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  #1   ^
Old Tue, May-14-19, 00:50
Demi's Avatar
Demi Demi is offline
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Default Canada’s new dietary advice is to avoid sugar substitutes. Will U.S. follow suit?

Quote:
From the Washington Post
May 13, 2019

Canada’s new dietary advice is to avoid sugar substitutes. Will U.S. follow suit?

As a Canadian dietitian who works and lives in the United States, I like to keep up with health policy in both countries. So, I was quite interested to see that Health Canada, the governmental agency responsible for public health, is charting a new course when it comes to dietary advice, particularly in the area of sugar substitutes. It’s a track that sharply diverges from the one the United States is on.

In a significant departure from the past as well as from the U.S. approach, Canada’s new food and dietary guidelines, released this year, say zero-calorie or low-calorie sugar substitutes are neither necessary nor helpful. “Sugar substitutes do not need to be consumed to reduce the intake of free sugars,” the guidelines say, adding that, because “there are no well-established health benefits associated with the intake of sweeteners, nutritious foods and beverages that are unsweetened should be promoted instead.”

In contrast, the 2015-2020 Dietary Guidelines for Americans (DGAs), issued by the U.S. Agriculture and Health and Human Services departments, suggest sugar substitutes may have a place in helping people consume fewer calories, at least in the short term, though “questions remain about their effectiveness as a long-term weight management strategy.” The guidelines neither encourage nor discourage their usage.

The differences may seem subtle, but dietary guidelines in each country are used to shape what is served at public institutions such as schools and are what many health-care professionals base their recommendations on. Language matters. But before we try to explain the difference in advice, let’s have a quick primer on sugar substitutes.

What are sugar substitutes?

Sugar substitutes include many categories, such as high-intensity sweeteners that are at least 100 times as sweet as sugar. They can be “artificial,” such as aspartame and saccharin, or “natural,” such as stevia and monk fruit. They can contain a negligible number of calories or be classified as low-calorie sweeteners, such as sugar alcohols.

In much of the research and in most policy documents, sugar substitutes are often discussed as a single category rather than a heterogenous group of compounds. This makes it challenging to know whether certain types are preferable.

Most concern seems to focus on artificial sweeteners. Six are approved by the U.S. Food and Drug Administration as ingredients in foods and drinks and as table sweeteners people can add themselves. The most ubiquitous is aspartame (sold as brand names NutraSweet or Equal), which is found in more than 6,000 food products, followed by sucralose (Splenda), acesulfame K (Sweet One or Sunett) and saccharin (Sweet’N Low or Sugar Twin), and the lesser-known neotame and advantame. You’ll find artificial sweeteners in a range of foods and drinks, including light yogurt, diet sodas, protein bars and chewing gum as well as baked goods and frozen desserts. Carbonated drinks are the top source of artificial sweeteners in the American diet.

What does the research say?

Research suggests that stevia and monk fruit, the natural sugar substitutes, are safe for human consumption, though it’s not clear whether they lead to weight loss. There has been conflicting research, however, about the safety of artificial sweeteners. Some studies have suggested that artificial sweeteners could increase the risk of Type 2 diabetes, heart disease, kidney disease and cancer, and may have a negative influence on the microbiome and mental health.

For example, research based on data from 37,716 men from the Health Professional’s Follow-up study and 80,647 women from the Nurses’ Health study published in Circulation last month found that consuming artificially sweetened beverages is associated with a greater risk of death as well as death from heart disease. The risk was found specifically for women consuming four or more servings of artificially sweetened beverages a day. The authors say this finding needs to be confirmed by future research, but it does raise questions about whether artificial sweeteners are necessary — or should be recommended at all.

[As zero-calorie natural sweeteners such as stevia surge in popularity, here’s what you need to know]

As for the U.S. contention that sugar substitutes might help people cut back on calories and sugar to improve their health or lose weight — that seems doubtful.

