Healthcare Professionals Newsletter, April 2021

April 1, 2021
Science Based Brief

The Role of Sweeteners in
Weight Management

Sweeteners

With a variety of sweeteners being widely present in foods, the role of non-nutritive sweeteners in weight management has been a controversial topic and point of research in recent years. It’s no secret that sweeteners typically contain calories and are used to enhance the flavor and sometimes the texture of food. Conversely, non-nutritive sweeteners (NNS), some of which are also known as artificial sweeteners (AS) and high-intensity sweeteners (HIS), provide little to no calories. Here is a look at the role sweeteners play in weight management.

Sweeter Than Sugar
Although sugar substitutes have been around for over 140 years, the last two decades have seen a dramatic uptick in the types of sweeteners available and the variety of foods where they can be found. Consumer interest in non-nutritive sweeteners can be divided into two groups: those looking to avoid health issues associated with a high intake of sugar and those who are obese, have diabetes or heart disease, and are looking to improve their choices to manage their health.1

Some non-nutritive sweeteners are described as being hundreds of times sweeter than table sugar, so a little goes a long way to help sweeten certain foods. But besides flavor, do these sweeteners have a role in helping with weight management?

With the increased interest in reducing sugar intake, non-nutritive sweeteners have become increasingly popular. They can help reduce the intake of calories from added sugars and reduce overall calorie intake, and hundreds of studies have examined their effectiveness in weight management.2,3

Non-Nutritive Sweeteners Along with a Healthy Diet and Lifestyle Can Help Manage Weight
A recent review noted that associations found between artificial sweeteners and obesity could be explained by an increase in artificial sweeteners intake to compensate for a poor diet.4 For example, if choosing a diet soda with a high-calorie fast food meal, the artificial sweeteners in the diet soda does not remedy the overall choices of the meal.

Some research shows that non-nutritive sweeteners cannot assist with weight management when the individual is not cognitively engaged in weight loss. Furthermore, there are discrepancies in observational and interventional studies about how non-nutritive sweeteners can play a role in managing weight. Some trials can be limited by highly controlled environments that do not reflect day-to-day dietary habits. When non-nutritive sweeteners are substituted for added sugars and included as a part of a healthy diet and lifestyle, they can help people limit energy intake and contribute to weight management.5

Consideration of glycemic index (GI) of a sweetener and glycemic load (GL) of the diet might help people make better sweetener choices for weight management.

The Glycemic Index and Weight Management
GI ranks carbohydrate-containing foods according to their blood glucose raising potential. These foods can be classified as high (≥70), moderate (56-69), or low (≤55) when compared to pure glucose, which has a GI of 100. The GL is determined by multiplying the quality of carbohydrate (GI) in a food by the amount of carbohydrate in that food. Several interventional studies have examined the effects of low GI/GL diets in reducing body weight and found they were as effective as low-fat diets. Overall, a diet rich in foods such as legumes, fruit, nuts, whole grains, and non-starchy vegetables can lower GL, adding credence to the importance of consuming a healthful diet along with low-GI sweeteners for weight management.6

A Sampling of Sweeteners
Erythritol, monk fruit and stevia are classified as natural alternative sweeteners (NAS). Studies suggest that when compared to artificial sweeteners, such as acesulfame-K, and also sugar-containing foods, NAS have beneficial effects on glucose metabolism; in short, how glucose is made available to the body for energy.7 The studies show conflicting results though, and more research is needed to confirm. The Pang 2021 review suggested that each AS may impart different effects on the body, making it important to consider AS individually in their role in weight management.4

A systematic review of non-nutritive sweeteners found that acesulfame-K and stevia did not increase blood glucose levels, suggesting a glycemic index of 0, but further studies are warranted.8

Here is a look at are some of the popular sweeteners used in the food industry:

Coconut sugar is extracted from the sap of the coconut palm tree, and is made through minimal processing.9 It supplies 15 calories per teaspoon, the same as table sugar.10 Although there are few studies on it, coconut sugar has a low glycemic index (35-42) compared to table sugar (63), which bodes well for its benefits in weight management.6

Erythritol is a low-calorie (0.2 kcal/g) sugar alcohol derived from the fermentation of natural sugars such as glucose and sucrose. Erythritol has a glycemic index of 0.12 Erythritol is not well absorbed in the digestive tract and is excreted unchanged in the urine, so it does not cause the digestive discomfort associated with some other sugar alcohols.12

Acesulfame-K, sometimes called acesulfame potassium or ace-K, has 0 calories and is a high-intensity sweeteners. As Acesulfame-K is broken down in the body, acetoacetamide is formed. This compound can be toxic in large amounts, so an acceptable daily intake has been set at 15 mg/kg body weight, which is about 1,000 mg for a person weighing 165 pounds, about the amount found in 23 sweetener packets.2,12

