Monday, October 14, 2024

Moderation is the key to use of non-sugar sweeteners, say doctors

Using non-sugar sweeteners (NSS) like aspartame, stevia in moderation, may not cause harm to people with diabetes, health experts have said.

A recent study conducted by the Indian Council of Medical Research showed that India is home to 101 million diabetics and 136 million pre-diabetic people.

The NSS are generally marketed as aiding weight loss or maintenance of healthy weight, and are frequently recommended as a means of controlling blood glucose in individuals with diabetes.

Common NSS include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and its derivatives.

In May, the World Health Organisation (WHO) shared new guidelines on NSS recommending against using them to control body weight or to reduce the risk of noncommunicable diseases (NCDs) like diabetes.

But health experts say using these in moderation cannot do any harm.

According to Dr B Sesikeran, former Director ICMR-National Institute of Nutrition, Hyderabad, the risk of consuming sugar is much higher than the minimal risk associated with sweeteners, that too with limited data from India.

“It is recommended to reduce the carbohydrate – sugar intake. Substituting added sugar in tea/coffee with one to two tablets of NSS is just fine. What is not ok is excess consumption of products just because they don’t have sugar, but are loaded with calories,” said Dr V. Mohan, Chairman and Chief of Diabetology – Dr. Mohan’s Diabetes Specialties Centre, Chennai.

The WHO guidelines state that free sugar intake increases overall energy intake which may lead to unhealthy diets and raise the risk of these diseases.

“NSS or low calorie sweeteners provide a safe option for reducing sugar and calorie intake without sacrificing the sweet taste”, Dr Mohan said, adding that “moderation may be the key”.

A recent study, one of the largest randomised clinical studies on sweeteners done so far in India, by Dr. Mohan’s team on sucralose, presented at the American Diabetes Association, showed that “replacing added sugar in daily tea/coffee/ milk with sweeteners showed benefits and no harm”. It rather helped in reduction of body weight and fat.

However, some health experts recommend that artificial sweeteners must be taken “with a pinch of salt”.

“Artificial sweetener is not an answer for bringing down your blood sugar and once we know that they are at a higher risk one should be watchful before using these artificial sweeteners,” Dr Udgeath Dhir, Director and Head of Cardiothoracic and Vascular Surgery (CTVS), Fortis Memorial Research Institute, told IANS.

This comes as a recent study conducted by the ICMR showed that India is home to 101 million diabetics and 136 million pre-diabetic people. The findings, published in the journal The Lancet Diabetes and Endocrinology, also showed that India is home to a whopping 315 million people with hypertension.

Dr Dhir said that some of the artificial sweeteners like aspartame are more associated with the risk of stroke while sucrose and stevia are more associated with the risk of cardiovascular disease like heart attacks.

Artificial sweeteners have also been shown to induce some inflammation in the gut, which leads to an unhealthy vessel wall. Patients who are already diabetic and hypertensive are already at risk of having heart disease, which is further aggravated.

Experts also believe there is a need for our own country’s guidelines on NSS, especially as their consumption in India is increasing.

“For long-term health benefits, I recommend reducing free sugar intake in our diets and switching to natural alternative sources of sugar, such as fruits and dates, rather than increasing the consumption of NSS,” said Dr. Charu Dua, Chief Clinical Nutritionist, Amrita Hospital, Faridabad.

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