We’ve spent the last 70 or so years searching for a sweetener that had no calories, no impact on blood sugar, no other ill effects—effectively, no consequences.
The World Health Organization declares that, for most people, non-nutritive sweeteners (including natural ones like stevia) have more risks than benefits.
Nutrition Diva is hosted by Monica Reinagel. A transcript is available at Simplecast.
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Hello and welcome to the Nutrition Diva podcast, a show where I try to put the latest nutrition headlines and research into perspective for you, so that you can make good decisions about what to eat. I also love to answer listener questions.
And in fact, before I get into the main topic today, which is the World Health Organization’s recent recommendation on low-calorie sweeteners, I want to answer a related question from Lin.
“There is lots of material everywhere saying that sugar is bad,” she wrote, “and that if you eliminate sugar from your diet, lots of good things happen. The only added sugar in my diet was the sugar in my morning tea. I cut this out entirely for 3 months to see the benefits. But the only thing I felt during those three months was a little extra tired. Now I’m wondering whether sugar is really all that bad.”
There are a lot of people out there saying that sugar is toxic and that you need to cut sugar out of your diet entirely. But there’s a popular saying in toxicology: the dose makes the poison. If you’re consuming 30 or 40% of your daily calories in the form of added sugars (which, sad to say, is not that unusual), eliminating sugar from your diet for three months could make a huge difference in how you feel and other markers of health.
But you know what? You’d probably get the same pay-off by cutting your sugar consumption down to 5% of your daily calories. And cutting it from 5% to 0%, as Lin did, probably wouldn’t make much of a difference at all.
Sugar is not toxic. However, immoderate consumption of added sugars can definitely lead to problems, which is why there is a multi-billion dollar market for sugar substitutes. But, as you may have seen in the headlines a couple of weeks ago, the World Health Organization just issued a controversial new recommendation on zero-calorie sweeteners.
The WHO continues to endorse a role for non-sugar sweeteners for people with diabetes. However, for everyone else, the WHO is now recommending against the use of non-sugar sweeteners—especially for the purpose of weight management.
Their review of the available evidence concludes that artificial sweeteners do not have any positive benefits in terms of reducing overweight or obesity, and may, in fact, do some harm.
The WHO concedes that the evidence is not air-tight. A lot of it is observational (correlation is not causation) and there are lots of confounding variables. So, they characterized this guidance as “conditional,” meaning that individual countries need to weigh the pros and cons in view of their own populations’ health risks and dietary patterns.
The other big surprise was that the WHO included both synthetic non-calorie sweeteners like Equal and Splenda, as well as sweeteners like stevia, which we tend to think of as more natural and, therefore, better for us.
We’ve spent the last 70 or so years searching for a sweetener that had no calories, no impact on blood sugar, no other ill effects—effectively, no consequences. One that would allow us to eat and drink as much sweet stuff as we wanted without worrying.
In the beginning, saccharine was the zero-cal sweetener of choice. When saccharine fell from favor (due, in part, to unfounded cancer concerns), newer artificial sweeteners like sucralose and aspartame more than took up the slack—helped along by the low-carb diet craze.
When those next-generation sweeteners started to be linked (inconsistently) to things like increased appetite and risk of Type 2 diabetes, or microbiome disruption, consumers flocked to erythritol, stevia, and monk fruit.
But these more natural sweeteners have limitations as well. Stevia can have a bitter aftertaste. Sugar alcohols like erythritol can have a weird mouthfeel or unwelcome laxative effects. And replacing sugar with any of these high-intensity, non-caloric sweeteners can affect the texture, moisture, and volume of processed foods and even shorten their shelf-life. What’s worse, earlier this year, erythritol was linked (inconclusively) to an increased risk of blood clots.
Not to worry, though. There are more non-caloric sweeteners in the pipeline! Food chemists are working to find new ways to mask the off-flavors, compensate for the effects on texture and volume, and even alter the shape of the molecules in foods in order to trick the taste buds into thinking that something tastes sweeter than it actually does. After all, there’s a lot at stake. The vast majority of manufactured juices, drinks, snack bars, yogurts, cereals, baked goods, and condiments contain added sugar or sweeteners. These products generate upwards of 50 billion dollars a year.
Consumers want this magic solution, too. Sugar tastes good! We’re biologically programmed to love it. But we don’t want to gain weight or develop diabetes. We put humans on the moon, for crying out loud. Surely, in this era of driverless cars and drone-delivered groceries, it should be possible to find a way to have our cake and eat it too.
