Dubai: A new guideline issued by the World Health Organisation (WHO) on non-sugar sweeteners (NSS) has sparked a raging debate in the UAE on the impact of the indiscriminate use of sugar substitutes by people for a variety of reasons.
Contrary to what was believed earlier, WHO has now recommended against the use of NSS to control body weight or reduce the risk of non-communicable diseases (NCDs). The recommendation is based on the findings that not only suggest that the use of NSS does not have any long-term benefit in reducing body fat in adults or children, but instead may potentially cause harm, increasing the risk of Type 2 diabetes, cardiovascular diseases and mortality in adults.
But given the sugar-free and sweetener-free recommendations, can your diet still be sweet? Are all types of sugars and NSS a no-no? Why? And what about diabetic patients?
Gulf News spoke to two doctors -- Dr Malik H. Almahmoud, Specialist Endocrinology from Saudi German Hospital, Dubai and Dr Ashwin Porwal, Specialist Internal Medicine from Medcare Medical Centre, Al Barsha, to demystify the not-so-sweet take on sweet diets.
Here are some basic questions addressed:
First, how common is the use of artificial sweeteners to reduce weight or control sugar levels in the UAE?
It is difficult to say how prevalent their use is due to lack of data. However, one study found that 25 per cent of adults in the UAE use artificial sweeteners on a regular basis.
In the US, research says 25 per cent of children and 41 per cent of adults consume zero calorie-artificial sweeteners. Their use started going up due to increased awareness among people about weight linked to calorie intake. Besides, commercial labelling of these products as healthy nutrients (diet, zero calorie, diabetic sugar and so on) encouraged their use.
What are the most common kinds of sweeteners people use?
What is it about artificial sweeteners that is harmful to the body?
Many researchers have pointed to the harm linked with the use of artificial sweeteners.
The side effects include digestive issues (abdominal pain and bloating), sugar craving, increased blood sugar levels, increased blood pressure and adverse effects on those with pre-existing mood disorders. WHO states that long-term use of them in non-diabetic individuals is linked with an increased risk of Type 2 diabetes, cardiovascular diseases, and even mortality in adults.
NSS are not a magic bullet for weight loss. They can help reduce calorie intake, but they will not help you to lose weight if you are not also eating a healthy diet and exercising regularly.
How do they work on harming the body?
NSS may harm the human body in a number of ways, including:
Disrupting gut bacteria: Some studies suggest that NSS can alter gut bacteria, which can have negative effects on digestion and nutrient absorption.
Increasing the risk of Type 2 diabetes: This may be because they can interfere with the body’s ability to regulate blood sugar levels.
Contributing to weight gain: Contrary to popular belief, NSS may not help with weight loss. In fact, they may contribute to weight gain by disrupting the body’s natural ability to regulate appetite.
Increased risk of heart disease: Some research suggests that consuming NSS may increase the risk of heart disease by promoting insulin resistance and inflammation.
Raising the risk of cancer: Some studies have suggested that NSS may increase the risk of certain types of cancer, such as bladder cancer and lymphoma.
Is it safe for diabetic patients to take NSS?
According to WHO, its recommendation on NSS applies to all people except individuals with pre-existing diabetes and includes all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars found in manufactured foods and beverages, or sold on their own to be added to foods and beverages by consumers.
“Replacing free sugars with NSS does not help with weight control in the long term. People need to consider other ways to reduce free sugar intake, such as consuming food with naturally occurring sugars like fruit, or unsweetened food and beverages, NSS 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.”
Any other exemptions to the WHO recommendation?
The recommendation does not apply to personal care and hygiene products containing NSS, such as toothpaste, skin cream, and medications, or to low-calorie sugars and sugar alcohols (polyols), which are sugars or sugar derivatives containing calories and are therefore not considered NSS.
What about the use of jaggery or cane sugar as substitutes for refined sugar?
Jaggery and cane sugar can be substitutes for refined sugar as they have a lower glycemic index and are considered more natural sources of sweeteners. They also contain some nutrients such as vitamins, minerals and antioxidants that are not present in refined sugar. However, it is important to note that these alternatives also contain calories and should be consumed in moderation. Individuals with certain health conditions such as diabetes should consult with their healthcare provider before using any sweeteners.
What then are the best sources of sugar?
Natural sugars and sugars with low to medium glycaemic index (as seen in brown sugar) are better than refined sugar or artificial sweeteners for body health and keeping weight in check when they are taken in their prescribed amounts. There are several sources of sugar that are considered healthier options compared to refined sugars.
Some of these include:
Fruit: Whole fruits like apples, bananas, oranges, berries and others contain natural sugars, fiber, and other nutrients.
Raw honey: Raw and pure honey contains minerals, antioxidants, and enzymes that are good for health.
Coconut sugar: It is derived from the sap of coconut palms and is a natural sweetener that contains some important minerals and antioxidants.
Maple syrup: Maple syrup is another natural sweetener that contains antioxidants and minerals, making it a better option than refined sugar.
Dates: Dates are a great source of natural sugars, fiber, and various nutrients, including potassium, iron, and magnesium.
However, it is important to remember that these sources of sugar should still be consumed in moderation as excessive intake of sugar can cause health problems.
In other words, a sweet diet can be derived from the healthier sources of sugar – subject to moderate consumption.