Study: Overweight Americans who pick diet drinks eat more food

Friday January 17, 2014

This post is from Healthwise

WASHINGTON: Heavy Americans who drink diet beverages rather than those sweetened with sugar appear to eat more, according to a study released on Thursday that raised questions about the role lower-calorie drinks play in helping people lose weight.

Researchers at Johns Hopkins University analyzed data from a U.S. survey of 24,000 people over a period of 10 years. People who were overweight or obese generally consumed the same amount of calories a day no matter what they drank, but those who chose diet drinks got more of those calories from food.

Outside experts were quick to caution that it is not clear what role, if any, diet drinks such as low- or no-calorie versions of sodas, sports drinks and teas played for people who ate more.

In the study, published in the American Journal of Public Health, overweight drinkers of diet beverages in the United States ate 1,965 in food calories a day compared to 1,874 calories among heavy people who drank regular sugar-sweetened beverages.

Among obese diet beverage drinkers, those who consumed low- or no-calorie drinks ate 2,058 calories a day in food versus 1,897 food calories for those who had regular drinks, researchers said.

Such differences were statistically significant, they added.

Lead author Sara Bleich said the results, when paired with other research, suggest that artificial sweeteners may affect people's metabolism or cravings, although more study is needed.

She acknowledged that people could be deciding to eat more since they are saving calories with their diet drinks.

"The push to diet soda may not make a lot of sense if you are then also eating more solid food," Bleich said. "The switch from a sugary beverage to a diet beverage should be coupled with other changes in the diet, particularly reducing snacks."

Critics said the analysis, based on data from the National Health and Nutrition Examination survey between 1999 and 2010, is flawed and that it is too early to say what, if any, role the low-calorie drinks or their artificial sweeteners play in weight loss.

Several researchers noted that the study did not track a set group of people over time and only looked at a 24-hour snapshot of what any individual consumed.

The beverage industry, which has long promoted diet drinks as an alternative to full-calorie beverages, defended such alternatives to help manage weight.

"Losing or maintaining weight comes down to balancing the total calories consumed with those burned through physical activity," the American Beverage Association said in a statement on Thursday.

Low- or no-calories drinks contain artificial sweeteners such as aspartame and sucralose. Many beverage companies are also turning to other alternatives, such as the extract of Stevia.

Kelly Brownell, a professor psychology and neuroscience at Duke University and dean of its Sanford School of Public Policy, said while the study was compelling and there are still many questions about such sweeteners, more data is needed.

"People need to separate the biology from the psychology," he said.

Bonnie Liebman, the director of nutrition at the Center for Science in the Public Interest, said while her group may have other questions about artificial sweeteners, "it's premature to conclude that it's something going on in your brain."

In the meantime there are other ways to watch your weight, she said: "You're much better off with water - or coffee or tea, if they're unsweetened."- Reuters

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http://www.thestar.com.my/Business/Business-News/2014/01/17/Overweight-Americans-Who-Pick-Diet-Drinks-Eat-More-Food/

Sweeteners may boost diabetes risk

Saturday September 27, 2014

This post is from Healthwise

BY RICHARD INGHAM

Artificial sweeteners are used as an alternative to sugar in battling diabetes and
weight gain, scientists now worry that this may no longer be the case. - AFP

Promoted as an aid to good health, artificial sweeteners may in fact be boosting diabetes risk, says a study.

Called non-calorific artificial sweeteners, or NAS, the additives are found in diet sodas, cereals and desserts – a huge market for people worried about weight gain and sugar intake.

Artificial sweeteners were found to elevate blood-glucose levels and alter gut bacteria, says scientists.

Some experts recommend NAS for people with type-2 diabetes, a disease that has attained pandemic proportions, and for a pre-diabetic condition called glucose intolerance, with elevated blood-sugar levels.

After leaving a sensation of sweetness on the tongue, NAS molecules pass through the intestinal tract without being absorbed. This explains why, unlike sugar, they add negligibly, if at all, to the calorie count. But scientists reported in the journal Nature that experiments on lab mice and a small group of humans found NAS disrupted the makeup and function of gut bacteria, and actually hastened glucose intolerance.

