The Diet Food That Could Be Mak­ing You Fat

Ar­ti­fi­cial sweet­en­ers abound. Yet they have weird af­ter­tastes, du­bi­ous ef­fects on blood sugar and grow­ing ev­i­dence shows that they may make you gain weight. WH breaks down the shaky fu­ture of sub­sti­tutes – and what they could be do­ing to your waist­line (a

Women's Health (South Africa) - - NEWS - BY MICHELLE STACEY

Go­ing sugar-free to lose weight? You need to know this...

With sugar on ev­ery­one’s “don’t” list (it’s now ac­cused of caus­ing not only weight gain, but pos­si­bly di­a­betes, can­cer and heart dis­ease) ar­ti­fi­cial sweet­ener use is soar­ing. We’re scarf­ing the stuff like never be­fore: con­sump­tion of sugar sub­sti­tutes surged by 54 per­cent be­tween 1999 and 2012 (go­ing up a star­tling 200 per­cent in kids) and de­mand is pre­dicted to rise an­other five per­cent by 2020. Sci­en­tists are tin­ker­ing with new plant-based va­ri­eties that aim to be health­ier and bet­ter-tast­ing than pre­vi­ous labcre­ated sweet­en­ers and sev­eral are al­ready on the mar­ket. All-nat­u­ral and nearly zero kilo­joules: what could pos­si­bly go wrong?

Ex­perts are in­creas­ingly un­sure of how to an­swer that ques­tion – or ex­actly what ad­vice to give to their clients. “There’s a lot of con­fu­sion about sugar sub­sti­tutes these days,” says nu­tri­tion­ist Ashley Koff. De­spite the health halo crown­ing the new sweet­en­ers – they come from leaves or fruit or some form of plant – a few things worry re­searchers: could they, like ear­lier sugar re­place­ments, pos­si­bly make peo­ple gain weight? Is some­thing still “nat­u­ral” if it has been chem­i­cally al­tered and ma­nip­u­lated? Here’s what we know so far.

THE BACK­STORY

Along­side doo-wop and hula hoops, ar­ti­fi­cial sweet­en­ers came of age in the 50s, promis­ing weight loss through kilo­joule re­duc­tion. They were also thought to be bet­ter for peo­ple with high blood-glu­cose lev­els, like di­a­bet­ics or those with in­sulin re­sis­tance, be­cause they helped them take in less sugar. Then, around the early 2000s, re­search be­gan to sug­gest that sweet­en­ers might pro­mote weight gain and ex­perts were mys­ti­fied. Some as­sumed a psy­cho­log­i­cal link ­– that if you know you’re sav­ing kilo­joules on your diet drink, you might sub­con­sciously up your food in­take. But more re­cently, as re­searchers delved deeper into the phys­i­o­log­i­cal mech­a­nisms un­der­ly­ing the sweet­ener-weight­gain con­nec­tion, an­other shocker emerged: sub­sti­tutes may ac­tu­ally in­crease your risk for high blood sugar, meta­bolic syn­drome and

di­a­betes – the very things they were sup­posed to pre­vent. A 2014 study in the jour­nal Na­ture found that af­ter peo­ple added ar­ti­fi­cially sweet­ened foods to their di­ets for just one week, their over­all blood-sugar lev­els rose. “This sug­gests in­sulin re­sis­tance, which is a step to­ward pre-di­a­betes,” says physi­cian nutri­tion spe­cial­ist Dr Melina Jam­po­lis. “In­sulin re­sis­tance makes it harder to lose weight be­cause in­sulin pro­motes fat for­ma­tion and pre­vents the break­down of fat, so it’s more dif­fi­cult to burn it off.” The re­sult? Stub­born ki­los plus a higher risk for di­a­betes. Sub­sti­tutes may also af­fect the di­ges­tion of other foods we eat, says Dr Eric Wal­ters, a chemist who has stud­ied sweet and bit­ter tastes. “There are sweet taste re­cep­tors through­out the in­testines that pump out glu­cose trans­porters to help you ab­sorb any sug­ars. So if you con­sume a diet drink along with starchy fried chips, which quickly break down into glu­cose, there are al­ready ex­tra trans­porters around. That moves the glu­cose into your blood­stream faster than usual.” That’s sci­en­tific speak for: here comes a blood-sugar spike! And crash! Which im­pacts hunger, mood and crav­ings and leads to more snack­ing. But sugar subs don’t stop there, oh no. They also might mess with your mi­cro­biome, ac­cord­ing to a 2014 study in mice show­ing changes in gut bac­te­ria that af­fected blood-sugar reg­u­la­tion. And re­search late last year in the US found that as as­par­tame – one of the most ubiq­ui­tous sweet­en­ers, on the mar­ket since the early 1980s – breaks down in the gas­troin­testi­nal tract, it pro­duces a chem­i­cal that in­ter­feres with a di­ges­tive en­zyme that may help pre­vent obe­sity, di­a­betes and meta­bolic syn­drome. “We used to think of these sweet­en­ers as metabol­i­cally in­ert, that they passed through your body without any mea­sur­able im­pact. But ev­i­dence is show­ing that may not be the whole story,” says Jam­po­lis.