Actually, I don’t think it is. Even if we could somehow invent or discover a compound that offered all the sweetness with none of the downsides, I don’t think it would be a positive development for our nutrition or health.
And, apparently, neither does the World Health Organization. In their new guidance, the WHO makes the radical suggestion that instead of searching for the perfect consequence-free sweetener, “people should reduce the sweetness of the diet altogether, starting early in life, to improve their health."
To be clear, I don’t actually think that sweetness, in and of itself, is the problem. After all, the WHO has no problem with whole foods that contain naturally-occurring sugars, such as fruit.
By contrast, a lot of the foods that we add sweeteners to, such as beverages, snacks, candy, and desserts, are foods that don’t add much nutrition to our diets. Finding a magical solution that would add that sweetness without adding calories or affecting blood sugar might make those foods less damaging. But it wouldn’t make them more nutritious. Instead of consuming 200 empty calories, maybe you’d only be consuming 50 empty calories—but you still wouldn’t have much to show for it.
You’d be so much better off eating 50 calories worth of fresh fruit or vegetables or some other nutritious food. And if we weren’t constantly bathing our taste buds in sugar and artificial sweeteners, those nutritious foods might taste a whole lot better to us.
When we eat a lot of sweetened foods, it decreases our ability to enjoy the subtler flavors of unsweetened foods like fruits, vegetables, and other healthy options. This is something I hear over and over again from people that I work with in programs such as the 30 Day Nutrition Upgrade—which helps people reduce their intake of both sugar and noncaloric sweeteners.
When they cut back on their consumption of sweetened foods, they almost invariably report a new appreciation for how great something as simple as a really good apple can taste. They are shocked to realize how much flavor and natural sweetness raw red peppers or roasted root vegetables contain. Many never enjoyed eating vegetables because they literally couldn’t taste them until they gave their taste buds a break from all the sugar. This is especially true for people who use a lot of artificial sweeteners.
Even before the WHO’s latest bombshell, I have argued that we need to stop searching for the perfect sweetener—the one that lets us eat as much sweet stuff as we want without worrying about the consequences. As long as you’re consuming them in moderate amounts, the sweeteners we’ve already got don’t pose any substantial risks.
Moderate consumption of added sugars is generally defined as no more than 25 grams of sugar per day, or the equivalent amount of noncaloric sweetener. If you’re using sugar or a noncaloric product that measures like sugar, that’s 6 teaspoons a day. If you’re using packets, it’s about 3 packets a day.
For packaged foods, the new Nutrition Facts label shows you the amount of added sugars and/or sugar alcohols, which is helpful. Unfortunately, with other noncaloric sweeteners like Splenda or stevia, you have to take your best guess as to how much is in there. I often check the Nutrition Facts for a comparable item that’s sweetened with sugar to use as a guide.
I don’t think it’s necessary to completely eliminate added sugar or artificial sweeteners from our diets. Both can fit into a healthy diet, provided that they are consumed moderately. When I drink soda, I usually choose diet soda—and don’t think twice about it. I’d rather not have the concentrated dose of sugar (or calories) that I’d get from regular soda, and I don’t mind the taste. That said, I can count my annual soda consumption on both hands. OK, maybe both hands and both feet, but it’s not a daily or even weekly habit. I mostly drink sparkling water or unsweetened coffee or tea.
We also want to make sure that sweetened or artificially sweetened foods aren’t displacing healthy foods from our diets. It all comes down to how you are using them. If I’m traveling and know that I won’t be able to get a meal, I will tuck a protein bar into my bag—and the one that I like is sweetened with erythritol. (Better that than a candy bar!) But I’m not eating a protein bar every day for lunch. Usually, I’m eating a big salad, or leftovers from the night before.
I hope that helps you feel a little more confident about managing the role of sugar or non-caloric sweeteners in your diet.
If you’d like to learn more about what the 30 Day Nutrition Upgrade is all about, there’s more info at https://nutritionovereasy.com/upgrade. If you are a health coach or wellness program manager and you’d like to find out about doing the Upgrade program with your community, workplace, or organization, I’d love to talk with you We are currently scheduling for the Fall of 2023 and into 2024. Reach out to me at nutrition@quickanddirtytips.com. That’s the same email that you can use to send comments about today’s episode or questions you’d like me to address in future episodes.