Response to Doctor Oz Show Allegations about Artificial Sweeteners in Flavored Milk
ATLANTA (April 1, 2013)
Calorie Control Council’s Position:
Recently, the Doctor Oz show aired a segment about the use of low-calorie sweeteners in flavored milk and other dairy products and made several unfounded allegations. The segment centered on a petition put forth to the FDA back in 2009 by the International Dairy Foods Association (IDFA) and the National Milk Producers Federation (NMPF) asking for permission to provide reduced-sugar alternatives to flavored dairy products, such as chocolate milk, without an added label claim such as “reduced calorie” or “no sugar added.” It is important to note that products using a low-calorie sweetener will still be labeled as such in the ingredients list.
During the segment, Dr. Oz also raised old questions about low-calorie sweeteners that were answered years ago. There is a vast amount of scientific research supporting the safety and use of low-calorie sweeteners.
Safety.All currently approved low-calorie sweeteners have fewer calories than sugar and have been deemed safe for use by the general population, including children. Low-calorie sweeteners are among the most thoroughly tested ingredients, both individually and as a group, in the food supply. All have been carefully evaluated and deemed safe by numerous expert scientific and regulatory bodies, including Health Canada; the U.S. Food and Drug Administration (FDA); the Joint Expert Committee on Food Additives (JECFA) of the World Health Organization (WHO) and Food and Agriculture Organization (FAO); and the European Food Safety Authority,
Benefits. Numerous human studies have demonstrated that low calories sweeteners may assist individuals in losing weight and/or maintaining weight loss – a critical issue in today’s environment of excess calorie intake and overweight.1-14 A joint statement from the American Heart Association and the American Diabetes Association states that, “Substituting non-nutritive sweeteners for added sugars in beverages and other foods has the potential to help people reach and maintain a healthy body weight and help people with diabetes with glucose control.”Additionally, the Academy of Nutrition and Dietetics’ 2012 position statement on low-calorie sweeteners, concluded that “It is the position of the Academy of Nutrition and Dietetics that consumers can safely enjoy a range of nutritive sweeteners and nonnutritive sweeteners when consumed within an eating plan that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans and the Dietary Reference Intakes, as well as individual health goals and personal preference.”15
Metabolic Syndrome. Studies that have examined any possible link between low-calorie sweeteners and cardiometabolic (metabolic syndrome) and cardiovascular outcomes have failed to prove cause and effect. For example, a 2012 study by two Harvard researchers, published in Circulation, did not find a link between beverages sweetened with low-calorie sweeteners and coronary heart disease.16 In that study, the researchers stated, “Our results highlight the need for cautious interpretation of studies reporting on positive associations between diet drinks and cardiometabolic and cardiovascular outcomes.”
Insulin Response. Human studies have demonstrated that low-calorie sweeteners do not affect insulin levels.17-19 A review article published in 2010 by Renwick and Molinary found, “there is no consistent evidence that low-energy sweeteners increase appetite or subsequent food intake, cause insulin release or affect blood pressure in normal subjects.”17 Because low-calorie sweeteners do not trigger insulin release, they do not lead to insulin resistance as Greenfield alleged.
Appetite. The scientific evidence also suggests that low-calorie sweeteners do not stimulate appetite or food intake. A review article published in 2010, which analyzed numerous studies that evaluated the metabolic effects of low-calorie sweeteners, found, “there is no consistent evidence that low-energy sweeteners increase appetite or subsequent food intake, cause insulin release or affect blood pressure in normal subjects.”17
Addiction. There is no scientific evidence to support Dr. Oz’s or Greenfield’s allegations of addiction to low-calorie sweeteners such as allegations of increased cravings of sweets, or that low-calorie sweeteners fool the body. Research shows that humans innately like sweets; that predisposition has helped humans survive for thousands of years. But, liking sweet foods is not an “addiction.” As the Academy for Nutrition and Dietetics recently noted in their position paper, “Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweeteners,” the “liking of sweet taste is innate” and “preference for sweet taste may be genetic.”15 An article in the June Journal of Nutrition found “there is little correlation between sensitivity to sweetness and liking or intake of sweet-tasting products.”20
Depression. It is unlikely that beverages would have much, if any, impact on depression. According to the National Institutes of Health (NIH), “Depression is a common but serious illness” and “is caused by a combination of genetic, biological, environmental, and psychological factors.” There is no scientific evidence that one component of the diet, such as diet drinks or low-calorie sweeteners, is responsible for depression. 21
Blackburn GL KB, Lavin PT, Keller SD, Whatley J. The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight. American Journal of Clinical Nutrition. 1997;65:409-418.