“NAT­U­RAL” SE­LEC­TION

The con­tin­ual drip-drip of neg­a­tive stud­ies has made the search for bet­ter low-kilo­joule sweet­en­ers, without the prob­lems of their pre­de­ces­sors, even more press­ing. But so far, the ev­i­dence on the new batch is mixed. Un­til the 1990s, all ar­ti­fi­cial sweet­en­ers had been created in the lab – this in­cludes fa­mil­iar names like sac­cha­rin, cy­cla­mate and as­par­tame (see the time­line on the next page). But within the past 20 years, two sweet­en­ers, su­cralose and ste­via, changed the game by us­ing a nat­u­ral sub­stance as a start­ing point. Su­cralose be­gins as ta­ble sugar, then sci­en­tists tin­ker with its atomic struc­ture; ste­via is a pu­ri­fied ex­tract made from leaves of the ste­via plant. Nat­u­ral is now the word ev­ery sugar sub­sti­tute wants to have on its la­bel (and in its PR port­fo­lio) – but the def­i­ni­tion of that isn’t as sim­ple as it seems. Al­lu­lose, which, in 2014, was given GRAS sta­tus – that stands for “Gen­er­ally Rec­og­nized As Safe” by the FDA – is found in jack­fruit, figs, raisins and other fruits. It has the same molec­u­lar for­mula as glu­cose and fruc­tose, but the quan­ti­ties in the fruit it­self are so mi­nus­cule that to make enough of it, the ac­tual prod­uct must be as­sem­bled on a molec­u­lar level in the lab. The com­pany calls the process “en­zy­matic con­ver­sion of fruc­tose to al­lu­lose.” Ex­tracts from the South­east Asian monk fruit were ap­proved as GRAS in 2010 and are now in­fused in prod­ucts like ice cream, bev­er­ages, yo­ghurt and sauces. Monk fruit ex­tract too has been ma­nip­u­lated to pro­duce a con­cen­trate that is 150 to 200 times sweeter than ta­ble sugar – which is the rea­son it (and other subs) can be used in tiny amounts with a near-zero kilo­joule load. (Some ex­perts feel this flavour in­ten­sity may re­train our tastes, keep­ing us crav­ing yet more sweet­ness.) Monk fruit is also way more ex­pen­sive than sugar and is of­ten com­bined with other less costly sweet­en­ers, like ste­via.

FASTER TO MAR­KET

Are these iso­lated, ex­tracted sub­stances truly “nat­u­ral,” as their mar­ket­ing sug­gests? Some peo­ple ar­gue with that de­scrip­tion – since the sub­stances are ma­nip­u­lated in a lab – but none­the­less, these prod­ucts have had a huge ad­van­tage in the ap­proval process. That’s be­cause the FDA’s GRAS sys­tem as­sumes safety in sub­stances made from some­thing that’s al­ready in the food sup­ply and ste­via leaves, for ex­am­ple, have been used in tra­di­tional medicines by indige­nous pop­u­la­tions in Brazil and Paraguay for gen­er­a­tions. So while it took 16 years of re­search and ev­i­dence of safety for as­par­tame to pass FDA re­view, the newer sweet­en­ers have moved along a much shorter path in the GRAS process. For in­stance, the “devel­op­ment pro­gramme” to get ste­via ap­proved took six years, ac­cord­ing to Dr Grant DuBois, a chemist who worked on the pu­ri­fied form of ste­via. This both­ers many re­searchers. “I don’t think we have enough data so far to say that monk fruit or ste­via are less con­cern­ing than other sweet­en­ers,” says Dr Zhaop­ing Li, chief of the di­vi­sion of clin­i­cal nutri­tion at UCLA in the US. “Any­time you have a sin­gle com­pound, con­sumed reg­u­larly and in large quan­ti­ties, it gen­er­ates con­cern over the long-term health risks.” And what about weight loss? So far the data sug­gests that the newer, “nat­u­ral” sub­sti­tutes have the same counter-in­tu­itive ef­fects as the ear­lier ar­ti­fi­cial sweet­en­ers. In new re­search from Sin­ga­pore, sci­en­tists asked volunteers to down ei­ther sug­ary drinks or diet ones made with as­par­tame, ste­via or monk fruit. The peo­ple who had the drinks with sub­sti­tutes – no mat­ter the source – ate more later and “made up for” the kilo­joules they had skipped. The prob­lem, says Koff, is “whether a low-kilo­joule sweet­ener has an ar­ti­fi­cial or a nat­u­ral source, what you’re do­ing is try­ing to fool your body.” But the body knows.

