3.11.0.0 Non­nu­tri­tive Sweet­en­ers

For some peo­ple with di­a­betes who are ac­cus­tomed to sugar-‍sweet­ened prod­ucts, non­nu­tri­tive sweet­en­ers (con­tain­ing few or no calo­ries) may be an ac­cept­able sub­sti­tute for nu­tri­tive sweet­en­ers (those con­tain­ing calo­ries such as sugar, honey, agave syrup) when con­sumed in mod­er­a­tion. While use of non­nu­tri­tive sweet­en­ers does not ap­pear to have a significant ef­fect on glycemic con­trol (127), they can re­duce over­all calo­rie and car­bo­hy­drate in­take (51). Most sys­tematic re­views and me­ta-­ana­ly­ses show benefits for non­nu­tri­tive sweet­en­er use in weight loss (128,129); how­ev­er, some re­search sug­gests an as­so­ci­a­tion with weight gain (130). Reg­u­la­to­ry agen­cies set ac­cept­able daily in­take lev­els for each non­nu­tri­tive sweet­en­er, defined as the amount that can be safe­ly con­sumed over a per­son’s life­time (35,131). For those who con­sume sugar-‍sweet­ened bev­er­ages reg­u­lar­ly, a low-‍calo­rie or non­nu­tri­tive-‍sweet­ened bev­er­age may serve as a short-‍term re­place­ment strat­e­gy, but over­all, peo­ple are en­cour­aged to de­crease both sweet­ened and non­nu­tri­tive-‍sweet­ened bev­er­ages and use other al­ter­na­tives, with an em­pha­sis on water in­take (132).