Sucralose, a high-intensity sweetener with 0 calories, is stable during baking and cooking making it a widely used sweetener. Studies show concern about its safety at high doses, so it has an acceptable daily intake of 5 mg/kg body weight, which is about 330 mg for a person weighing 165 pounds, about the amount found in 23 sweetener packets. 2,10,12

Monk fruit is a plant extract used as a natural sweetening agent for centuries in China. It has 0 calories.10,13

Stevia Rebaudiana, commonly known as stevia, is derived from a plant found in South America and was first used over 200 years ago.12,14 It is a sustainable sweetener using lower inputs of land, water, and energy to produce the same amount of sweetness when compared to beet sugar and cane sugar. Stevia has 2 kcal/g.14

Organic cane sugar provides 16 calories per teaspoon10, and when used in small quantities, a little goes a long way for enhancing the palatability of healthy foods which can lead to improvements in dietary choices that help people manage weight gain.15,16

Sweeteners in Orgain Products
Orgain prefers organic, natural, and sustainable sweeteners. Monk fruit is a sweetener in the 20g Clean Protein Shakes and Plant Protein Shakes. Organic stevia is used in many of the products and organic coconut sugar is found in the Simple Organic Protein Powder. Organic erythritol, found naturally in fruits and vegetables, is used to sweeten some products including the Organic Protein Bar. And organic cane sugar is used to lightly sweeten the Nutritional Shakes, and the 2020-2025 Dietary Guidelines for Americans recommends using a small amount of added sugars to nutrient-dense foods, such as these shakes, to help people consume them.16

The position statement of the Academy of Nutrition and Dietetics notes that when they are used in place of added sugar, non-nutritive sweeteners can help manage weight.15 Certain sweeteners may offer a promising approach to managing weight when used along with a healthy diet and lifestyle.

Grey Line

1 Liauchonak I, Qorri B, Dawoud F, Riat Y, Szewczuk M. Non-Nutritive Sweeteners and Their Implications on the Development of Metabolic Syndrome. Nutrients 2019; 11, 644. doi:10.3390/nu11030644
2 Mooradian A, Smith M, Tokuda M. The Role of Artificial and Natural Sweeteners in Reducing the Consumption of Table Sugar: A Narrative Review. Clinical Nutrition ESPEN 2017; 18:1-8. http://dx.doi.org/10.1016/j.clnesp.2017.01.004
3 Lohner S, Toews I, Meerpohl JJ. Health Outcomes of Non-Nutritive Sweeteners: Analysis of the Research Landscape. Nutrition Journal 2017; 16:55. doi:10.1186/s12937-017-0278-x
4 Pang MD, Goossens GH, Blaak EE. The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis. Frontiers in Nutrition 2021; 7:598340. doi: 10.3389/fnut.2020.598340
5 Sylvetsky A, Rother K. Non-Nutritive Sweeteners in Weight Management and Chronic Disease: a review. Obesity 2018; 26(4): 635–640. doi:10.1002/oby.22139
6 Linus Pauling Institute. Oregon State University. Glycemic Index and Glycemic Load. Available at: https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load, accessed 3/4/2021
7 Mejia E, Pearlman M. Natural Alternative Sweeteners and Diabetes Management. Current Diabetes Reports 2019; 19:142. https://doi.org/10.1007/s11892-019-1273-8
8 Nichol A. Holle MJ. An R. Glycemic Impact of Non-Nutritive Sweeteners: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. European Journal of Clinical Nutrition 2018; 72-796-804. https://doi.org/10.1038/s41430-018-0170-6
9 Gardner E. Coconut Sugar. British Dental Journal 2017. 223:10. https://doi.org/10.1038/sj.bdj.2017.1011
10 Nutritionix Database, nutrition facts for coconut sugar. Available at: https://www.nutritionix.com/food/coconut-sugar, nutrition facts for monk fruit available at: https://www.nutritionix.com/i/lakanto/monkfruit-sweetener/58cb8bbdc72595302a02df5f accessed 3/5/2021.
11 Trinidad TP, Mallillin AC, Sagum RS, & Encabo R R. Glycemic Index of Commonly Consumed Carbohydrate Foods in the Philippines. Journal of Functional Foods 2010; 2(4):271–274. https://www.sciencedirect.com/science/article/pii/S1756464610000575
12 Moriconi E, Feraco A, Marzolla V, Infante M, Lombardo M, et al. Neuroendocrine and Metabolic Effects of Low-Calorie Sweeteners and Non-Calorie Sweeteners. Frontiers in Endocrinology 2020; 11:444. doi: 10.3389/fendo.2020.00444 https://www.sciencedirect.com/science/article/pii/S1756464610000575
13 Tey SL, Salleh NB, Henry J, Ford CG. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake. International Journal of Obesity 2017; 41:450-457. doi:10.1038/ijo.2016.225
14 Ashwell M. Stevia, Nature’s Zero-Calorie Sustainable Sweetener.Food and Nutrition 2015; 50:3. DOI: 10.1097/NT.0000000000000094
15 Khan T, Sievenpiper JL. Controversies About Sugars: Results from Systematic Reviews and Meta‑Analyses on Obesity, Cardiometabolic Disease and Diabetes. European Journal of Clinical Nutrition 2016; 55 (Suppl 2):S25–S43. DOI 10.1007/s00394-016-1345-3
16 USDA. Dietary Guidelines for Americans 2020-2025. Available at DietaryGuidelines.gov, accessed 3/11/2021.
17 Journal of the Academy of Nutrition and Dietetics. Position Paper. 2012;112:739-758