CON­QUER­ING CRAV­INGS

So what’s a con­sci­en­tious healthy eater to do... Be­sides just give up and be­come an un­con­sci­en­tious, un­healthy eater? One av­enue, says Koff, is to look hard at your sweet crav­ings. “Sub­sti­tutes keep us hooked on sweet tastes,” she says. “Some of the ar­ti­fi­cial sweet­en­ers are tens of thou­sands of times as sweet as sugar. Some­one who con­sumes them of­ten is go­ing to eat an ap­ple and no longer think it tastes sweet at all,” says Koff. Re­searchers al­ready know that the “sweet tooth,” while in­nate, can also be cul­tur­ally in­flu­enced. Ev­i­dence: 330ml of Coke has 35g of sugar in South Africa, ver­sus 32g in the ver­sion sold in Thai­land. We re­ally can re­train our taste buds by cut­ting down on all sug­ars, real and ar­ti­fi­cial. Not that it’s an easy task. Pack­aged foods con­tain some form of sweet­ener – and while many of these sweet­en­ers have been made in the lab, prod­ucts aren’t re­quired to tout that on their la­bels. So when you eat a “nat­u­rally” sweet­ened yo­ghurt or a whole­wheat English muf­fin, you may un­know­ingly be in­gest­ing sugar sub­sti­tutes. “The front of the prod­uct pack­ag­ing is purely de­signed for mar­ket­ing rea­sons. The con­sumer reads words like gluten-free, whole grain, nat­u­ral, sugar-free, low­carb on the front and can eas­ily fall into the trap of think­ing that it’s a healthy prod­uct and buy it im­me­di­ately,” ex­plains in­te­gra­tive clin­i­cal nu­tri­tion­ist Lara de Chazal. “The key to mas­ter­ing your own health is to be­come an in­gre­di­ent and la­bel ex­pert and to turn the pack­age over and scru­ti­nise the in­gre­di­ent list­ing and nu­tri­tional val­ues to be sure that all the in­gre­di­ents and nu­tri­tional val­ues are aligned with your par­tic­u­lar health goals,” says De Chazal. And even then, the subs can hide in plain sight in the “Nu­tri­tional Facts.” (Did you know that re­biana is ste­via ex­tract? Now you do.) Who can (or wants to, for that mat­ter) mem­o­rise the en­tire list of generic names for lab-en­hanced sweet­en­ers? Di­eti­cian at Lila Bruk and As­so­ci­ates, Sa­man­tha Burns also ex­plains how South African food man­u­fac­tur­ers have used mar­ket­ing strate­gies to bam­boo­zle buy­ers, “In the past they used to la­bel sweets ‘fat free’ on the front of the pack­age, im­ply­ing that the prod­uct is “health­ier”, when in fact, yes, it is fat free, but let’s not men­tion the huge amounts of sugar you will be con­sum­ing,” says Burns. How­ever, af­ter new South African food la­belling and ad­ver­tis­ing reg­u­la­tions (R146) were passed in March 2010, all la­bels and ad­ver­tis­ing of food prod­ucts in South Africa have been re­vised and strict rules have been put into place. La­bels on pack­ag­ing now must only be fac­tual, not con­fus­ing to the con­sumer,” says Burns. This is great, but un­for­tu­nately sugar subs still pose a big prob­lem. “Ar­ti­fi­cial sweet­en­ers are not re­quired by law to be listed on the front of pack­ag­ing, only in the in­gre­di­ent list. This means that con­sumers are not al­ways aware of them. To make things worse, food and bev­er­age com­pa­nies are re­ly­ing heav­ily on ar­ti­fi­cial sweet­en­ers as a re­sult of sugar tax­a­tion, mak­ing it more dif­fi­cult for con­sumers to keep up to date with in­gre­di­ents,” says Burns. That’s why some nu­tri­tion­ists say it may be best to choose real sugar (try Natura un­bleached, non-GM, non-ra­di­ated sugar) over sub­sti­tutes. Re­mem­ber to limit your in­take to six tea­spoons of added sugar per day (the World Health Or­ga­ni­za­tion’s rec­om­men­da­tion). Other lesspro­cessed sources in­clude raw honey and maple syrup – the real stuff, not maple-flavoured syrup! “You’ll get vi­ta­mins, min­er­als and plant nu­tri­ents, along with the sat­is­fac­tion of carbs and kilo­joules,” says Koff. And there’s one other uber-sim­ple fix: “Buy less food that comes in a box,” says nu­tri­tion­ist Jackie New­gent. Af­ter all, mel­ons and straw­ber­ries are de­li­ciously sweet – and don’t even re­quire a nu­tri­tional-facts la­bel.

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