Diet Beverages and Weight Regulation: Up for Debate

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Diet Beverages and Weight Regulation: Up for Debate
Does drinking diet beverages make you more likely to overeat and become overweight? Or do more overweight people who overeat tend to drink diet drinks? Can a healthy lifestyle include diet beverages?
These are just a few of the questions that consumers and nutrition professionals ask. Literature on the subject is mixed, and while most of us know that water is the best option to quench thirst, what if you really want something sweet? Are diet beverages a good option?
The debate about the impact of artificial sweeteners on food sensitivities, cancer risk, and other diseases is ongoing, despite the “generally recognized as safe” status with the US Food and Drug Administration. However, this article will focus exclusively on diet beverages and weight management.
Diet beverages and weight gain

A number of large population studies in the 1970s and 1980s showed a link between higher artificial sweetener consumption and weight gain. Much of the research about diet beverages and weight gain is related to our brain chemistry and sugar cravings. When we drink diet beverages, our body is primed to have something sweet, but it does not receive the sugar and calories associated with the sweetness because diet soda has zero calories. This creates a disconnect between our brain and body, so we now look to eat something to satisfy this newly created unfulfilled craving.

There is also some thought that extremely sweet artificial sweeteners blunt the body’s ability to detect sweet flavors, causing users to desire to add more and more sugar (and calories) to foods to become satisfied. A study by Green and Murphy examined the effects of artificial sweetener via brain magnetic resonance imaging. Saccharin created a stronger response in the brains of people who did not normally drink diet soda, compared to those who did. Furthermore, people who drink more diet soda tended to have less brain reactivity to saccharin-sweetened beverages. In other words, they become used to it and likely required more to reach similar brain stimulation. However, not all research is in agreement. A 2015 review by Bellisle examined numerous studies and found no association between the use of low-energy sweeteners and an increased appetite for sweet flavor.
Diet beverages and weight loss/maintenance

A review by Popkin and Duffey concluded that people are drinking many more calorically dense (ie, sugary) beverages than they used to. Most people tend not to reduce food intake when consuming these drinks, so we are taking in more calories than before, gaining weight, and developing related metabolic diseases, such as cardiovascular disease and diabetes. Therefore, people are often advised to drink fewer sugary beverages. But can you replace them with diet drinks and actually get positive results? Some researchers say “yes.”

According to Raben and Richelsen, large population studies in the United States show a connection between artificially sweetened beverage consumption and lower calorie intake, type 2 diabetes risk, and cardiovascular disease risk. These findings are supported in a review of randomized controlled trials by Miller and Perez which found that substituting low calorie sweeteners for regular calorie foods and beverages can result in modest weight loss. According to Phelan et al, artificially sweetened beverages are used more frequently by those who have maintained significant weight loss, compared to those who were never overweight.
However, diet drinks are not the only difference. Weight loss maintainers also drink significantly fewer sugary beverages and more water, compared to those who were overweight. In other words, those who have lost weight have adopted generally healthier (or less caloric) habits than those who have never had to lose weight. Diet beverages are perhaps only one piece of the puzzle. This is confirmed by Yang who cited the results of two interventional studies that suggested that artificial sweeteners do not help reduce weight when used alone.
The bottom line

Moderate consumption of diet beverages may serve as a useful strategy for decreasing caloric intake when used as part of a comprehensive weight-loss strategy that includes other positive changes in eating habits and physical activity. It is important that individuals who choose to consume diet beverages understand how this impacts their appetite and taste for other naturally sweet foods to avoid compensatory overeating. Try eating half of a piece of fruit, drinking a diet soda, and then eating the other half. It will likely taste much less sweet.

References and recommended readings
Bellisle F. Intense sweeteners, appetite for the sweet taste, and relationship to weight management. Curr Obes Rep. 2015;4(1):106-110. doi:10.1007/s13679-014-0133-8.
Green E, Murphy C. Altered processing of sweet taste in the brain of diet soda drinkers. Physiol Behav. 2012;107(4):560-567. doi:10.1016/j.physbeh.2012.05.006.
Miller PE, Perez V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr. 2014;100(3):765-777. doi:10.3945/ajcn.113.082826.
Phelan S, Lang W, Jordan D, Wing RR. Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals. Int J Obes (London). 2009;33(10):1183-1190. doi:10.1038/ijo.2009.147.
Raben A, Richelsen B. Artificial sweeteners: a place in the field of functional foods? Focus on obesity and related metabolic disorders. Curr Opin Clin Nutr Metab Care. 2010;15(6):597-604. doi:10.1097/MCO.0b013e328359678a.
Yang Q. Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010;83(2):101-108. Accessed January 9, 2016.
Contributed by Jason Machowsky, MS, RD, CSCS, CDN

Updated by staff

Review Date: 2/5/16

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