Substituting Low-Calorie Sweetened Beverages for Sugar-Sweetened Beverages to Prevent Obesity and Cardiometabolic Diseases: Still a Good Idea?

Could Insulin Be a Better Regulator of Appetite/Satiety Balance and Body Weight Maintenance in Response to Glucose Exposure Compared to Sucrose Substitutes? Unraveling Current Knowledge and Searching for More Appropriate Choices

“…Hence, the use of diverse SSs may separately or concurrently decrease the levels of consumed sugar and thus decrease the calorie intake [ 46 ]. The impacts of SS sweeteners on the glucose metabolic process have extensively been examined [ 47 , 48 ]. Nevertheless, there are no conclusive data so far concerning the impacts of SS intake in comparison to either sugar, placebo, or nutritive low-calorie sweeteners intake on the potential clinical benefits or impairments regarding hemoglobin A1c (HbA1c), body weight, and side effects in individuals with diabetes mellitus type I or type II [ 47 , 48 ].…”

“…Moreover, there is a trend to pay more attention to the evidence from observational studies compared to randomized controlled clinical trials. However, randomized controlled clinical trials should require a greater priority in the established hierarchy of evidence as they can better infer causality than observational cohort studies [ 48 ]. All the above potential differences and limitations of the existing literature constitute a crucial challenge in interpreting conflicting results, highlighting the strong demand for additional research in order for a more precise conclusion to be drawn.…”

Government Policies to Reduce Free or Added Sugars and Use Nonsugar Sweeteners Should Support Plant-Rich Dietary Patterns, a Healthy Microbiome and Planetary Health

“…Chatelan et al. [ 3 ] explored whether governments should advise individuals to replace sugary beverages with low calorie–sweetened beverages containing nonnutritive sweeteners (hereafter, called ) to prevent obesity and cardiometabolic diseases but did not address sugary beverage policies [ 3 ]. Current Developments in Nutrition also has a special issue ( https://cdn.nutrition.org/cdnut-enabling-transformation-of-food-systems ) on food systems transformation to support the ( ) Sustainable Development Goals 2030 Agenda (SDG).…”

“…These global trends suggest that national governments must prioritize policy coherence to develop guidelines for populations and businesses to reduce both free or added sugars aligned with recommended targets (<10% of total daily energy intake) and the types and amounts of to support a healthy human microbiome, healthy weight, and ecosystems [ 3 , [7] , [8] , [9] , [10] , [11] , [12] ].…”

“…Chatelan et al. [ 3 ] concluded that NSS benefits are small, may produce altered gut microbiomes, but outweigh potential cardiometabolic health harms. Although improving glucose concentrations and cardiometabolic health are important, research must also evaluate effective policies to support the UN’s food systems transformation efforts.…”