Sucrose compared with artificial sweeteners - Weight Management - sugar substitutes prevent weight gain

Nutrition Research Newsletter, Nov, 2002 by A Raben, T Vasilaras, C Moller, A Astrup

Today, there is still no consensus on the usefulness of substituting artificial sweeteners for sucrose to obtain better weight control. Considering the worldwide increase in the prevalence of obesity, it seems important to clarify whether artificial sweeteners can help regulate body weight or not. It has been suggested that eliminating sucrose from the diet will increase the relative dietary fat content, which will then result in increased energy intake and body weight over the long term. The purpose of the present study was to monitor changes in ad libitum energy and macronutrient intakes, body weight, and body composition during 10 weeks of supplementation with either sucrose or artificial sweetener.

The study had a parallel design with two intervention groups. Subjects (n=41) were 20 to 50 years old, overweight, healthy, not dieting, and not pregnant or lactating. For 10 weeks, one group received supplemental drinks and foods containing sucrose while the other group received similar drinks and foods containing artificial sweeteners. Subjects were not informed about the true purpose of the study, but were all told that they would receive supplements containing artificial sweeteners, some of which would be newly developed.

Subjects were instructed to consume a specific minimum amount of either sucrose-sweetened or artificially sweetened drinks and foods every day during the 10-week intervention period. The beverages consisted of several soft drinks and flavored fruit juices. The solid food consisted of yogurt, marmalade, ice cream, and stewed fruits. To maintain the fat intake from the provided foods as similar as possible for the two groups, subjects in the sweetener group were given additional butter or corn oil every week. The amount of supplemental drinks and food to be consumed were calculated on the basis of a sucrose intake of ~2 g/kg body weight daily. In addition to the experimental diet, subjects were free to consume their own diet ad libitum until they felt pleasantly satisfied.

Energy intake from the sucrose supplements was about three times higher than that from the sweetener supplements. Significantly higher amounts of total carbohydrate and sucrose were consumed from the sucrose supplements, whereas significantly higher amounts of fat and protein were provided in the sweetener supplements. The intakes of fat and protein in absolute amounts and the total weight of foods and drinks did not differ significantly between the two groups. The average intake of sweetened drinks was ~1285 g/d. Records of ad libitum food intake (including supplements) showed that total energy intake increased significantly in the sucrose group but remained consistent in the sweetener group compared with habitual energy intake. The energy density of the diet was significantly lower in the sweetener group than in the sucrose group. Body weight and fat mass (FM) increased in the sucrose group and decreased in the sweetener group during the 10-week intervention. For the sucrose group, the total weight gain at week 10 averaged 1.6 kg, of which 1.3 kg was a gain in FM. For the sweetener group, the total weight loss at week 10 averaged 1.0 kg, of which 0.7 kg was fat-free mass (FFM) and 0.3 kg was FM. After 10 weeks of supplementation, systolic and diastolic blood pressure had increased in the sucrose group but decreased in the sweetener group. The seven-day food diaries completed three times during the intervention showed no significant differences between the two groups' ratings of hunger, fullness, palatability of the food, and general well being.

This is the first long-term intervention study that has compared the effects of artificial sweeteners and sucrose, without any energy restriction, on energy intake and body weight in overweight subjects. The researchers found that energy intake, body weight, FM, and blood pressure increased after 10 weeks of supplementation with sucrose, whereas a decrease or no change in these variables was seen with supplementation with artificial sweeteners. The macronutrient composition of the diet in the sucrose group matched the dietary recommendations for total fat and carbohydrate more closely than that in the sweetener group. A weight gain in the sucrose group and a weight loss in the sweetener group were therefore not expected, to the contrary, the researchers expected a weight gain in the sweetener group and a weight loss in the sucrose group.

One likely reason for the increases in energy intake and body weight in the sucrose group is the fact that ~70% of the sucrose came from fluids. Energy obtained from fluids has been found to be less satisfying than energy from solid foods. Therefore, overweight individuals may want to consider choosing beverages containing artificial sweeteners rather than sucrose to prevent weight gain.

A Raben, T Vasilaras, C Moiler, A Astrup. Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects. Am J Clin Nutr 76(4):721729 (October 2002) [Correspondence: A Raben. Research Dept of Human Nutrition, Centre for Advanced Food Studies, The Royal Veterinary & Agricultural University, 30 Roligheclsvej, DK-1958 Frederiksberg C, Denmark. E-mail: ar@kvl.dk]