Bellisle F DA. Intense sweetener, energy intake and the control of body weight. European Journal of Clinical Nutrition. 2007;61:691-700.
Berryman GH HG, Taylor JD, Sanders P, Weinburg MS. A case of safety of cyclamate and cyclamate-saccharin combinations. American Journal of Clinical Nutrition. 1968;21:673-687.
de la Hunty A GS, Ashwell M. A review of the effectiveness of aspartame in helping with weight control. British Nutrition Foundation Nutrition Bulletin. 2006;31:115-128.
Kanders BS BG, Lavin PT, Kienholz M. Evaluation of weight control. Boca Raton: CRC Press; 1996.
Kanders BS LP, Kowalchuk MB, Greenberg I, Blackburn GL. An evaluation of the effects of aspartame on weight loss. Appetite. 1988;11(supplement 1):73-84.
Magnuson. Aspartame: a safety evaluation based on current use levels, regulations, toxicological and epidemiological studies. Critical Reviews in Toxicology. 2007;37(629-727).
Mattes R PB. Nonnutritive sweetener consumption in humans: Effects on appetite and food intake and their putative mechanisms. American Journal of Clinical Nutrition. 2008;89:1-14.
Morris DH MM, Bell KJ, Ward A. Weight loss and consumption of artificial sweeteners among overweight women and men. Journal of the American Dietetic Association. 1989;9(Supplement A):94.
Phelan S LW, Jordan D, Wing RR. Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals. International Journal of Obesity. 2009;33:1183-1190.
Rabin A VT, Moller AC, Astrup A. Sucrose compared with artificial sweeteners: Different effects on ad libitum food intake and body weight after 10 wk of supplementation in over-weight. American Journal of Clinical Nutrition. 2002;76:721-729.
Tordoff MG AA. Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. American Journal of Clinical Nutrition. 1990;51:963-969.
Rolls. Effects of intense sweeteners on hunger, food intake, and body weight: A review. American Journal of Clinical Nutrition. 1991;53:872-878.
Gardner, et al. Nonnutritive Sweeteners: Current Use and Health Perspectives : A Scientific Statement From the American Heart Association and the American Diabetes Association. Circulation. 2012; 126: 509-519.
Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweeteners. Journal of the Academy of Nutrition and Dietetics. 2012;112:739-758.
deKoning L MV, Kellogg MD, Rimm EB, Willett WC, Hu FB. Sweetened Beverage Consumption, Incident Coronary Heart Disease and Biomarkers of Risk in Men. Circulation. 2012.
Renwick AG, Molinary SV. Sweet-taste receptors, low-energy sweeteners, glucose absorption and insulin release. British Journal of Nutrition. 2010;104(10):1415-20.
Coulston, F and Gori. Aspartame: Review of safety. Regulatory Toxicology and Pharmacology. 2002;35(2):78-81.
Carlson HE and Shah JH. Aspartame and its constituent amino acids: Effects on prolactin, cortisol, growth hormone, insulin, and glucose in normal humans. American Journal of Clinical Nutrition. 1989;49:427-432.
Drewnowski, et al. Sweetness and Food Preference. Journal of Nutrition. 2012;142(6):1142S-1148.
Do you have questions about low-calorie sweeteners? Want to learn more about maintaining a healthy lifestyle? You asked and we listened. Our resident Registered Dietitians answered the most popular questions about low-calorie sweeteners.
