Low-calorie drinks have similar effect to water on weight loss, study says

Sweeteners are ingredients that taste intensely sweet but do not add calories to the diet. Whether in drops in coffee or in the composition of industrialized foods, they are alternatives to sugar for those who have diabetes, metabolic syndrome or are simply trying to lose weight.

Its efficiency was already known, but a new review of studies published in JAMA (Journal of the American Medical Association, in Portuguese), showed that its benefits can be compared even with those of water.

Scientists from several European and North American institutions selected 17 clinical trials that compared the effects of low or no calorie sugary and sweetened drinks with water, observing the results in the weight reduction process.

In total, the surveys involved 1,733 overweight or obese adults who had diabetes or were at risk of developing the disease. They were followed up for 12 weeks.

At the end of the analysis, the experts concluded that replacing sugary drinks with sweetened ones was associated with a loss of 1.06 kg and a significant reduction in BMI (body mass index), body fat and liver fat – all cardiometabolic risk factors. , which lead to heart attack and stroke.

In addition, consumption of these sweetened beverages was related to a small weight loss and greater reduction in systolic blood pressure compared to water. In other words, when it comes to weight loss, drinking low- or no-calorie sweetened liquids has similar results as water in weight loss. But are sweeteners really all that?

According to endocrinologist Clayton Macedo, from Abeso (Brazilian Association for the Study of Obesity and Metabolic Syndrome), the result of the research needs to be looked at carefully. Despite having been published in a reputable scientific journal, he stresses that the conclusion demonstrates an association, not a cause-and-effect relationship.

“Also, the weight loss found was 1.06 pounds. Everything was statistically significant, but what does that number mean in the universe of an overweight population? I’m not invalidating it, but we need to see the purpose of the final message.” , evaluates.

Nutritionist Gisele Hayek, a specialist in Hygienic Sanitary Control of Food by Pró Alimento, in São Paulo, adds that the period of analysis is too short to draw great conclusions. “Three months is too little to say that that conduct is the best or that we have a result as good as the water”, she says.

Márcia Terra, nutritionist and director of Sban (Brazilian Society of Food and Nutrition) and member of the Scientific Council of Anad (National Association for Diabetes Care), defends the quality of the research, remembering the fact that it is a systematic meta-analysis, which shows that it is a robust and important study, and that the authors themselves point to moderation in the strength of the evidence.

“This research mapped works in important scientific databases and was careful with the risk of bias. The result, at least in my opinion, was as expected. The study was nice because drinks with sweeteners are always the target of criticism and many works show negative results, but very questionable”, he points out.

a controversial substance

The review published in JAMA also concluded that there is no evidence of harm or side effects associated with switching from sugary drinks to sweetened beverages. However, there is discussion among experts in the field about the long-term safety of the product.

Several studies investigate the relationship between sweeteners and problems in the gut microbiota. A recent review by American, Caribbean and Nigerian scientists showed changes in the gut related to the consumption of various artificial types.

“This deregulation is crucial for the development of obesity and for the insulin resistance mechanism. Perhaps the sweeteners are contributing to this worsening”, says endocrinologist Macedo.

Another review, released by the Canadian Medical Association, suggests that frequent intake of this ingredient is associated with increased BMI and cardiometabolic risk.

“As it is artificial, the sweetener is a substance that we do not have in the body. So, the organism ends up not tolerating it well and can read it as if it were a toxin, which in turn has an affinity for fatty tissue. In the medium to long term, it would become a stimulus for the increase of this tissue”, says nutritionist Gisele Hayek.

Most studies that indicate these events, however, are performed in animals and cells in vitro or are observational. That means more investigations – controlled and done on humans – are needed to hit the hammer.

Who should consume sweeteners and which ones are best

Sweeteners are approved for consumption and go through extensive processes to attest to their safety. In Hayek’s view, their use is valid in the dietary reeducation of diabetics, people with metabolic syndrome or individuals who wish to lose weight only as an adaptation tool.

“For those who cannot simply interrupt the intake, it is a very punctual alternative. The idea is to wean, decrease and remove the patient’s addiction to the sweet taste”, he recommends.

In addition, the nutritionist indicates giving preference to natural versions, such as xylitol, stevia and erythritol, instead of artificial sucralose, cyclamate and acesulfame. In these cases it is important to check the food label.

“Just remembering that xylitol and erythritol, because they are polyols, ferment. Therefore, for those who suffer from gas or irritable bowel syndrome, they are not recommended because they can cause discomfort”, adds Hayek.