But whether replacing those drinks with lower calorie options that include alternative sweeteners, like diet soda, is a viable option for people at risk of diabetes and other conditions remains a point of contention.
“There is a history of observational data correlating consumptions [of certain alternative sweeteners] with health risks including obesity and adiposity-based disease including diabetes, heart disease, and stroke,” Karl Nadolsky, DO, director of the Diabetes, Obesity & Metabolic Institute in Maryland, told Verywell.
Yet, he emphasized that while there are plausible concerns about the effects of artificial sweeteners, they can be helpful in replacing high sugar beverages. This is especially true for people struggling with their weight or chronic diseases like diabetes.
Most recently, data published in JAMA Open Network supports this. Specifically, a new study review showed that, over the moderate term, low and no-calorie sweetened beverages were associated with small reductions in weight and lower risk of health problems like heart disease and metabolic syndrome.
This is where sugar alternatives can help. Sugar alternatives can offer the sweetness of sucrose (table sugar), but with very few calories or are calorie-free. These alternatives can be naturally-occurring (like stevia) or synthetically created (like aspartame). But these sugar alternatives have been linked to health problems, too.
Can Alternative Sweeteners Be an Option?
Previous research shows that swapping out your sugar-sweetened drink (like regular soda) for water can result in weight loss.
While water should be your top beverage of choice, having other beverage options that offer a sweet taste with no calories can appeal to people who want a little variety.
Researchers conducted a systematic review and meta-analysis to determine whether drinks made with sugar alternatives can be a viable choice for people at risk for diabetes who are trying to lose weight. To conduct this analysis, researchers utilized 17 randomized clinical trials that had asked people to use beverages with alternative sweeteners. They looked at whether there was evidence that using these beverages was linked to health outcomes like weight loss and a lower risk of health problems like heart disease, high blood pressure, and high blood sugar.
“Only trials that were at least two weeks in duration (median follow-up was 12 weeks) with low or no-calorie sweetened beverages, sugar-sweetened beverages, and/or water with cardiometabolic risk factors were included,” Néma McGlynn, MSc, RD, registered dietitian and principal author of the study, told Verywell.
She added that they included studies that investigated the substitution of:
Low- and no-calorie sweetened beverages for sugar-sweetened beveragesWater for sugar-sweetened beveragesLow- and no-calorie sweetened beverages for water
Results showed that substituting sugar-sweetened beverages with sugar alternatives was associated with reduced body weight, body mass index (BMI), percentage of body fat, and liver fat levels.
“The small improvements seen with low- and no-calorie sweetened beverages for sugar-sweetened beverages are similar to those associated with water for sugar-sweetened beverages,” McGlynn explained. “The evidence supports the use of low- and no-calorie sweetened beverages over the moderate term as an alternative replacement strategy for sugar-sweetened beverages in adults with overweight or obesity who are at risk for or have diabetes.”
So, for people who are trying to lose weight to reduce their diabetes risk, it appears that “low- and no-calorie sweetened beverages is one tool that can be considered as part of an overall treatment plan to help people with weight loss or managing diabetes,” McGlynn added.
Other Ways to Reduce Your Added Sugars
Along with choosing drinks like water or low- and no-calorie sweetened beverages, there are other ways to satisfy your sweet tooth while reducing added sugars, including:
Using fruit, like dates and 100% orange juice, as a sweetener in recipes instead of sugarSaving sweet treats for special occasionsBeing mindful of proper portion sizes when enjoying foods with added sugarsAvoiding hidden sources of added sugars, like many jarred pasta saucesLimiting the use of fat-free condiments that may have more added sugars than full-fat choices (like fat-free salad dressings)
