A review of the effectiveness of aspartame in helping with weight control

Abstract

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 ...

Intense sweeteners, energy intake and the control of body weight

“…For a 75-kg person, this would represent a weight loss of around 0.2 kg/week. According to de la De La Hunty et al (2006), the close agreement between the predicted and the observed weight loss suggests that the 0.2 kg/week estimated is robust and applicable to a variety of aspartame-containing foods. Intense sweeteners, energy intake and the control of body weight F Bellisle and A Drewnowski…”

“…As a result, diet beverages might represent the optimal use of intense sweeteners in the context of a weight control strategy. Although they have been shown to be associated with some modest weight loss in RCTs (De La Hunty et al, 2006), intense sweeteners are not appetite suppressants. Their ultimate effects will depend on their integration within a reduced energy diet.…”

“…They provide very diverse and complementary pieces of information on a very complex subject. A recent meta-analysis (De La Hunty et al, 2006) considered only those RCTs that did measure energy intake for at least 24 h and/or measured weight changes. The RCT is considered the best experimental design, but in many circumstances it is difficult to implement, especially when dealing with human subjects who have established habits and preferences and will not easily be randomized.…”

Estevia (stevia rebaudiana), edulcorante natural y no calórico

“…La mayoría de los estudios indica que aspartame reduce la ingesta de alimentos y puede ayudar a controlar el peso (33). Otros en cambio sugieren que el aspartame podría incrementar el apetito.…”

Response to “Letter to Fowler et al. 2008”

“…Unfortunately, as discussed in our article, in the case of artificial sweeteners, the relevant clinical trials had several features which limited comparability with our results: in particular, short duration (the longest intervention being 16 weeks), enforced supplemental caloric intake in the comparison group, and/or major co-interventions. Once de la Hunty et al (4) excluded studies with enforced-intake comparison groups, and excluded follow-up periods from their final meta-analysis model (thus minimizing response bias), the alleged benefit of aspartame use for body weight was minimal (P = 0.05). Even their final model, however, did not take into account the relative contributions from concomitant interventions, such as exercise, which had influenced inter-group outcomes in the largest clinical trial analyzed (5).…”