Caloric Sweeteners and Health: What is the Truth?

June 16, 2017–The following presentation is from the “2016 Sweetener Systems Conference Summary,” sponsored by Orochem. All presentations and/or adapted versions made available by the speakers are posted on Global Food Forums Inc’s store pagePlease consider attending our 2017 Sweetener Systems Conference, November 7th, at the Westin Hotel, Lombard, Ill., USA. 

Panel: Sweeteners and Nutrition: New Developments & Reality Checks
Panel #1: Caloric Sweeteners and Health: What is the Truth?

Obesity results from a failure to achieve energy balance. It is unclear whether susceptible individuals become obese because their physiological mechanisms of food intake control are compromised, or whether these same control mechanisms are overridden and compromised by environmental factors (e.g., sedentary lifestyles). [For larger version of chart, click on image.]

G. Harvey Anderson, Ph.D., University of Toronto Professor of Nutritional Science and Physiology, got straight to the point: “There is insufficient evidence upon which to make public policy regarding caloric sweeteners consumption—but the horse has left the barn—and we must deal with the consequences.”

Caloric sweeteners are under siege. Very recently, the U.S. National Science Foundation’s Institute of Medicine (IOM) declared there was insufficient evidence upon which to set upper limits to caloric sweetener consumption, but it nonetheless recommended that they constitute no more than 25% of total calories. This recommendation was based not upon health issue mitigation, but on preventing the displacement of foods that contribute essential nutrients to the diet.

In contrast, the 2015 Dietary Guidelines Advisory Committee declared that caloric sugar consumption should be limited to no more than 10% of dietary calories, due to “negative impacts” on type II diabetes, cardiovascular health and dental caries. The WHO also supported a policy of limiting caloric sweetener consumption to no more than 10% of the diet and, perhaps, to less than 5% of the diet. “And…there is now talk of imposing world-wide sugar consumption taxes,” said Anderson.

“Obesity is the public health concern that started this campaign,” explained Anderson. “We know that obesity comes from excess food intake, meaning an energy imbalance, but it remains unclear whether obesity develops from physiological systems that
make us susceptible to environmental causes, such as sedentary lifestyles, or from environmental causes alone.”

Therefore, caution is warranted.

With respect to the U.S. Dietary Guidelines, for example, “We know that many of the guidelines have proven themselves wrong, over time. We keep shifting around claims, such as fat causes obesity or cardiovascular disease, only to have them later proven wrong.” This has hurt the credibility of nutritional policy-making.

Sweeteners are a normal part of life, and humans are exposed to sweet tastes from in utero to death. There are also many benefits to sweet foods. They tend to be safe; easy to store; easy to transport; require no preparation; and are relatively inexpensive. In addition, caloric sweeteners can play important roles in rendering highly nutritional products palatable, such as bitter fruit (e.g., cranberry) or high-fiber cereal products (e.g., cereal or granola bars).

So, given all these considerations, what does the evidence say? Anderson referenced the work of his University of Toronto colleague, John Sievenpiper, MD, Ph.D., FRCPC. Sievenpiper undertook a systematic review of all published studies linking sweetener consumption to health concerns, in order to critically assess whether caloric sweeteners cause diabetes and obesity (as per the U.S. 2015 Dietary Guidelines Advisory Committee). He determined that no studies had been able to statistically link caloric sweetener consumption levels to either obesity or diabetes.

Such absences of associations were found for both sucrose and fructose. Certainly, no documented associations were found that could justify public policy-making on caloric sweetener consumption, summarized Anderson.

Sievenpiper also referenced studies that linked the consumption of specific foods to weight gain. Here, a weak but statistically significant association was found between weight gain and sugarsweetened beverage consumption. But, similar gains were also found for French fries, potato chips, nuts, potatoes and, even, yogurt. In sum, the studies appeared only to prove that increased energy consumption leads to weight gain. “If you eat more, you get fatter,” summarized Anderson.

Effects of sugar-sweetened beverage intake on obesity were also more difficult to categorize. Many food intake studies rely upon consumer recall. In general, people can recall their frequency of consumption much better than their quantity of consumption, said Anderson. It also can’t be ascertained whether sugar-sweetened beverage consumption levels translate directly into weight gain or serve as markers for other lifestyle factors that relate to obesity (e.g., sedentary lifestyles).

Put together, these results are inconclusive, maintained Anderson, and there remains far more work to be done before public policy-makers can credibly recommend optimal levels of caloric sweetener consumption.

“Caloric Sweeteners and Health: What is the Truth?” G. Harvey Anderson, Ph.D., University of Toronto Professor of Nutritional Science and Physiology, Harvey.anderson@utoronto.ca

 

Posted on:June 15, 2017

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