Equal

Weight Management

A National Health Issue

Currently, over 7 million Australians (about 60 percent) over the age of 25 are overweight¹. Given that overweight and obesity are associated with an increased risk of diseases like cardiovascular disease, cancer and type II diabetes; healthy weight management is one of the nations major health issues.

Managing weight - fat restriction versus total energy control

There is general agreement that maintaining energy balance is central to weight management. Energy expenditure is a critical part of the equation and exercise recommendations should be included with dietary recommendations². But it is energy intake where the focus often lies, in particular on the restriction of dietary fat. It has been suggested that dietary fat is metabolised less efficiently than carbohydrate or protein and therefore it is easier to lose weight on a low fat diet³. However, total kilojoule reduction, rather than diet composition, seems to be the primary determinant of weight loss⁴. Short-term studies suggest that diets, which restrict total energy, are more effective in terms of weight loss than diets which restrict only fat⁵. Fat restricted diets have been shown to result in only modest weight loss⁶.

Naturally, dietary fat reduction is recommended as part of an overall strategy to reduce energy balance^6,7. But concerns have been raised that fat reduction can be over-emphasised at the expense of total energy intake and physical activity. For instance, there are an increasing number of low fat foods available on the Australian market, yet some of these may contain significant amounts of sugar or other carbohydrates and consequently the energy density is similar to higher fat versions. Such foods are not useful in terms of weight loss^6,8. Sweeteners like Equal can replace nutritive sweeteners like sugar at a kilojoule saving of up to 62 kJ/teaspoon.

Effects of aspartame on hunger, and food intake

In a comprehensive review, there was no consistent or compelling evidence that consuming foods with aspartame increases total food intake or body weight⁹. Only a few studies showed enhancement of hunger following intake of aspartame-sweetened water, but these failed to demonstrate a link between increased hunger and increased energy intake. In fact, the wide body of evidence pertaining to the use of aspartame in beverages or foods suggests that the consumption of these products is associated with reduced or unchanged energy intake⁹.

Effects of aspartame on weight management

Kanders et al¹⁰ conducted a randomised, controlled, prospective clinical trial investigating whether the addition of aspartame to a multidisciplinary weight control program would improve weight loss and long-term weight control in obese women. One hundred and sixty three obese women were placed on a low energy diet for a 4-month active weight loss phase. They were randomly assigned to either consume or abstain from aspartame-sweetened foods and beverages. This was followed by a 12-month weight maintenance phase and a 19-month follow-up when participants were encouraged to continue or abstain from aspartame according to their original group assignment. During the active weight-loss phase, participants were also instructed on behavioural and lifestyle strategies and encouraged to exercise.

The follow up data show women in both groups lost about 10% of body weight during the weight-loss phase. Among those women in the aspartame group, consuming more aspartame was associated with a greater weight loss. During maintenance, participants in both groups experienced weight gain, however this was significantly less in the aspartame group compared to the no aspartame group. Other factors associated with better weight maintenance included increased exercise and greater self-reported eating control.

References:

1. Australian Institute of Health & Welfare, Heart Stroke and Vascular diseases. National Centre for monitoring Cardiovascular Disease. AIHW Cat. No. CVD13, April 2001
2. World Health Organisation. 1998. Obesity - Preventing and managing the global epidemic. Report of a WHO consultation on obesity. WHO.
3. Flatt JP. 1995. Use and storage of carbohydrate and fat. AJCN 61(suppl):952S-9S.
4. Alford BB, Blankenship AC, Hagen RD. 1990. The effects of variations in carbohydrate, protein and fat content of the diet upon weight loss, blood values and nutrient intake of adult obese women. JADA 90:534-40.
5. Harvey-Berino J. 1998. The efficacy of dietary fat versus total energy restriction for weight loss. Obes Res 4:347-56.
6. Bray GA, Popkin BM. 1998. Dietary fat intake does affect obesity. AJCN 68:1157-73.
7. Astrup A, Toubro S, Raben A, Skov AR. 1997. The role of low-fat diets and fat substitutes in body weight management: what have we learned from clinical studies? JADA 27 (suppl):s82-7.
8. Willett WC. 1998. Is dietary fat a major determinant of body fat? AJCN 67(suppl):556s-62S.
9. Rolls J, Shide DJ, 1996. Evaluation of Hunger, Food Intake, and Body Weight. In: Tschanz C, Butchko H, Stargel W, Kotsonis F, (Eds.) The Clinical Evaluation of a Food Additive. pp 275-287. New York, CRS Press.
10. Kanders BS, Blackburn GL, Lavin PT, Kienholz, M. 1996. Evaluation of Weight Control. In: Tschanz C, Butchko H, Stargel W, Kotsonis F, (Eds.) The Clinical Evaluation of a Food Additive. pp 289-299. New York, CRS Press.