A review by the nonprofit research foundation Cochrane, conducted for the World Health Organization, examined 56 studies into the effects of sugar substitutes on health. It found that there is no evidence sugar substitutes provide any benefit — and may even have some risks.

An analysis of U.S. dietary intake from 2003 to 2004 shows that people tend to add artificial sweeteners to their diets rather than replacing sugary foods and beverages with them.

The same seems to be true for children. This month, research published in the Pediatric Obesity journal revealed that in U.S. children, drinking artificially sweetened beverages is associated with consuming more calories and sugar.

Why the difference in advice?

U.S. and Canadian health officials are looking at the same research and have populations with similar health issues. So why the difference in guidelines regarding sugar substitutes?

The new Canadian approach seems to be that if a food or beverage doesn’t have a demonstrated health benefit, it doesn’t belong in your diet. Their 2019 guidelines suggest that people’s taste buds will adapt to less-sweet tastes when they reduce their consumption of sweetened foods and beverages — and using high-intensity sweeteners delays that process.

This is a marked change from Canada’s last dietary guidelines, released in 2007, which advised the general population to consume sugar substitutes in moderation and to cut back on them if they noticed any digestive symptoms such as gas and bloating.

The new Canadian recommendations may seem tougher, but I see them as being clearer and something for people to aspire to. (Canada’s latest Food Guide takes a stand on several other divisive nutrition issues. For example, it promotes whole grains as the only grains to put on your plate, while the U.S. guideline is that at least half of your grains be whole grains.) The U.S. view seems to be focused on encouraging health behaviors that are thought to be more achievable.

Alice H. Lichtenstein, a professor of nutrition science and policy at Tufts University and member of the 2015-2020 DGA committee, seems skeptical of an all-or-nothing approach to sugar substitutes. She expressed her stance in an editorial in Circulation, responding to the study that said consuming artificially sweetened beverages is associated with a greater risk of death. “To a certain extent, as a community, we can take the high road about beverage recommendations: Drink water (or flavored water) in place of [sugar-sweetened beverages]. However, continuing this simple approach would be disingenuous because we know that it has not worked well in the past and there is little reason to expect that it will work well in the future.”
Over email, Lichtenstein said: “For some people, I suspect the use of high-intensity sweeteners is helpful in avoiding excess energy intake. For others, it might not be helpful.”

A 2018 advisory from the American Heart Association also takes a more middle-ground approach to sugar substitutes than Canada’s, stating that they can play a role in helping people to reduce the amount of sugar-sweetened beverages they’re drinking. The advisory also says beverages containing low-calorie sweeteners could be especially useful for people who are used to sweetness and find water unappealing at first.

I turned for insight to Marion Nestle, a renowned American author and professor emerita of nutrition, food studies and public health at New York University. She said over email: “What we know about artificial sweeteners is for sure that they are not necessary. On a population basis, they do not seem to help people lose weight, but they may help some individuals. So, both approaches are valid. Personally, I follow a food rule not to eat anything artificial, so these sweeteners are off my dietary radar.”

When I asked what she thought was the reasoning behind the differing approaches to sugar substitutes taken by the U.S. and Canadian governments, she responded, “One can only speculate that the lobbying for artificial sweeteners worked better in the U.S. than in Canada.”

Whatever the reason for the disparate approaches, I found one hint that the viewpoint in the United States might be changing. Last month, the American Diabetes Association released a Nutrition Consensus Report that recommends that water replace sugar-sweetened beverages. If sugar substitutes are used, the report says, people should receive nutrition counseling to help them avoid replacing the calories and carbohydrates with food.

The authors also note that any proposed advantages to sugar substitutes haven’t been proven, and that there could be potential adverse effects, such as impacts on hunger, confusion around calorie intake and the possibility that use of sugar substitutes could be replacing healthier options.
Could the United States be slowly shifting its guidance around sugar substitutes, including artificial sweeteners? The approaching 2020-2025 DGAs will let us know.