“Artificial sweeteners were extensively introduced into our diets with the intention of reducing caloric intake and normalising blood glucose levels without compromising the human ‘sweet tooth’,” the paper states.

“Our findings suggest that NAS may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight,” it says bluntly.

Scientists led by Eran Elinav and Eran Segal of the Weizmann Institute of Science in Israel added three commonly-used types of NAS - aspartame, sucralose or saccharin – to the drinking water of mice in body-size appropriate doses equivalent to recommended maximum human intake. Those rodents given NAS developed glucose intolerance, whereas mice that drank only water, or water with sugar, did not.

Next, the researchers transplanted faeces from NAS-fed and glucose-fed mice into rodents bred to have no gut bacteria of their own.

The blood-glucose levels of the NAS transplant recipients rose sharply, the team found - and their gut bacteria worked harder than the other group’s at extracting glucose from nutrients.

The next step was to apply these insights to humans.

Poring over questionnaires and health data from non-diabetic people, the team found a “significant” link between glucose intolerance and higher NAS consumption.

Finally, the researchers placed volunteers who did not normally use NAS on a seven-day regimen that included the maximum sweetener intake recommended by the US Food and Drug Administration (FDA).

Within five to seven days, four developed elevated blood-glucose levels and an altered gut bacteria mix, apparently mirroring the effect in mice.

Past investigations into NAS have delivered mixed results. Some showed benefits in weight loss and glucose tolerance, while others suggested the opposite.

The picture is muddied by the fact that many NAS consumers are people who already have diabetes or are prone to it.

The new experiments are a red flag, the team says.

“This calls for a reassessment of today’s massive, unsupervised consumption of these substances,” says Elinav.

Experts say to be cautious when using artificial sweeteners as they may not be the magic bullet that helps fight obesity and diabetes. – Filepic

Independent commentators praised the work for its innovation, but warned against overreaction.

The human trial involved just seven people over a week, and wider and longer trials are needed to draw any firm conclusion, they say.

“Human diets are complex, consisting of many foods, the consumption of which can vary in amounts, and over time,” warns John Menzies of the Centre for Integrative Physiology at the University of Edinburgh in Scotland.

“This research raises caution that NAS may not represent the ‘innocent magic bullet’ they were intended to be to help with the obesity and diabetes epidemics,” Nita Forouhi, a University of Cambridge epidemiologist tells Britain’s Science Media Centre.

“But it does not yet provide sufficient evidence to alter public health and clinical practice.” – AFP

http://www.thestar.com.my/Lifestyle/Health/2014/09/27/Sweeteners-may-boost-diabetes-risk/

Thin People Get Diabetes, Too

August 1, 2014

This post is from Healthwise

Nearly 20% of people with this disease are not overweight…

It’s widely known that type 2 diabetes tends to strike people who are overweight. In fact, about 85% of people with diabetes are carrying extra pounds. But what about those who aren’t overweight?

A popular misconception: It’s commonly believed—even by many doctors—that lean and normal-weight people don’t have to worry about diabetes. The truth is, you can develop diabetes regardless of your weight.

An unexpected risk: For those who have this “hidden” form of diabetes, recent research is now showing that they are at even greater risk of dying than those who are overweight and have the disease.

What you need to know about diabetes—no matter what you weigh…

THE EXTRA DANGER NO ONE EXPECTED

No one knows exactly why some people who are not overweight develop diabetes. There’s some speculation that certain people are genetically primed for their insulin to not function properly, leading to diabetes despite their weight.

Still, because diabetes is so closely linked to being overweight, even researchers were surprised by the results of a recent analysis of 2,600 people with type 2 diabetes who were tracked for up to 15 years.

Startling new finding: Among these people with diabetes, those who were of normal weight at the time of diagnosis were twice as likely to die of non–heart-related causes, primarily cancer, during the study period as those who were overweight or obese.* The normal-weight people were also more likely to die of cardiovascular disease, but there weren’t enough heart-related events to make that finding statistically significant.

