Weight loss tips: Do artificial sweeteners like Stevia work?

This story has been updated with comment from the Atlanta-based Calorie Control Council.

Of the 41 percent of American adults and 25 percent of U.S. children who consume artificial sweeteners, most consume them at least once a day, according to a study published earlier this year.

And the Academy of Nutrition and Dietetics has said artificial sweeteners can be used to manage weight or blood sugar by limiting energy intake.

But if you're looking for a sweet secret solution to your weight loss woes, new research warns against falling into the growing trap of artificial sweeteners or low-calorie sugar substitutes for weight management.

In fact, according to the new study, published Monday in the Canadian Medical Association Journal (CMAJ), artificial sweeteners (like stevia, aspartame or sucralose) may actually lead to heart disease, higher risk of obesity, diabetes, high blood pressure and, yes, long-term weight gain.

To determine whether or not artificial sweeteners are associated with the negative long-term effects previous studies have cited, researchers from the University of Manitoba’s George and Fay Yee Centre for Healthcare Innovation examined more than 11,000 studies on both artificial and natural sweeteners, performed a meta-analysis of 37 studies and then divided them into randomized controlled trials (seven) and longitudinal studies (30).

In total, scientists followed more than 400,000 people for an average of 10 years, with seven of those studies (the randomized controlled trials) involving 1,003 people for an average of six months.

Here’s what the researchers found:

In the short seven randomized control trials of 1,003 people, those who consumed artificial sweeteners did not lose or gain more weight or see a decrease in body mass index (BMI) or in waist conference than the controls in that group.
The 30 longer, observational studies showed people who consumed those low-calorie sweeteners were actually more likely to face increased risk of type 2 diabetes (14 percent), obesity, heart disease, high blood pressure and other related cardiovascular issues (32 percent higher risk for the heaviest participants compared to the lightest).
The longer observational studies also pointed toward an increase in BMI and waist circumference due to consumption of artificial sweeteners.

“Despite the fact that millions of individuals routinely consume artificial sweeteners, relatively few patients have been included in clinical trials of these products. We found that data from clinical trials do not clearly support the intended benefits of artificial sweeteners for weight management,” Ryan Zarychanski, assistant professor at University of Manitoba and author of the study, said.

But there are some limitations to the study. For example, the way people consumed artificial sweeteners in the clinical trials may not exactly mimic how people would actually consume them.

Most of those involved in the randomized trials were on a weight-loss program, but the larger population consuming low-calorie sweeteners may not be doing so to lose weight.

Additionally, the Atlanta-based Calorie Control Council said the link between weight gain and heart disease with low-calorie sweeteners "paints with too broad a brush," noting that "obesity is a complex condition" with multiple facets and can't be generalized.

In a statement, the council added the possibility of publication bias.

“Low-calorie sweeteners are a tool to help provide sweet taste without calories to address one aspect of calorie intake. Taste preferences are an important component of dietary habits but successful weight management requires a well-rounded strategy,” Robert Rankin, president of the Calorie Control Council, said.

“Individualized strategies are critical for successful body weight management and should address not only dietary preferences, but also physical activity, and medical considerations to help each person achieve their health goals, including those related to chronic diseases such as cardiovascular disease, diabetes, obesity and hypertension.”

Meghan Azad, lead author of the study and an assistant professor, cautioned against the consumption of artificial sweeteners until more research is done to identify long-term health effects.

Azad and her colleagues are currently researching how such sweeteners consumed by pregnant women may impact their baby's weight, metabolism and gut bacteria, according to Medical News Today.

In the meantime, instead of using artificial sweeteners as a healthy substitute for sugar, try to decrease your sweet tooth altogether by consuming fruit-infused water, black coffee or plain yogurt with fruit, Azad told NPR.

Read the full study at CMAJ.ca.

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