Why is obesity defined as a disease - and when does it really endanger us?/Walla system
In May 2023, the World Health Organization (WHO) published a recommendation not to use artificial sweeteners for the prevention of obesity.
The organization explained that their recommendation is based on systematic reviews, which found no evidence that drinking diet drinks is beneficial for long-term weight loss.
We also noted that the consumption of artificial sweeteners may lead over time to significant damage to health, such as type 2 diabetes and cardiovascular diseases.
The announcement was received with astonishment, since only a year before, the same organization had published a very comprehensive research review that examined a variety of aspects related to sweeteners.
Among other things, it was noted that clinical studies found that consumption of artificial sweeteners is associated with slight weight loss and a decrease in body mass index (BMI).
A connection was also found between the artificial sweeteners and the reduction of the general consumption of calories, and the calories coming from sugars in particular.
This gap was especially noticeable when the use of sweeteners came at the expense of the consumption of sweetened beverages containing regular sugar.
Moreover, one of the largest and longest clinical studies conducted on the subject revealed that a weight loss diet that included the consumption of calorie-free sugary drinks was more beneficial than a similar diet in which the participants switched from drinking such drinks to consuming only water.
The artificial sweetener drinkers lost an average of six kilograms a year after the experiment, compared to about two and a half kilograms for the water drinkers.
The gap was even greater when the subjects who withdrew from the experiment before its end were subtracted from the data.
It is important to know that all the study participants used to regularly drink calorie-free sugary drinks before, so you have to be careful and not conclude that these drinks are indeed more effective for dieting than water for all people.
It is possible that the sweetened juice drinkers who were asked to switch to drinking water compensated for the loss of sweetness in their drinks by consuming more calories in their food.
However, the study does clearly illustrate that the sweeteners may help to achieve stable weight loss in those who are used to their taste, so the sweeping recommendation to avoid them may make it difficult for such people to maintain their weight loss over time.
The World Health Organization has published a recommendation not to use artificial sweeteners to prevent obesity.
So why did he say exactly the opposite a year ago?/ShutterStock
Beyond maintaining weight loss over time, there are studies that have examined the very success of losing weight during the diet.
In the clinical study on which the previous study was based, for example, it was found that almost two-thirds of the subjects in the sweetener group reduced at least five percent of their weight within three months, compared to 43 percent of those who drank the water.
The average weight loss was almost 6 kg in the sweetener group, compared to 4 kg in the water group.
A few months ago another study was published that directly examined the effect of sweeteners on weight loss.
The article summarized the first three months of a follow-up that should last two years, so its findings are not final.
The study involved 493 healthy subjects with overweight or obesity, who usually consume cold drinks at least three times a week, but less than two liters per day of sugary drinks.
During the diet, the participants were asked to consume daily at least two servings (330 ml) of a calorie-free sugary drink or of water, depending on the group to which they were randomly assigned. At the end of the first three months, the same average weight loss of almost six kilograms was recorded in both groups. A significant difference between those who used to consume artificially sweetened beverages and those who switched to consuming them following the study.
Consuming calorie-free sweetened beverages may also reduce sugar intake from other sources, compared to consuming only water. Furthermore, when people who are accustomed to drinking diet drinks seem to reduce their intake , they tend to consume more desserts and other sweet foods, and their diet may suffer as a result.
More in Walla!
The leading health fund presents: the services that will make your life easier
in collaboration with Kalit
When people who are used to drinking diet drinks reduce their consumption, they tend to consume more desserts and other/disposable sweet foods, Merav Liron Gilboa
There is no doubt that drinking water is good for health.
However, it turns out that the consumption of diet drinks also affects in a similar way the possibility of achieving a significant reduction in body weight, i.e. a reduction of at least five percent of the initial weight - and subsequently also an improvement in various health indicators.
A study found that it is possible to achieve such a decrease even if the transition to drinking calorie-free sugary drinks is not accompanied by any other change in diet.
It may be that the new recommendation is related to the type of research
A review published in 2022, based on a multitude of data and studies, found that there is indeed a connection between the consumption of diet drinks and artificial sweeteners and weight loss.
The effect was particularly pronounced under diets that were not restricted in calories and in people with obesity, and was also seen when the subjects switched from high-calorie sugary drinks to drinks with artificial sweeteners.
It seems that the new guidelines of the World Health Organization were mainly based on observational studies, which examine trends and relationships between variables in the population but cannot determine the direction of the relationship, i.e. what influenced what.
Newer, more rigorous interventional experimental studies generally find that calorie-free sugary drinks have a beneficial effect on body weight and other health measures, or at least do no harm.
Some of these studies are still ongoing, so we can expect more information about the long-term effects of consuming artificial sweeteners.
It is possible that the gap between the findings of these studies and the observational studies that preceded them is related to reverse causality.
It may be, for example, that people who consume a lot of calorie-free sugary drinks do not suffer health problems as a result, but quite the opposite - they may have switched to consuming drinks with sugar substitutes because of previous health problems, or due to weight gain.
However, there may also be a bias in the opposite direction.
First and foremost, it should be noted that people who volunteer to participate in interventional studies on nutrition are usually imbued with motivation for health change, so it is not clear to what extent they represent the general public.
For reference, their daily average of steps was over 8,000, which may reflect that they try to stay healthy more than most obese people.
Also, the studies lack detail regarding the persistence and responsiveness of the members of each group to the menu change, their total daily fluid intake and the other types of drinks they consumed.
Previous research reviews have found this information to be important as well.
One way or another, high-quality interventional studies find that, contrary to the warnings of the World Health Organization, consumption of calorie-free sugary drinks helps to lose weight over time, or at least does not harm efforts to lose weight.
Therefore, there is concern that a recommendation to avoid them may make it difficult for many overweight people to lose weight or maintain a constant weight.
If this is true, the recommendations will do more harm than good.
For more articles on the Davidson Institute for Science Education website - click here
More on the same topic:
artificial sweeteners
diet
Davidson Institute