Nutrition

Nutrition Advisory Board Member
Spotlight: Jill Castle, MS, RDN

Jill

This month, we sat down with Orgain’s pediatric nutrition advisor and one of the nation’s premier childhood nutrition experts, Jill Castle, MS, RDN. Jill blends current research, practical application and common sense to inspire audiences to think differently about feeding kids. A sought-after speaker, media contributor, and member of the Board of Advisors for Parents Magazine, Jill shared with us about her journey toward earning the RDN credentials, details on her informative podcast, and advice for HCPs on how to counsel families on healthy eating.

1. We would love to hear about your journey toward becoming a Registered Dietitian Nutritionist. Why did you decide to pursue this profession?

After being a chemistry major and “experiencing” organic chemistry, I decided to switch my major but I didn’t really know what I wanted to pursue. My father encouraged me to take a nutrition class. He was a fan of Richard Simmons’ “Deal a Meal” and saw the power of paying attention to what you eat. I took a Nutrition 101 undergraduate class and fell in love with the topic! As my study of nutrition grew, it was a no-brainer to go into pediatric nutrition. I love children, food and the psychology of feeding and eating.

2. What is one of the most frequently asked question that you receive from parents and what are your recommendations?

I am asked about snacking and picky eating a lot. I’m asked so much that I decided to capture my advice in two books. The Smart Mom’s Guide to Healthy Snacking provides parents with a blueprint for raising smart snackers. From food guidance and how to monitor snacking to how to serve snacks and build independence using snack time, I encourage parents to bring as much predictability and structure to snacking as they do for mealtimes.

As it relates to picky eating, my advice captures food, feeding and child development, or the whole child model I used with my own kids and clients. Food advice alone won’t cure picky eating. In fact, I tend to focus less on food and more on feeding and development, because picky eating is often a symptom of a developmental milestone. Picky eating requires a deeper look at the child in the context of his temperament and development, as well as the feeding practices parents are using. I get more granular and try to empower parents with more knowledge about picky eating and extreme picky eating (ARFID) in my book, Try New Food: How to Help Picky Eaters Taste, Eat & Like New Foods.

3. Can you please share any advice for healthcare professionals in counseling families on healthy eating?

Counseling encapsulates an intimate relationship with families. I think it’s important to bring a lot of humanity and ask questions. To be able to tolerate the exploration of possibilities for change (or not). And to especially ask questions about what families need, where they’re at right now, and what transformation or change they expect to achieve from working with someone on their nutrition. It’s also important not to bring biases and assumptions to the table. For example, it’s not productive to judge the health quality of the family food supply or assume families can access or afford fresh fruits and vegetables. We need to meet each family where they’re at, and we won’t know this unless we ask.

Personally, and from a nutrition perspective, I use the philosophies of “all foods can fit” and “how can we add to the diet?” (rather than eliminate or take away).

4. Tell us about The Nourished Child® podcast? What has been your most memorable episode thus far?

The Nourished Child® launched in 2016 with the intention of creating further dialogue around childhood nutrition, providing parents with practical, evidence-based tips and strategies around feeding kids through expert interviews and professional guidance. I’m proud to say the show has 131 episodes to date, over 350,000 downloads, and has hosted more than 80 different expert guests.

There are so many memorable episodes for me, but the ones that really stand out are the ones where I’ve learned something new, like episode #109 where I interviewed a teen who had experienced bariatric surgery, or episode #86 which was about emotions and eating in children. Of course, I’m a fangirl too, so interviewing Dr. Perri Klass (author and writer for the New York Times) and Olympian Gevvie Stone have been personal highlights.

5. What interested you in becoming a member of the Orgain Nutrition Advisory Board?

When I was in private practice, I saw a lot of underweight kids. Many parents wanted a nutritional supplement that was not only convenient and nutritious, but also more natural and sourced from ingredients they could recognize. That’s what led me to Orgain. Orgain’s line of both plant-based and dairy-based nutritional beverages and whole grain bars are something parents and professionals can feel good about giving to kids.

