Journal Article

Practical Strategies to Help Reduce Added Sugars Consumption to Support Glycemic and Weight Management Goals

Edelman, Steven V, Warshaw, Hope

2021

Overview

Overconsumption of added sugars is a key contributor to the growing obesity, prediabetes, and type 2 diabetes pandemics. The nutrition therapy guidance of the American Diabetes Association recognizes that using low- and no-calorie sweeteners (LNCS) to reduce consumption of added sugars can reduce low–nutrient-density sources of calories and carbohydrate to beneficially affect glycemia, weight, and cardiometabolic health. This article provides information for primary care providers, diabetes care and education specialists, and other diabetes clinicians on the safety of LNCS and summarizes research evidence on the role of LNCS in glycemic and weight management. It also provides practical strategies for counseling individuals about how to integrate LNCS into their healthy eating pattern. The increasing number of adults and children/adolescents who are overweight and obese in the United States is a national health concern. Numerous studies have shown that overweight and obesity are significant risk factors for several interrelated health conditions, including prediabetes, type 2 diabetes, cardiovascular and cerebrovascular disease, hypertension, stroke, and other significant health conditions of increasing concern (1,2), such as nonalcoholic steatohepatitis and nonalcoholic fatty liver disease (3). Excessive weight is a concern in individuals with type 1 or type 2 diabetes and is a leading risk factor for prediabetes (4) because it decreases insulin sensitivity, which creates additional challenges in achieving and maintaining management of glycemia and other cardiometabolic health metrics (5). Given the growing pandemics of type 1 and type 2 diabetes, prediabetes, and obesity and their associated costs (6), it is imperative that primary care providers (PCPs), diabetes care and education specialists, and other diabetes clinicians provide people who have or are at risk for developing diabetes with practical strategies for weight management and healthier eating. For many people, the most challenging part of their diabetes care plan is knowing what to eat and adhering to a healthy eating plan over time (7). Some individuals can achieve some success by reducing consumption of added sugars by choosing foods and beverages sweetened with low- and no-calorie sweeteners (LNCS) and using their preferred type and forms of table-top LNCS to sweeten foods and beverages. LNCS, the term used throughout this publication, are also referred to as low-calorie sweeteners, nonnutritive sweeteners, sugar substitutes, and high-intensity sweeteners (8). As sweetening ingredients, LNCS add no or negligible calories to foods and beverages. This article reviews evidence supporting the safety and efficacy of LNCS in glycemic and weight management. It also provides practical strategies for clinicians to help people with diabetes and prediabetes effectively use LNCS to replace full-calorie sources of added sugars to assist with weight management and glycemic goals.

• Publisher: American Diabetes Association
• Subject: Calories / Diabetes / Fatty liver / Glycemic index / Nutrition therapy / Obesity / Syrups & sweeteners / Weight control