Q. More and more nutrition advice seems to be anti-sugar these days. So are artificial sweeteners a good alternative, especially when it comes to weight loss?

A. Many people consume artificial sweeteners, which include acesulfame, aspartame, neotame, saccharin, stevia plant extract, and sucralose, because they want to lose weight, avoid the “empty” (non-nutritious) calories of sugar, or avoid weight gain. Replacing concentrated sugar with products that have few, if any, calories should tilt energy balance in favor of weight loss. Some short-term studies suggest that artificial sweeteners may have that effect.

But other research raises concern that they may do just the opposite and actually promote weight gain. How so? Artificial sweeteners are extremely sweet — hundreds to thousands of times sweeter than table sugar. So people who habitually consume them may end up desensitized to sweetness. Healthful, satiating foods that are less sweet, such as fruits and vegetables, may become unappetizing by comparison. As a result, the overall quality of the diet may decline. The calories removed from the diet by the sugar-for-sweetener swap may sneak back in, in the form of refined carbohydrates and low-quality fats.

In addition, some research has identified sweetness receptors in fat tissue. This raises the possibility that artificial sweeteners could cause weight gain by directly stimulating the development of new fat cells.

— by Howard LeWine, M.D.
Editor in Chief, Harvard Men’s Health Watch

Image: © BigRedCurlyGuy/Getty Images

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