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Sweeteners like sucralose can increase fat absorption and the risk of (pre)diabetes. Especially in people who are overweight. This is evident from a new study with (stem) cells from human adipose tissue.
Sweeteners or Sugar?
Before I make a lot of people angry again: I’m not saying that sweeteners are worse than sugar. Actually, I’m not saying anything myself, I’m just describing the conclusions of a study. But apparently, I need to clarify this first. The study by George Washington University does not conclude that sweeteners like sucralose are ‘worse’ than sugar [2]. That comparison is not made at all. It only looks at the effects of the sweetener itself on fat cells. And those effects don’t seem to be so positive, especially in people who are overweight. This does not mean that they should have drunk sugary soda instead. At most, you can conclude that they would be better off not drinking soda.
Sweeteners like sucralose and aspartame are popular because they can provide the same sweetness as sugar, but with much fewer or even no calories. So, if someone is used to regularly drinking coffee, tea, or soda with sugar, you should be able to save some calories here. However, it is quite difficult to judge whether sugar substitutes actually help with weight loss. In the article about aspartame, I cited studies that showed no added value in weight loss. Some studies even showed some negative effects such as increased BMI and increased appetite. In studies where weight loss was observed, this could be attributed to a modified diet and increased activity.
Do You Lose Weight by Replacing Sugar with Sweeteners?
But writing about the pros & cons of sweeteners remains difficult. Which sweeteners do you research? What effects are you researching? How do you research it and on whom? But even when it specifically comes to the effect of replacing sugar with sweeteners on weight, it remains complex. How do you take into account that the result is influenced by the researcher themselves (‘publication bias’), for example?
In 2014, a meta-analysis was conducted attempting to compare the outcomes of multiple randomized controlled trials (RCTs) and prospective cohort studies (PCS) [1]. Of the 522 studies they found on this topic, 24 remained that met all the criteria. Studies that, for example, lasted long enough, used clear dosages, and independently studied the sweeteners. Of those studies, there were 15 randomized controlled trials in which the researchers themselves controlled the intake of sweetener. The other 9 studies were prospective cohort studies in which the sweetener use of the participants was studied in their ‘natural environment’.
No Association or Small Association between Sweeteners and Lower Weight
The PCS showed that sweeteners had no association with weight and fat mass, but did have with an increased BMI. How BMI can rise without weight increasing, I don’t quite understand unless people became smaller because of the sweetener. But that will be due to my limited enthusiasm for statistics.
However, the RCTs did show a positive effect on body weight by replacing sugar with sweeteners. Because these studies are normally considered more valuable (than the PCS) due to their design, the makers of the meta-analysis therefore conclude that sweeteners can work.
If I were the manufacturer selling diet or light sodas, this would be the study I would cite. I think you can’t find much stronger evidence that sweeteners can help with weight loss.
But the effect according to the analysis is not very strong. On average, people lost 0.8 kg in the 15 studies. It is a pity that the average duration of the RCTs is not mentioned. These varied from 3 to 78 weeks.
So, if you want to lose 0.8 kg in 3 to 78 weeks, does it make sense to replace your sugar with sweeteners? Below the article, you’ll find the link to the study. I’d like to hear if you find a way to come to a conclusion that makes a greater impression at birthday parties.
Should Sweeteners be Used Primarily for Prevention?
However, there is a big ‘but’. All RCTs in the mentioned meta-analysis were conducted among obese people or people who are overweight. In the article about aspartame, I described studies that showed different effects on blood glucose and insulin between people who are overweight or have a normal weight. In the new study from Washington, we also see that people who are overweight can expect more adverse effects from sweeteners. The findings were presented on March 18 during the annual meeting of the Endocrine Society in Chicago [2].
So, are sweeteners mainly interesting for preventing overweight, but less suitable for curing it?
“Sweeteners Increase Fat Absorption in Fat Cells”
Researchers at George Washington University looked at the effect of the sweetener sucralose in two ways.
First, they took stem cells derived from human adipose tissue. These cells can still develop into adult fat cells, muscle cells, or bone cells. They then placed these cells for 12 days in a petri dish in a medium that stimulates fat production. In this way, they mimicked an environment that causes obesity. They then added an amount of sucralose that would correspond to the concentration in the blood when you drink four cans of diet soda daily. They then looked at gene expression and found that the expression of genes characteristic of fat production and inflammation was increased.
With this knowledge, they conducted a second experiment. Now they examined samples of adipose tissue obtained from the abdominal fat of 18 people who reported drinking diet sodas. These mainly contained sucralose and in small amounts aspartame and/or Acesulfame-K. Fourteen participants were obese, the remaining four had a normal weight.
Here, they found similar changes in gene expression in the same genes with increased activity of glucose transporters. These glucose transporters would, through increased uptake of glucose by the cell, lead to an increase in fat storage.
However, in the four participants with a normal weight, the effect on gene expression was not significant.
Conclusion
To be fair; I personally have little to do with sweeteners because I still drink a little coffee with my sugar. Given that I eat too few calories rather than too many, there is no reason for concern about weight. So, I can easily say that it’s better to learn to have less sugar in your diet than to replace your sugar with sweeteners.
But I can’t make it much more positive than that.
References
- Miller PE, Perez V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. The American Journal of Clinical Nutrition. 2014;100(3):765-777.
- endocrine.org
