Exploring the use of natural sweeteners
as a weight management solution.
Tuesday 21st November, 15:00 -
15:20, Room 7.
Dr Emma Derbyshire, Independent
Nutrition Consultant, Nutritional
Insight Ltd.
Presentation outline:
o The UK weight situation.
o Unravelling the confusions.
o Sweeteners - The facts.
o Latest evidence.
o Conclusions.
The weight issue.
Obesity prevalence
increased from 15% in
1993 to 27% in 2015.
Prevalence of morbid obesity
has tripled since 1993.
National Statistics, 2017
Latest Statistics.
Prevalence of UK Overweight & Obesity.
♂ 68% ♀ 58%
National Statistics, 2017
Latest Statistics.
National Statistics, 2017
Highest obesity
levels are in the 55-
64 age group.
Sweeteners – the facts.
Low calorie
sweeteners (LCS)
Bulk sweeteners
Zero calories.
Only need to be used in
tiny amounts.
Intense sweet taste.
≈ 2.4 calories/g vs. 4
calories/g in sugar.
Used in larger amounts.
Provide structure to
products.
Sweet Confusions.
Harricharan M et al. (2015) Eur J Public Health 25(3): 472-6..
Survey of 75 dietitians from across
Europe revealed disagreement,
ambivalence & uncertainly about
sweetener use.
“I try to talk them out of
it”
“I do not use and have
not yet advised”
“I let them use their free
choice”
“I tell them if they want
to (use them), they can”
“I have no problems with
them at all”
Sweet Confusions.
o Sweeteners often accused of stimulating sweetness
which could impact on body weight control.
o Not been proven
o RCTs in children & adults suggest LCS reduce rather
than increase the intake of sugar-containing foods
thus facilitating rather than impairing weight loss.
Bellisle F (2015) Curr Obes Rep 4(1): 106-10.
Are they safe?
Classed as food ingredients.
Strictly regulated in Europe.
Have been allocated an E number.
Acceptable Daily Intakes (ADI) have been set for permitted sweeteners.
What’s in them?
Types: Contains: Equivalent in
sweetness:
Typical use:
Hermesetas
mini sweeteners
Saccharin &
Sucralose
1 tablet =
1 teaspoon of sugar.
In tea, coffee and other
hot drinks.
Hermesetas
granulated
Saccharin &
Cyclamate
1 cup sugar =
1 cup Hermesetas.
Cooking, baking, sprinkling
on cereals, fruits, desserts
& in hot drinks.
Hermesetas
liquid
Saccharin &
Cyclamate
10 drops (0.5 ml)
= 1 teaspoon of
sugar.
5ml = 50g sugar.
Cooking, baking,
cereals, fruits & drinks.
Hermesetas
SteviaSweet
Steviol
Glycosides
1 tablet =
1 small teaspoon of
sugar.
In tea, coffee and other
hot drinks.
Weight Management.
Low sugar diets.
Aim to eat breakfast every
day.
Avoid fad diets. Realistic changes.
Lose weight steadily 1-2lb
per week.
Sweeteners can help to
lower the sugar and energy
content of a diet.
http://www.nhs.uk/Livewell/loseweight/Pages/start-losing-weight.aspx
Energy Tally.
1 tsp sugar = 20
kcal.
1 LCS mini-tab =
0 kcal.
4 hot drinks with 1 tsp sugar
=
+80 kcal/day
+560 kcal/week
+2,240/month
= Potential to save on 26,880 kcal over a year!
Resultant weight loss of around 8lbs
(4kg) per year!.
o A review of 16 RCTs.
o Switching sugar for LCS
reduces our average daily
calorie intake by 10%.
o Statistically significant weight
loss of 0.2kg per week.
De La Hunty (2006) Nutrition Bulletin 31: 115-128.
The Science.
o Review also conducted a meta-analysis.
o Estimated a fall in BW by 3% over a 12 week period when
switching from sugar to LCS.
De La Hunty (2006)
Nutrition Bulletin
31: 115-128.
The Science.
Equivalent to 10kg over a
year for a 75kg person!
The Science.
Te Morenga (2012) BMJ 346:e7492.
Collated data from 30
trials & 38 cohorts.
Intakes of free sugars
or SSB were a
determinant of BW.
Changes in BF mediated by
changes in energy intakes –
swapping sugar for starchy
carbohydrates did not
affect BW…
The Science.
Miller PE & Perez V (2014) Am J Clin Nutr 100(3):765-77.
15 RCTs – sugar
replaced with LCS,
LCS modestly but significantly
reduced:
- Body weight (kg)
- BMI
- Weight circumference (cm)
Concluded: May be a useful
dietary tool to improve
compliance with weight
loss/management programmes.
Recent RCT.
Compared effects of
drinking water/NNS.
Drank 710ml of
each daily over 1
yr.
Water gp maintained 2.5kg
weight loss.
NNS gp maintained 6.2kg
weight loss.
Concluded: NNS may be an
effective weight loss/management
tool in the context of suitable
programmes. Peters et al. (2016) Obesity 24(2): 297-304.
Health & Wellbeing – The Facts:
o LCS in drinks instead of sugar could save more than
26,000 calories a year, helping with weight management.
o LCS may guard against caries and periodontitis. With
sugary drinks the pH value in the mouth drops for about
30 mins providing ideal conditions for plaque bacteria to
get to work.
o LCS may help people with diabetes to manage their
condition by helping to keep blood glucose levels stable.
Where we are now – an update..
Derbyshire EJ (2017)Complete Nutrition Volume 9, Number 3: 59-62.
Concluding points:
o Obesity continues to be an ongoing problem – also seeing
more ‘morbid obesity’.
o Alongside long term changes to diet and physical activity
LCS are a useful tool to support & improve compliance with
weight management programmes.
o Research suggests that LCS may mediate reductions in
energy intakes.
o Consistent messages are needed using the evidence-base
rather than media scare-mongering.
Related reading:
Derbyshire EJ (2017) The Re-emergence of Sweeteners & their Potential Role in Sugar Reduction. Complete Nutrition Volume 9, Number 3: 59-62.
Peters JC et al. (2016) The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial. Obesity (Silver Spring) 24(2):297-304.
Miller PE & Perez V (2014) Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr 100(3):765-77.
National Statistics (2017) Statistics on Obesity, Physical Activity and Diet, England 2017. NHS Digital.
Te Morenga L et al. (2012) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 346:e7492.
