar substitute Stevia, or artificial
sweetener Neotame on 53 adult men and women with overweight or obesity.
Until now, virtually all studies of the
effects of sweeteners and sweetness enhancers on appetite and glycemia have
been conducted using beverages as the vehicle. Few studies include volunteers
with overweight or obesity and few have included volunteers of both sexes.
Most studies have only compared a single
sweetener, mostly aspartame, with a control, and very few studies have examined
the effect of repeated daily intake of a known sweetener or sweetness enhancer
in the normal diet.
The new trial took place at the University of
Leeds and the Rhône-Alpes Research Center for Human Nutrition (CRNH-RA), France
between 2021 and 2022. Participants were all aged 18 to 60, with overweight or
obesity.
The trial consisted of three two-week
consumption periods, where participants consumed biscuits with either fruit
filling containing sugar; natural sugar substitute Stevia, or artificial
sweetener Neotame, each separated by a break of 14-21 days. Day 1 and day 14 of
the consumption periods took place in the lab.
Participants were instructed to arrive in the
lab after an overnight fast, a blood sample was taken to establish baseline
levels of glucose, insulin, and appetite-related hormones.
They were also asked to rate their appetite and food preferences.
After consuming the biscuits, they were asked
to rate how full they felt over several hours. Glucose and insulin levels were
measured, as were ghrelin, glucagon-like peptide 1, and pancreatic polypeptide
– hormones associated with the consumption of food.
The results from the two sweetener types
showed no differences in appetite or endocrine responses compared to sugar, but
insulin levels measured over two hours after eating were reduced, as were blood
sugar levels.
SWEET project joint co-ordinator Professor
Anne Raben, from the University of Copenhagen, Denmark, said: “The findings
show that sweeteners are a helpful tool to reduce intake of added sugar without
leading to a compensatory increase in appetite or energy intake, thereby
supporting the usefulness of sweeteners for appetite, energy, and weight
management.”
Reference: “Acute and two-week effects of
neotame, stevia rebaudioside M and sucrose-sweetened biscuits on postprandial
appetite and endocrine response in adults with overweight/obesity—a randomised
crossover trial from the SWEET consortium” by Catherine Gibbons, Kristine
Beaulieu, Eva Almiron-Roig, Santiago Navas-Carretero, J. Alfredo Martínez,
Beverley O’Hara, Dominic O’Connor, Julie-Anne Nazare, Alain Le Bail, Cécile
Rannou, Charlotte Hardman, Moon Wilton, Louise Kjølbæk, Corey Scott, Hariklia
Moshoyiannis, Anne Raben, Joanne A. Harrold, Jason C.G. Halford and Graham
Finlayson, 28 March 2024, eBioMedicine.
DOI:
10.1016/j.ebiom.2024.105005