Sugar substitutes helped maintain diet results - European study findings

This is the conclusion reached by researchers from the Universities of Maastricht and Copenhagen who conducted a large, year-long clinical study, SWEET, published in the journal Nature Metabolism.

The study included 341 overweight and obese adults and 38 children from four European countries. Participants first underwent a two-month weight loss phase on a low-calorie diet and then followed a sugar-restricted diet (no more than 10 per cent of total calories) for 10 months.

Households were randomly assigned into two groups: one continued to avoid artificial sweeteners and the other actively used products with sugar substitutes. Such sweeteners included aspartame, acesulfame-K, stevia, saccharin, erythritol, xylitol and inulin.

After one year, the group using the sweeteners (S&SE) showed a more sustained weight loss - 1.6kg more than the control group. Those who strictly followed all the recommendations had a difference of up to 3.7kg.

Thereduction in sugar intake was 12 grams a day higher in the S&SE group, and the proportion of calories from sugar fell 2.4 percentage points more than in the control group.

Analysis of gut bacteria showed that participants who consumed sugar substitutes had an increased proportion of microbes associated with short-chain fatty acid (SCFA) production, such as Megasphaera, Prevotella, Butyricimonas. An increase in methane-forming bacteria of the genus Methanolobus was also observed.

Although cardiometabolic parameters (e.g. cholesterol levels) did not differ between the groups after 12 months, the S&SE group showed better BMI, LDL and HDL values during the first 6 months. There was also a decrease in hip volume.

However, the S&SE group complained more often about GI side effects - abdominal pain, flatulence, stool thinning. No serious adverse effects were reported.Among children, there was an overall age-related decrease in BMI, but no significant differences were found between groups.

"Our study confirms that the use of sugar substitutes as part of a healthy diet can be a safe and effective tool for weight control in overweight adults," the authors conclude.

The results of the SWEET study emphasise the potential of sugar substitutes as part of dietary strategies to prevent obesity, especially when combined with a mindful approach to nutrition.