Sabrina Palomino | Zero sugar … zero risk?

For those with a sweet tooth, the idea of enjoying desserts and beverages that are sweet but low in calories sounds like a dream come true, right?

For decades, zero-sugar, zero-calorie, and diet drinks have been a popular choice for people with diabetes and those watching their weight. These products contain additives designed to provide a sweet taste without the high caloric content of regular sugar. Known as non-nutritive sweeteners, sugar substitutes, and artificial sweeteners, these ingredients allow individuals on strict diets to enjoy the sweetness they crave without the associated calories.

These sweeteners have many names and forms, and they have become a staple for those seeking to maintain a healthier diet while still enjoying sweet flavours. But, do zero sugars come with zero risks?

Both the World Health Organization (WHO) and the American Heart Association (AHA) advise that adults and children limit their daily (added) “free sugars” intake: a maximum of nine teaspoons for men, six teaspoons for women, and less than six teaspoons for children. Excess sugar can be present in many presumed healthier options such as energy drinks and sports drinks. However, popular energy drinks and sports drinks can contain over nine teaspoons of sugar per serving, exceeding these recommendations. These drinks typically include artificial and natural sweeteners, caffeine, as well as electrolytes.

Many persons consume these energy drinks recreationally without engaging in endurance activities. Although these beverages may seem like a healthy alternative, it is generally better to opt for naturally refreshing fluids without added sugars or substitutes to quench thirst. Recommended options include plain water, low-fat and unsweetened milk, unsweetened plant-based milk, whole fruits, fruit and/ or vegetable-infused water, and coconut water in moderation.

ARTIFICIAL SWEETENERS

Common non-nutritive sweeteners (NNS) include acesulfame K, aspartame, saccharin, sucralose, stevia, and stevia derivatives. These artificial sweeteners can be 100-400 times sweeter than table sugar. Consuming foods with sweet flavours, regardless of calorie content, can condition the body to prefer sweetness, so it is beneficial to promote healthier habits.

The WHO in May 2023 would have issued a recommendation against the use of NSS to control body weight or reduce the risk of non-communicable diseases (NCD). Francesco Branca, WHO director for nutrition and food safety, stated, “NNS are not essential dietary factors and have no nutritional value. People should reduce the sweetness of the diet altogether, starting early in life, to improve their health.”

In 2019, the Ministry of Health and Wellness introduced the Interim Guidelines for Beverages in Schools, aiming to gradually reduce the sugar content in sweetened beverages sold on school grounds. The guidelines initially set the maximum sugar content at 6g/100ml in 2019, with an annual decrease to the current limit of 2.5g/100ml, effective from January 2023. The Interim Guidelines discourage the use of artificial sweeteners. Similarly, the AHA advises against prolonged consumption of NNS-containing beverages by children. Labelling a product as zero sugar while maintaining a sweet taste can be misleading, as frequent consumption of sugar substitutes is not risk-free.

The WHO advises against using NNS, as research indicates no long-term benefits in reducing body fat in adults or children. Moreover, extended use of NNS has been linked to potential undesirable effects, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.

AND FOR ATHLETES AND ACTIVE INDIVIDUALS?

We would have watched and enjoyed the events at the Paris Olympics, so, of course, why not put some of the focus on how artificial sweeteners might affect our athletes and active individuals? In light of recent studies on the ill-effects of artificial sweeteners, athletes and those with training goals in mind should take into consideration their current health before considering their use as alternatives for sugar. The modern-day athlete often selects their foods more wisely than the average person, with the hopes of enhancing their performance, reducing injury risks and investing in their longevity.

While the occasional splurge on less than optimal food choices is not going to be a problem for an active, hard-charging power athlete, the bitter truth is that regularly adding things like xylitol, erythritol, aspartame, and other artificial sweeteners to an otherwise healthy diet creates problems and sometimes is even worse than sugar itself. Athletes’ bodies tend to readily use sugars (they appear in the blood as glucose) to replenish depleted muscle glycogen stores. So, for those long, hard workouts, or for persons looking to begin a training regimen, natural sweeteners might be a better choice.

Natural sweeteners, derived from plants or fruits like apples and pears, offer alternatives to traditional sugar that may come with additional nutrients and lower glycemic impacts. When leveraged effectively in an athlete’s diet, these sweeteners can serve as a tool for sustained energy delivery and improved metabolic health. However, as with any energy source, timing and context in consumption are key elements that can influence athletic performance outcomes.

BOTTOM LINE …

It’s understandable why the average person might believe they are making healthier choices by opting for beverages adorned with “zero calorie” labels. However, consider the disservice you may be doing to yourself by prioritising flavour over quality. Our children are especially vulnerable, as they rely on adults to guide them in making beneficial health choices. Those living with diabetes often long for the freedom to eat and drink without restrictions, making them susceptible to marketing tactics that emphasise zero-calorie options.

While we indeed have only one life to live, it’s crucial to focus on adding more vitality to our years rather than merely counting the years we have left. Reading food labels and staying informed about your health status is essential. Regularly monitor your blood pressure, blood sugar, cholesterol, and weight by undergoing routine screenings. Knowing your numbers can help you maintain a healthier lifestyle or make a move to change your current lifestyle. After all, there’s nothing sweeter than good health.

Sabrina Palomino is a registered dietitian and nutritionist. Send feedback to ghapjm@gmail.com