Experts highlight benefits of sweeteners for healthier diets, but call for clearer communication

20 Oct 2023 --- US-based researchers suggest that low- and no-calorie sweeteners (LNCS) play a critical role in healthier eating habits by reducing sugar and calorie intake. They conclude that LNCS are safe and that the most rigorous studies have repeatedly demonstrated that they aid in weight management.

Georgetown University’s Business for Impact released the conclusions in a whitepaper after reviewing well-designed randomized controlled trials, which they explain is the gold standard for assessing causal effects. 

The studies support that using LNCS instead of regular-calorie sweeteners leads to benefits in weight loss, lower body mass index (BMI) and reduced energy intake. Moreover, the authors note that LNCS do not impact blood glucose and insulin levels. 

“I hope the paper provides clarity on the efficacy and safety of these ingredients so that they can incorporate them into more foods and beverages to help reduce added sugar and calories,” Hank Cardello, author of the whitepaper and executive director of the Leadership Solutions for Health and Prosperity program at Georgetown University, tells Nutrition Insight. 

“The main goal was to examine the state of low-/no-calorie sweeteners to yield an objective, rigorous assessment of their efficacy, safety and potential role in helping consumers manage their weight.”

He calls for food companies to use more of these ingredients to reduce calories and added sugar and urges dieticians to help improve consumer communication. 

Reducing added sugar in diets 
The report asserts that increasing their adoption within permitted regulatory limits can contribute to the “potential reduction of seventy billion grams of added sugar and two hundred twenty-five billion calories in the diet.” This assessment is based on a 10% reduction in added sugar over the next five years. 

Increasing adoption of LNCS can contribute to reduction of added sugar and calories in diets.The authors urge government and public health officials to prioritize educating consumers and the media about the benefits of LNCS in mitigating the obesity crisis.

During a launch event for the report, Dr. Richard Mattes, professor of nutrition science at Purdue University, Indianna, US, explained that there is a role for LNCS in food products as substituting added sugar through a low-calorie sweetener has the “potential to reduce sugar intake, total energy intake and be efficacious.” 

“The evidence is that many, many people in the population would benefit from that reduction [in calories] and shows that the substitution of low-calorie sweeteners for sugars does result in beneficial effects on measures of adiposity, whether it’s percent body fat, BMI or waist circumference.” 

He adds that currently, in the US, people derive around 13% of dietary energy from added sugars, while the WHO direct guidelines set a target for 10%. Moreover, the 2020 Dietary Guidelines for Americans’ Advisory Committee established a 5-6% limit. 

Scientific support    
The report’s authors urge that government agencies such as the FDA and public health organizations must proactively communicate and clarify the benefits and safety of LNCS to consumers.

LNCS are among the most scrutinized ingredients in the food supply for safety, assessed by the FDA, the European Food Safety Authority and the FAO and WHO Joint Expert Committee on Food Additives (JECFA). 

Recently, JECFA reconfirmed the current acceptable daily intake of aspartame after the sweetener was classified as “possibly carcinogenic to humans” by the International Agency for Research on Cancer (IARC). 

The whitepaper notes that policymakers, the WHO and other non-profit organizations should use randomized control trials rather than observational studies to allow for more accurate decisions regarding the efficacy of LNCS. 

Earlier this year, the WHO stated that long-term use of non-sugar sweeteners does not have long-term benefits in weight management and may even have undesirable effects. However, several experts called the supporting evidence insufficient. 

Consumer confusion 
During the launch event, Jacqueline London, a registered dietician, author and media spokesperson on making better health more accessible, points toward issues in marketing and communication on the safety of LNCS as consumers express concerns about their safety and use. 

In the case of IARC’s classification of aspartame, London notes that although the evidence shows the sweetener is generally safe, some communication and language used were confusing for consumers. 

She adds: “What I think is fascinating about the discussion of low and no-calorie sweeteners versus added sugar is that the evidence is clear, and yet there continues to be so much misinformation and confusion online.” 

The number of food products containing LNCS is currently low, while over 70% of consumers want to limit sugars.“Sometimes there is a disconnect between what we know the evidence shows and the consumer’s practical application because there’s still so much confusion about nutrition information.” 

Regarding social media, London notes that the industry has to work with it. “We have to consider how we’re going to be louder, how we’re going to make more noise about actual evidence-based nutrition information that can be applied to people’s everyday real lives.”

Implications for industry and policy 
The whitepaper states that the number of food products containing LNCS is currently low.  

For products containing added sugar or LNCS, 87% only contain added sugar, while LNCS alone was found in only 8% of products. 

Meanwhile, sugar content is the item that consumers look for most frequently on food nutrition labels, while over 70% of consumers are looking to limit or avoid sugars. 

According to the whitepaper, consumers want simplicity on food labels. The authors urge food manufacturers to elevate the visibility of the four nutrients most considered by consumers — sugar content, calories, sodium and added sugar — to the exact prominent placement of calories on labels. 

The authors call for food manufacturers to align with government and public health officials to find ways to help augment the acceptance of LNCS to meet consumer concerns regarding their intake of added sugar. 

In the launch event, Mattes calls for a change in the approach to research on LNCS, where people “that are skeptical about the rule of low-calorie sweeteners in the food supply and those that find them useful to work together.” 

“We have been studying the safety and efficacy of these compounds for a very long time and don’t seem to be making progress on reaching consensus and a recommendation widely accepted on their role in a healthful diet.” 

London adds that a combined effort of public and private sectors is needed to determine what it means to have a health-promoting pattern of eating, which food products should be included and how ingredients such as LNCS can play a fundamental role in making meaningful change in consumer lives. 

By Jolanda van Hal