Strategies to reverse the upward trend in obesity rates need to focus on both reducing energy intake and increasing energy expenditure. The provision of low-or reduced-energy-dense foods is one way of helping people to reduce their energy intake and so enable weight maintenance or weight loss to occur. The use of intense sweeteners as a substitute for sucrose potentially offers one way of helping people to reduce the energy density of their diet without any loss of palatability.This report reviews the evidence for the effect of aspartame on weight loss, weight maintenance and energy intakes in adults and addresses the question of how much energy is compensated for and whether the use of aspartame-sweetened foods and drinks is an effective way to lose weight.All studies which examined the effect of substituting sugar with either aspartame alone or aspartame in combination with other intense sweeteners on energy intake or bodyweight were identified. Studies which were not randomised controlled trials in healthy adults and which did not measure energy intakes for at least 24 h (for those with energy intakes as an outcome measure) were excluded from the analysis. A minimum of 24-h energy intake data was set as the cut-off to ensure that the full extent of any compensatory effects was seen. A total of 16 studies were included in the analysis. Of these 16 studies, 15 had energy intake as an outcome measure. The studies which used soft drinks as the vehicle for aspartame used between 500 and about 2000 ml which is equivalent to about two to six cans or bottles of soft drinks every day.A significant reduction in energy intakes was seen with aspartame compared with all types of control except when aspartame was compared with non-sucrose controls such as water. The most relevant comparisons are the parallel design studies which compare the effects of aspartame with sucrose. These had an overall effect size of 0.4 standardised difference (SD). This corresponds to a mean reduction of about 10% of energy intake. At an average energy intake of 9.3 MJ/day (average of adult men and women aged 19-50 years) this is a deficit of 0.93 MJ/day (222 kcal/ day or 1560 kcal/week), which would be predicted (using an energy value for obese 116 A. de la Hunty et al. © 2006 British Nutrition Foundation Nutrition Bulletin , 31 , 115-128tissue of 7500 kcal/kg) to result in a weight loss of around 0.2 kg/week with a confidence interval 50% either side of this estimate.Information on the extent of compensation was available for 12 of the 15 studies. The weighted average of these figures was 32%. Compensation is likely to vary with a number of factors such as the size of the caloric deficit, the type of food or drink manipulated, and timescale. An estimate of the amount of compensation with soft drinks was calculated from the four studies which used soft drinks only as the vehicle. A weighted average of these figures was 15.5%.A significant reduction in weight was seen. The combined effect figure of 0.2 SD is a conservative figure as it excludes ...

OBJECTIVE: To investigate the associations between energy density (ED) and macronutrient composition in the National Diet and Nutrition Survey of Children aged 1 1 2 ± 4 1 2 y, hypothesizing that high-ED diets tend to be high in sugars as well as fat. DESIGN: Further analysis of data from a cross-sectional dietary survey of 1675 children with complete 4-day weighed dietary records. Differences in diet composition and food choice between children with diets of high, medium and low ED (de®ned as kJag of all food and drink) were identi®ed. The possibility of confounding by water, or by soft drinks, was also explored in age-adjusted correlations. RESULTS: High-ED diets ( b 3.7 kJag of total diet) were proportionately richer in fat and lower in carbohydrate, compared with diets of low ED (`2.9 kJag). In contrast to the hypothesis, high-ED diets were found to be proportionately lower in sugars, and higher in starch. Children with high-ED diets consumed more of a whole range of foods: meat, eggs, potatoes, cereal products, confectionery, sugarapreserves and savoury snacks, but consumed less soft drinks, water and fruit. CONCLUSION: The inverse relationship observed between sugars and energy density may be partly attributable to the reciprocal relationship between sugars and fat, expressed as a proportion of energy. It may also re¯ect developing preferences in young childhood for a more adult-type, energy-dense, diet. Further work is required to verify EDamacronutrient relationships in other age groups, as the results have potential implications for obesity prevention and for food product development.