Christy Brissette is a registered dietitian, nutrition writer, TV contributor and president of 80TwentyNutrition.com.




https://www.washingtonpost.com/life...m=.693554b9f0ab
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  #2   ^
Old Tue, May-14-19, 05:33
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DaisyDawn DaisyDawn is offline
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Interesting. Artificial sweeteners is one of the reasons why I've been as successful as I have been, its prevented me from going off plan many, many times. I've met all my health and weight goals while using a.s. several times a day, going on 7 years now. So for me personally, there's definitely benefits to including a.s. into my diet.

Last edited by DaisyDawn : Tue, May-14-19 at 05:42.
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Old Tue, May-14-19, 06:36
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bluesinger bluesinger is offline
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During my 47 years of LC eating, I've never stopped using AS. I import my favorite (Sugar Twin with cyclamates) from Canada. I first started using cyclamates in Germany all those years ago. The USA is one of the few countries where they are illegal, hence the import necessity.

No AS would have made it virtually impossible for me to stick to LC eating. Culturally, as a child I drank thick, sweet tea so I guess I'm imprinted. My pantry is filled with my attempts to use natural LC sweeteners, but yuck.

At 74, there are few LC foods left which I can consume, having developed intolerances over the years. Taking away my AS might push me over the edge. Hope that doesn't happen.
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Old Tue, May-14-19, 06:40
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DaisyDawn DaisyDawn is offline
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As a side-note, I recently watched this video and thought it was pretty interesting, I use sucralose (splenda), so I was pleased to see that it was one of the sweeteners they tested.

https://www.youtube.com/watch?v=CYfqvTZWilw&t=8s
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Old Tue, May-14-19, 20:05
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Dodger Dodger is offline
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I've managed to become mostly sugar-substitute free. I do use some stevia occasionally.
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Old Wed, May-15-19, 04:44
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DaisyDawn DaisyDawn is offline
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Quote:
Originally Posted by Dodger
I've managed to become mostly sugar-substitute free. I do use some stevia occasionally.


Have you seen any benefits from cutting it out?
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  #7   ^
Old Wed, May-15-19, 19:33
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Dodger Dodger is offline
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Quote:
Originally Posted by DaisyDawn
Have you seen any benefits from cutting it out?

Nothing other than I found that I don't really miss the sweet taste of things.
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  #8   ^
Old Thu, May-16-19, 04:47
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DaisyDawn DaisyDawn is offline
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Quote:
Originally Posted by Dodger
Nothing other than I found that I don't really miss the sweet taste of things.


I have noticed that since I've cut way back on diet soda over the past few weeks and have replaced it with unsweetened flavored sparkling water, that I've been naturally cutting back on the splenda in my coffee, I'm probably at half of what I was using. I can see myself at some time just cutting it out, but we'll see
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  #9   ^
Old Thu, May-16-19, 08:26
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Calianna Calianna is online now
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I was such as sugar addict that I think if I'd tried to go LC without any artificial sweeteners at all to ease the way, I'd still be on the sugar roller coaster. I was never much into sodas to begin with - candy and cookies were my preferred sugar delivery substances.

Currently, I use stevia, mostly because while I'm sure I could get used to unsweetened greek yogurt, I really like vanilla and chocolate yogurt. When I mix some vanilla or unsweetened cocoa powder into my plain greek yogurt, adding a little stevia brings out the vanilla and chocolate flavors. Doing so hasn't sparked much of any kind of desire for any other sweets - well, once every few months, I'll make a LC mug cake or something along those lines, which I sweeten with stevia, but that's about as far as the craving for sweet ever goes.
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Old Thu, May-16-19, 09:24
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GRB5111 GRB5111 is offline
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Quote:
Originally Posted by Dodger
I've managed to become mostly sugar-substitute free. I do use some stevia occasionally.

