Can sugar, an American staple used by countless bakers and cooks, really be that terrible for you?

Well, yes. For some time now, eating sugar-sweetened foods and beverages has been identified as the cause of any number of negative health prospects, including being overweight or even obese, type 2 diabetes, and metabolic syndrome. Because of these findings, many health care experts have proposed that non-caloric, high-intensity sweeteners (such as saccharin, aspartame, and sucralose) provide, if not a beneficial alternative to sugar, at least a less damaging one. Many people switched from regular soft drinks to 'diet' versions of the same and started checking the labels on other foods and beverages to make sure they were made with something other than sugar.

Yet many other claims --- confusing claims --- have been cited over the years. Studies spanning the past 40 years have suggested alternately that sugar-substitutes may be 'potentially helpful,' 'potentially harmful,' or have 'unclear effects' with regard to your health. New evidence, in fact, states that people who frequently consume sugar substitutes may be at an increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease.

Truth is, when it comes to artificially-sweetened beverages, as few as one of these drinks per day may be enough to significantly increase the risk for a number of health problems.

Weight Gain

The San Antonio Heart Study documented weight change in men and women over a seven- to eight-year period and offers evidence that weight gain and obesity were significantly greater in those drinking diet beverages compared with those who did not drink them. In another study, where the participants were adolescents, intake of artificially-sweetened beverages was associated with increased body mass index and increased body fat percentage in males and females at a two-year follow-up. Meanwhile, in Australia, where drinking artificially-sweetened beverages has increased while drinking sugar-sweetened beverages has declined, the rate of obesity has not decreased but been on the rise.

Metabolic syndrome

Various studies have reported greater risk of metabolic syndrome for consumers of diet soft drinks. Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist, and abnormal cholesterol levels — that occur together, and increase your risk of stroke, heart disease, and other diseases. Recent studies suggest that those who drink artificially-sweetened beverages may have double the risk of metabolic syndrome, compared with non-consumers. In studies that compared the risk of metabolic syndrome in people who drank either sugar-sweetened or artificially-sweetened beverages, the magnitude of the increased risk was frequently similar for both regular and diet beverage consumers.

Type 2 diabetes

In a European study, the risk for developing type 2 diabetes more than doubled for participants in the highest quartile of diet beverage consumption, compared with non-consumers. Of course, sugar-sweetened beverage consumption was also associated with an increased risk of type 2 diabetes. Data from the Nurses' Health Study also indicated that risk for type 2 diabetes was amplified in those consuming at least one diet drink or sugar-sweetened drink per day; the same evidence was found by a European investigation into cancer and nutrition. Importantly, a pronounced spike in the risk of type 2 diabetes related to drinking artificially-sweetened beverages was seen even in those participants who were at a normal weight at the start of the study.

Hypertension and Cardiovascular Disease

Within given age groups, the risk for coronary heart disease was significantly elevated in women who consumed more than two artificially-sweetened beverages per day or more than two sugar-sweetened beverages per day. Similarly, another study shows the risk of coronary heart disease was significantly elevated by both types of drinks. Consuming at least one artificially-sweetened beverage daily significantly elevated risk for hypertension for women in a number of studies; the same effect was found when the women in the study drank sugar-sweetened beverages. Results from another study indicated that daily consumption of artificially-sweetened beverages showed significantly increased risk of vascular events, equal in magnitude to daily consumption of sugar-sweetened beverages.

Why?

Taken together, findings from all of the studies suggest that consuming artificial sweeteners is just as bad for you as sugar... and artifical sweeteners may even exacerbate the negative effects of sugar. Meanwhile, both the availability and the consumption of artificial sweeteners have been steadily increasing in the U.S. Roughly one-third of adults and 15 percent of children aged two to 17 years old report consumption of low-calorie sweeteners in the years 2007 and 2008.

"The current public health message to limit the intake of sugars needs to be expanded to limit intake of all sweeteners, not just sugars," said Susan E. Swithers, author of the review.

One interesting hypothesis as to the reason for these negative effects is that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses and your natural ability to adjust to glucose and energy and create an internal equilibrium. Frequent consumption of high-intensity sweeteners may have counterintuitive effects that mess with your metabolism. In fact, people who regularly consume artificial sweeteners show altered activation patterns in the brain's pleasure centers in response to sweet taste, suggesting that these products may not satisfy the desire for sweets. Studies in mice and rats have shown that consumption of noncaloric sweeteners dampens their physiological responses to sweet taste and causes the animals to overindulge in calorie-rich, sweet-tasting food and so pack on extra pounds.

Sound familiar?

 

Source: Swithers SE, Patterson NA. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends in Endocrinology & Metabolism. 2013.