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Editor's e-Note
The Truth About Nonnutritive Sweeteners and Prediabetes

There’s been conflicting evidence over the years about the effects of nonnutritive sweeteners on people with prediabetes and diabetes. Some studies have suggested that regular consumption of nonnutritive sweeteners in foods and beverages can increase appetite and cause weight gain, while others have shown they don’t boost appetite and can lead to weight loss. This month’s E-News Exclusive explores this controversy and offers tips on how to counsel clients and patients.

After reading the article, visit Today’s Dietitian’s website at www.TodaysDietitian.com. You’ll find the digital edition of the July issue, which features highlights from Today’s Dietitian’s first annual spring symposium that took place at the Tropicana Las Vegas in May, plus you’ll find the latest news and information relevant and reliable to daily practice. We welcome your feedback at TDeditor@gvpub.com. Enjoy the e-newsletter, and follow Today’s Dietitian on Facebook and Twitter.

— Judith Riddle, editor
Field Notes
Are Nonnutritive Sweeteners Helpful for Prediabetes?
By Constance Brown-Riggs, MSEd, RD, CDE, CDN

In the United States, there are 86 million adults living with prediabetes, a condition that increases the risk of type 2 diabetes, heart disease, and stroke.1 Research supports that achieving a healthy body weight and increasing physical activity reduces the risk of type 2 diabetes by up to 58%.2

According to the 2012 scientific statement from the American Heart Association and the American Diabetes Association, substituting nonnutritive sweeteners for added sugars in beverages and other foods has the potential to help people reach and maintain a healthy weight and control blood glucose. However, myths and misinformation regarding the role of nonnutritive sweeteners in weight management and appetite control have patients with prediabetes questioning their use.

This article discusses the latest research on nonnutritive sweeteners’ effectiveness on weight loss and appetite control, and provides tips on counseling individuals with prediabetes about their use.

Prediabetes
People with prediabetes have blood glucose levels that are higher than normal but not high enough for a diabetes diagnosis. Without lifestyle changes, including achieving weight loss and increased physical activity, 15% to 30% of people with prediabetes will develop type 2 diabetes within five years of their prediabetes diagnosis.2 Nonnutritive sweeteners play an important part in helping these individuals reduce caloric intake, improve diet quality, and lose weight.

“When someone is already prediabetic, their blood sugars can be higher than ideal. Therefore, eating foods that are very high in carbohydrates, such as cakes and cookies, isn’t desirable. Nonnutritive sweeteners, in turn, can sometimes provide a patient with a better alternative than eating their usual sweetened desserts and beverages,” says Marlisa Brown, MS, RD, CDE, CDN, president of Total Wellness in Bay Shore, New York.



Weight Loss and Appetite Control
Previous studies have suggested that using nonnutritive sweeteners may increase a person’s appetite for sweet foods and cause weight gain.3,4 Sylvia E. Meléndez-Klinger, MS, RD, LDN, owner of Hispanic Food Communications in Chicago, says new research from a groundbreaking randomly controlled trial proves differently. “The most recent study published in the June 2014 issue of Obesity directly compared the effects of nonnutritive sweetened beverages to water on weight loss. The study found that subjects who consumed nonnutritive sweetened beverages lost 44% more weight than controls over 12 weeks,” she says.

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In the August issue

Top 10 diabetes meal patterns

A look at dairy’s probiotic power

Gluten-free fast food

Building a career through public speaking

Diabetes resource guide
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This app lets users snap photos of their meals and create a daily food diary. It then estimates the number of calories they ate, making food tracking easier. Users can get a rough estimate of what they’re eating as opposed to tediously entering every single food throughout the day. Learn more »

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Have a dietetics-related question that you'd like our expert, Toby Amidor, MS, RD, CDN, to answer? E-mail TDeditor@gvpub.com or send a tweet to @tobyamidor, and we may feature your query!
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Field Notes
Experts Say Multifactorial Approach Is Best to Treat Diabetes Mellitus

In a recent commentary published in the American Journal of Managed Care, researchers emphasized the critical need for clinicians to aggressively use a multipronged approach to reduce the risk of complications and premature death from type 2 diabetes.

“There’s an emerging pandemic of type 2 diabetes that’s related to the dramatic increase in obesity, fast becoming the leading avoidable cause of death worldwide,” says Charles H. Hennekens, MD, DrPH, the first Sir Richard Doll professor and the senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at Florida Atlantic University. “People with type 2 diabetes have twice the risk for premature death due to complications from kidney failure, stroke, heart failure, and blindness due to retinopathy.”

The authors stated that intensive glucose control, a cornerstone of treatment for patients with diabetes, is necessary but not sufficient to achieve the maximum benefits in reducing complications and premature death. Clinicians should consider adopting all approaches of proven benefits in screening and managing their patients, which include adjunctive drug therapies to therapeutic lifestyle changes to achieve sustained weight loss, increases in physical activity, and lipid, blood pressure, and glycemic control.

Read more »
 
Other News
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Overestimate Exercise Intensity

A new study by Canadian researchers suggests that most people don’t know what moderate exercise means and often overestimate how vigorously they’re working out, according to The New York Times.

Cold Exposure May Change White Fat,
Aiding Weight Loss

The Los Angeles Times takes a look at a team of scientists who are using cold exposure to turn white fat beige, potentially aiding weight loss.
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