J Korean Diabetes.  2023 Dec;24(4):221-226. 10.4093/jkd.2023.24.4.221.

Diabetes and Non‑Nutritive Sweeteners

• Lee J

• KMID: 2550163
• DOI: http://doi.org/10.4093/jkd.2023.24.4.221

Abstract

Non-nutritive sweeteners (NNS) can provide strong sweetness in small amounts and have fewer calories compared to sugar. However, there is much debate within the academic community regarding their long-term impact on health. For individuals with diabetes who find it challenging to reduce added sugar intake, limited short-term use of NNS may be considered as a step toward reducing sugar consumption. However, ultimately, it is important to reduce both sugar-containing beverages and those containing NNS. Diabetes educators should educate patients about the need for caution when consuming NNS and provide guidance on healthy food choices.

Keyword

Diabetes mellitus; Education; Non-nutritive sweeteners

Reference

1.Jung J. Action plan for sugars reduction. Food Sci Ind. 2016. 49:12–6.

2.Han TC., Seo I., Lim HJ., Kih MJ. Reducing sugar content in processed foods using high intensity sweeteners. Food Sci Ind. 2016. 49:29–39.

3.Park SY., Moon GB., Kim YS., Kim SH. Simple sugar intake in diabetics and non-diabetic patients who visit primary care clinic. Korean J Fam Pract. 2021. 11:29–38.

4.World Health Organization. Guideline: sugars intake for adults and children. Geneva: World Health Organization;2015. p. 1–59.

5.Ministry of Health and Welfare; The Korean Nutrition Society. Dietary reference intakes for Koreans 2020. Sejong: Ministry of Health and Welfare;2020.

6.Malik VS., Popkin BM., Bray GA., Després JP., Willett WC., Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010. 33:2477–83.

7.Malik VS., Popkin BM., Bray GA., Després JP., Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010. 121:1356–64.

8.Malik VS., Pan A., Willett WC., Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013. 98:1084–102.

9.Malik VS., Schulze MB., Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006. 84:274–88.

10.Vartanian LR., Schwartz MB., Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 2007. 97:667–75.

11.Sheiham A., James WP. A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake. BMC Public Health. 2014. 14:863.

12.Sheiham A., James WP. A new understanding of the relationship between sugars, dental caries and fluoride use: implications for limits on sugars consumption. Public Health Nutr. 2014. 17:2176–84.

13.Korean Diabetes Association. Clinical practice guidelines for diabetes. 8th ed.Seoul: Korean Diabetes Association;2023.

14.Korean Dietetic Association. Manual of medical nutrition therapy. 4th ed.Seoul: The Korean Dietetic Association;2022. p. 163.

15.U.S. Food and Drug Administration. Aspartame and other sweeteners in food. Available from: https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweet-eners-food (updated 2023 Jul 14).

16.National Institute of Food and Drug Safety Evaluation. Risk assessment of sweeteners. Cheongju: National Institute of Food and Drug Safety Evaluation;2016.

17.Korean Diabetes Association. Information for practicing dietary therapy. Available from: https://www.diabetes.or.kr/general/dietary/dietary_06.php.

18.Ministry of Food and Drug Safety. Notification no. 2022-66. Labeling standards of foods, etc. Available from: https://www.mfds.go.kr/brd/m_207/view.do?se-q=14822&srchFr=&srchTo=&srchWord=&srchTp=&itm_seq_1=0&itm_seq_2=0&multi_itm_seq=0&company_cd=&company_nm=&page=1 (updated 2022 Sep 6).

19.World Health Organization (WHO). Use of non-sugar sweeteners: WHO guideline. Geneva: WHO;2023.

20.Avena NM., Rada P., Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008. 32:20–39.