Non-nutritive sweeteners and cardiometabolic health: Are sweeteners healthier than sugar?

Dr. Kimberly Fernandes, BHSc, MD, CCFP
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​The start of the New Year is a common time for everyone to take a closer look at their health. Those of us that hit the gym have probably noticed that it is busier than ever! While being physically active is important, our diets also play a large role in our health. Anecdotally, I have often had patients and friends opt for sweeteners in their food and drinks (aspartame, sucralose, stevioside, etc.) as they are calorie neutral compared to sugar. We like to think that this will help us lose weight (which comes with a host of health benefits!), but are non-nutritive sweeteners better for your health?

Will they actually help you lose weight?

A recent study was published in the Canadian Medical Association Journal in December 2017 on this very question. It combined the results of multiple studies that looked at the effect of non-nutritive sweeteners on body mass index, weight, obesity and other cardio metabolic outcomes such as the incidence of hypertension (high blood pressure) and diabetes (poorly controlled blood sugar). Interestingly, consumption of non-nutritive sweeteners was associated with weight gain, increase in waist circumference, and higher rates of obesity, hypertension, and diabetes. It should be noted however, that the study did not take into account family history, individual behaviours with respect to health and exercise, total daily calorie consumption, and other variables that would influence the outcome. Basically, people who choose non-nutritive sweeteners may have other health conditions or behaviours that predispose them to these negative outcomes. Further studies are needed to investigate these variables in relation to non-nutritive sweeteners and other health behaviours in the population.

At the end of the day, it seems that we cannot have our cake and eat it too. Although the above study shows that non-nutritive sweeteners are not helpful when it comes to weight loss and improved cardio metabolic health, we need to remember that there is more to our diet then just relative sugar consumption and that exercise is also an important factor. While non-nutritive sweeteners have been approved by Health Canada and are safe for consumption, it is important to remember that although the cake sweetened with stevia may not contain calories from glucose (sugar), it will contain calories from all the other ingredients. Opt for a smaller piece or replace it entirely with a much healthier fruit.

A healthy approach to weight loss is a plan that combines proper diet and regular exercise. Please speak with a healthcare professional if you have any questions or concerns about healthy weight loss.

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