Same here. Rarely use stevia, as I too no longer miss the taste of sweet things.
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  #11   ^
Old Fri, May-17-19, 01:14
RonnieScot RonnieScot is offline
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I think they are a good tool for tricking body during weight loss. Helps to not be deprived of everything in one hit! but ideally to be phased out for long term. I try to only eat healthy food, actual food now. So for me
I don’t think they have a place in regular kids foods: I don’t want my kids having anything sweeter than an apple or other whole fruit. Processing food, even if technically LC into other things is a slippery slope. Things blended, puréed and baked like almond flour, sweeteners, butter and cream... just going to encourage over consumption. So, I think best largely avoided. Same with drinks: my toddler loves my black coffee and 100% cocoa, it’s bitter as anything, I think because he’s never had sweeter stuff or anything baked.
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Old Fri, May-17-19, 06:42
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teaser teaser is online now
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I enjoy artificial sweeteners and haven't seen any benefit when I've cut them out. So I use them. I don't think an official stance against them is any better than an official stance for them, the research is sort of divided. Don't need it, so go with prudence and don't use it, just in case it's bad? Again, I enjoy the sweetness, and I don't consider enjoying food/taste a trivial benefit. Food is not just for nourishing our bodies, any more than speaking is merely for passing on data.
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Old Fri, May-17-19, 07:31
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LCer4Life LCer4Life is online now
 
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I haven’t used sweeteners since quit using it in coffee years ago. I’ve been lucky as I never was much if a sweet tooth person. Salty carbs was my downfall. I think it is a good substitute for getting sugar cravings out of your system and better for you.
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  #14   ^
Old Fri, May-17-19, 09:28
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Bob-a-rama Bob-a-rama is offline
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I think drinking unsweetened beverages is better for you in most cases. Especially when it comes to drinking water instead of soda pop, sports drinks, and so on.

However I don't think stevia or monk fruit has ever been suspected as being bad for you by a peer-reviewed, published scientist not working for the sugar companies.

I avoid aspartame and other artificial sweeteners just to be 'on the safe side of doubt'. It may be an overkill, and they might be perfectly safe, but I don't need them, so I avoid.

I drink a lot of water, and I put stevia in tea and coffee, neither of which I consume in excessive amounts.

I drink water from my tap (underground well) which goes through a water softener. I add a trace mineral blend to the drinking water to replenish some of the good minerals the softener takes out. A gallon a day isn't out of the question.

I don't buy bottled water, because it is nothing but tap water put in plastic that leeches out into the water and probably isn't very good for me. I have glass bottles that I use to take water with me when I go out.

Since it's unethical to run complete human experiments, and since so many people with financial interests send tacit or outright bribes to governments and health organizations, we have to go with out 'gut feelings' in the long run, and hope we are right.

Bob
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Old Fri, May-17-19, 10:45
CityGirl8 CityGirl8 is online now
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Quote:
Originally Posted by bluesinger
No AS would have made it virtually impossible for me to stick to LC eating. Culturally, as a child I drank thick, sweet tea so I guess I'm imprinted. My pantry is filled with my attempts to use natural LC sweeteners, but yuck.

...Taking away my AS might push me over the edge. Hope that doesn't happen.
It sounds like they're talking about all substitutes, not just artificial ones.

Like several others, I still use a sugar substitute when I want something sweet. And I've had the same experience that being LC really shifts your sweet tooth, so wanting something becomes less and less often. I've never found a "natural" substitute that I don't think is disgusting, so I stick with Splenda.

But I don't fundamentally disagree with the idea that sweeteners aren't necessary for a healthy diet. They're fine when we want treats.

Where I disagree is that they're saying it doesn't make a difference whether you have sugar or substitutes if you're using sweeteners rarely because the calories difference is minimal. This is only true if a) you really do eat sweet things very rarely and b) your metabolism can tolerate sugar. But for people that eat sweet things more often (even a couple of times a week) their theory relies on CICO and the old saw that it's fat that really matters because theirs more calories in it. Sigh.
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