Another strike against sugar:

http://www.medicalpost.com/mpcontent/article.jsp?content=20030108_160400_4960


January 14, 2003 Volume 39 Issue 02


 NUTRITION CLINIC:
Weighing in on diet drinks
 Do sugar substitutes reduce weight?

 By Khursheed Jeejeebhoy
 In western society the consumption of water as a beverage has been
superseded by the consumption of pop and other sweetened drinks. In addition,
sugar is a part of many foods such as yogurt, ice cream, marmalade, jams and
jellies, which are eaten as snacks between or as a part of meals. These
drinks and foods contribute significantly to daily energy intakes.
 In order to reduce energy intake, sugar substitutes are used to sweeten
drinks and snacks, and many overweight folk consume these drinks or snacks in
an effort to lose weight. Does it have the desired effect?
 There have been arguments for and against the use of sugar substitutes. An
argument against is based on the observation (in some studies) that energy
taken as sugar in drinks and snacks may be compensated by a reduction of
dietary energy intake from other sources. Furthermore, taking sugar
substitutes may result in the increased consumption of fat, which may
increase obesity.
 On the other hand, an argument for the use of artificial sweeteners is that
reducing sugar intake in the diet could restrict a major source of energy in
persons consuming junk foods.
 Several short-term studies comparing the effects of sugar and sugar
substitutes have given conflicting results. Some showed an increase in
appetite with artificial sweeteners and therefore suggested consuming these
sugar substitutes may enhance energy from non-sugar sources, namely fat, and
thus promote weight gain. On the other hand, clinical studies in obese
subjects comparing the effect of sugar versus carbohydrates that are slowly
absorbed (low glycemic index) showed that sugar, in contrast to
low-glycemic-index carbohydrates, stimulated energy intake and prevented
weight loss. However, this study cannot be extrapolated to prove sugar
substitutes would not have a similar effect.
 To resolve these uncertainties, a study lasting 10 weeks was performed.
Obese volunteers with a body mass index (BMI) of 27 kg/m2 to 28 kg/m2 were
randomized to drinking soft drinks and eating snacks containing either sugar
or a sugar substitute. The subjects were provided with a choice of several
different soft drinks. The caps and labels were altered to blind the subjects
to what they were consuming.
 In addition, they were provided with snacks of yogurt, ice cream, etc.,
containing sugar or artificial sweetener. Subjects in the trial were asked to
consume a minimum amount of these products so as to ensure that those
randomized to receive sugar took about 23% of total energy in the form of
sugar. Irrespective of the randomization, all subjects were allowed to eat
other foods in unlimited quantities.
 The sugar-fed group (SG) consumed about 3,500 kJ per day (about 870
kilocalories) in supplemental drinks and solids. The artificial sweetener
group (AG) consumed about 1,000 kJ per day (about 250 kilocalories). The
increase of energy intake as supplement in SG was associated with rise in
total energy intake, which continued to increase significantly over the 10
weeks.