Last update:

   09-Mar-2021
 

Arch Hellen Med, 38(2), March-April 2021, 187-194

REVIEW

Low calorie sweeteners – their application in diabetes mellitus and obesity

C.D. Dimosthenopoulos,1 N.L. Katsilambros2,3
1Department of Clinical Nutrition, "Laiko" University Hospital, Athens,
2"Christeas Hall" Research Laboratory, Medical School, National and Kapodistrian University of Athens, Athens,
3First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens, "Laiko" University Hospital, Athens, Greece

Low calorie sweeteners (LCS) are added ingredients of food and beverages which are used to provide the desired sweetness and to help in reduction of the intake of sugars. In the EU, eleven different forms of LCS have been approved for use, and appear with the "E" reference on standard foods and beverages. The consumption of LCS, according to the majority of studies, is safe at acceptable daily intake (ADI) levels, and their safety has been confirmed after extensive scrutiny by food safety authorities, such as the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). The use of LCS can show benefits in calorie reduction, weight loss and glucose control, when used as a sugar substitute, in the context of a balanced diet. Some recent studies, however, have shown that LCS can contribute to the development or worsening of metabolic diseases, such as obesity, type 2 diabetes mellitus (DM), and cardiovascular disease. Artificial low- or non-calorie sweeteners do not appear to affect blood glucose levels in most studies, or contribute to better glycemic control in people with type 2 DM, although the evidence is conflicting. Long-term trials are therefore required to determine the specific clinical benefits of reducing added sugars and replacing them with LCS, and to provide new data on the mechanisms by which LCS may affect metabolic health, both positively and negatively.

Key words: Diabetes mellitus, Low calorie sweeteners, Nutrition, Obesity.


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