Possible reasons for the higher death rates among normal-weight people with diabetes…

• The so-called obesity paradox. Even though overweight and obese people have a higher risk of developing diabetes, kidney disease and heart disease, they tend to weather these illnesses somewhat better, for unknown reasons, than lean or normal-weight people.

• Visceral fat, a type of fat that accumulates around the internal organs, isn’t always apparent. Unlike the fat you can grab, which is largely inert, visceral fat causes metabolic disturbances that increase the risk for diabetes, heart disease and other conditions. You can have high levels of visceral fat even if you’re otherwise lean. Visceral fat can truly be measured only by imaging techniques such as a CT scan (but the test is not commonly done for this reason). However, a simple waist measurement can help indicate whether you have visceral fat (see below).

• Lack of good medical advice. In normal-weight people who are screened and diagnosed with diabetes, their doctors might be less aggressive about pursuing treatments or giving lifestyle advice than they would be if treating someone who is visibly overweight.

HOW TO PROTECT YOURSELF

It’s estimated that about 25% of the roughly 29 million Americans with diabetes haven’t been diagnosed. Whether you’re heavy or lean…

• Get tested at least once every three years starting at age 45—regardless of your weight. That’s the advice of the American Diabetes Association (ADA). You may need even earlier testing and/or more frequent tests if you have risk factors, such as a family history of diabetes and/or a sedentary lifestyle. Talk to your doctor.

Remember: If your weight is normal, your doctor may have a lower clinical suspicion of diabetes—a fancy way of saying he/she wouldn’t even wonder if you have the condition. As a result, the doctor might think it’s OK to skip the test or simply forget to recommend it. Ask for diabetes testing—even if your doctor doesn’t mention it.

A fasting glucose test, which measures blood sugar after you have gone without food for at least eight hours, is typically offered. Alternative: The HbA1c blood test. It’s recommended by the ADA because it shows your average blood glucose levels over the previous two to three months. Many people prefer the A1c test because it doesn’t require fasting. Both types of tests are usually covered by insurance.

• Pull out the tape measure. Even if you aren’t particularly heavy, a large waist circumference could indicate high levels of visceral fat. “Abdominal obesity” is defined as a waist circumference of more than 35 inches in women and more than 40 inches in men. Even if you are under these limits, any increase in your waist size could be a warning sign. Take steps such as diet and exercise to keep it from increasing.

To get an accurate measurement: Wrap a tape measure around your waist at the level of your navel. Make sure that the tape is straight and you’re not pulling it too tight. And don’t hold in your stomach!

• Watch the sugar and calories. The Harvard Nurses’ Health Study found that women who drank just one daily soft drink (or fruit punch) had more than an 80% increased risk of developing diabetes.

Research has consistently linked sweetened beverages with diabetes. But it’s not clear whether the culprits are the sweeteners (such as high-fructose corn syrup) or just the extra calories, which lead to weight gain. Either way, it’s smart no matter what you weigh to eliminate soda and other supersweet beverages from your diet—or if you don’t want to give them up, have no more than one soft drink a week, the amount that wasn’t associated with weight gain in the study. Remember: A single soft drink often contains hundreds of calories.

• Get the right type of exercise. People who want to lose weight often take up aerobic workouts, such as swimming or biking, which burn a lot of calories. But if you don’t need to lose weight, strength training might be a better choice. When you add muscle, you significantly improve insulin sensitivity and enhance the body’s ability to remove glucose from the blood.

Walking may not sound very sexy, but it’s one of the best exercises going because it has both aerobic and muscle-building effects. In fact, walking briskly (at a pace that causes sweating and mild shortness of breath) for half an hour daily reduces the risk for diabetes by nearly one-third. That’s pretty impressive!

*Normal weight is defined as a body mass index (BMI) of 18.5 to 24.9…overweight is 25 to 29.9…and obese, 30 or above. To calculate your BMI, go to nhlbi.nih.gov and search for “BMI Calculator.”

Source: Mercedes Carnethon, PhD, associate professor of preventive medicine and epidemiology at Northwestern University Feinberg School of Medicine in Chicago, where she specializes in population studies of diabetes, obesity, cardiovascular disease and fitness.

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