In case you missed, it, be sure to watch Jill’s webinar presented as part of Orgain’s Professional On-Demand Webinar Series, “Pediatric Nutrition Breakthroughs: 5 Advances Every Practitioner Should Know” Click here to watch it now.

Orgain in Practice

Practitioner Testimonial

This month, Sarah Sorensen, MS, RD shared her personal story on how she has used Orgain to help in the management of Inflammatory Bowel Disease and why she confidently recommends Orgain to her patients.

Keith Hine, MS, RD, Senior Director of Healthcare and Sports

“Orgain has changed my life! These delicious shakes and products offer much more than a quality taste. They have greatly contributed to my management of Inflammatory Bowel Disease. Through both partial and exclusive enteral nutrition, Orgain is a product that I don’t feel forced to drink, but one that I actually look forward to as a part of my daily routine – my cup of coffee.

As an inpatient dietitian, I recommend Orgain to patients similar to me, and especially for anyone whose looking for a clean, nutritious product with the flavors they will love! From wholesome ingredients to a variety of tasteful flavors, Orgain has truly maximized nutrition in a therapeutic way.”

– Sarah Sorensen, MS, RD

New at Orgain

Orgain’s Packaging Refresh

Packaging Refresh

We are excited to share that Orgain’s packaging has been refreshed for 2021! It has a more premium look and feel with easier-to-read labels making it faster to identify which products are dairy or plant-based! With more detailed information on the nutrition facts panel, we hope this update will give you more helpful information to share with your patients and clients. In addition to the front of the package, here’s what you’ll find on our nutrition labels:

– Soluble and insoluble fiber
– Mono- and polyunsaturated fats
– Indication of vitamins and minerals supplying 10% daily value or more per serving

Keep an eye out for the updated Orgain packages and let us know when you see them in stores or tag us in your pictures on social media! We would especially love to hear your feedback on the new packaging!

Healthcare Community

Share Your Opinion

We asked Orgain’s Healthcare Ambassadors how they help patients and clients personalize their plates while working toward their health goals during National Nutrition Month and beyond. Here is what your colleagues had to say:

“As a dietitian, I believe there is no one-size-fits-all approach to nutrition and take my clients personal history, and dietary cultural preferences, into account when recommending meal and snack ideas. No matter which diet is recommended, I think it’s important to incorporate cultural foods and even find new ways to prepare them, if necessary. I also recommend eating with lots of color and variety, including exploring new ways to eat fruits and veggies whenever possible!”
– Samina Kalloo, RDN, CDN

We value the expertise of healthcare professionals and want to hear from you! Join the conversation and share your opinion in the Orgain Healthcare Ambassador Collective group on Facebook for a chance to be featured in next month’s newsletter!

What ingredients do you talk about the most with your patients and clients?

Click here to weigh in with other Orgain Healthcare Ambassadors! If you haven’t already, request an Ambassador account, then join the private group on Facebook. We look forward to hearing from you!

Professional Education

Upcoming Orgain-Sponsored Live Webinars by Subject Matter Experts

Webinar Thumbnail
Intermittent Fasting: A Novel Approach to Reduce the Risk of Cardiometabolic Disease or Just Another Diet Fad?

Kristin Hoddy, PhD, RD

Approved for 1.0 CPEU for RDNs and DTRs
April 22, 2021 at 2pm EDT

REGISTER HERE
Webinar Thumbnail
Food Truths, Trends and the Pandemic: Diet and Nutrition Trends Impacting Health

Kathleen M. Zelman, MPH, RDN, LD

Approved for 1.0 CPEU for RDNs and DTRs
June 10, 2021 at 2pm EDT

REGISTER HERE
Webinar Thumbnail
Recovery Nutrition for Athletes: Sifting Out the Science from the Sensationalism

Becca McConville, MS, RD, LDN, CSSD, CEDRD-S

Approved for 1.0 CPEU for RDNs and DTRs
August 12, 2021 at 2pm EDT

REGISTER HERE
Webinar Thumbnail
Eating Like the World Depends On It (because it does…)

David L. Katz, MD, MPH, FACPM, FACP, FACLM

Approved for 1.0 CPEU for RDNs and DTRs
September 9, 2021 at 2pm EDT

REGISTER HERE
Webinar Thumbnail
Prescribing Wellness: Practitioner Steps for Patient Success.

Beryl Krinsky, MBA, MS, RD, LDN

Approved for 1.0 CPEU for RDNs and DTRs
October 7, 2021 at 2pm EDT

REGISTER HERE
Webinar Thumbnail
Individualizing Nutrition for Type 2 Diabetes: Out with the Old, In with the New

Angela Manderfeld, MS, RD, CDCES, BC-ADM

Approved for 1.0 CPEU for RDNs and DTRs
November 11, 2021 at 2pm EDT

REGISTER HERE

You May Also Like