Effect of high levels of intense sweetener intake in insulin dependent diabetics on the ratio of dietary sugar to fat: A case-control study

Objective: To examine the influence of intense sweetener consumption on nutrient intakes in insulin dependent diabetics compared to controls. Design: Case-control food consumption survey. Setting: Dietary data were collected from individuals in Ireland between 1998 and 1999. Subjects: Diabetics were recruited through diabetic outpatient departments of St. James's Hospital Dublin. Controls were friends of the patients or staff/students of Trinity College and University College Dublin. Of the 171 diabetics contacted, 122 agreed to participate (70% response rate) and 119 completed the study. Interventions: In all, 3-day food diaries were used to collect the food consumption data. Main outcome measures: Fat - sugar seesaw, intense sweetness. Results: Patients had significantly higher % energy from starch, lower % energy from sugars and a high intake of fibre compared to controls. In both groups, there was an inverse relationship between % energy from fat and % en from sugar, with the diabetics at the lower level of sugar intake. A score of intense sweetness intakes was computed and across tertiles of this score, there were no significant effects on macronutrient intakes. Conclusion: The fat-sugar seesaw present in the diabetic group was at a lower level compared to the control group. A high intake of intense sweeteners does not have a detrimental effect on macronutrient and micronutrient intakes.