Artificially Sweetened Beverages

Ludwig, David S.

doi:10.1001/jama.2009.1822

Cited by 62 publications

(50 citation statements)

References 11 publications

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“…Sugar-sweetened beverages provide a high dose of added sugar leading to a rapid spike in blood glucose and insulin, 17 providing a plausible mechanism to link consumption to the development of stroke and dementia risk factors. Like sugar-sweetened soft drinks, artificially-sweetened soft drinks are associated with risk factors for stroke and dementia, 1, 14, 15 although the mechanisms are incompletely understood, and inconsistent findings have been reported.…”

Section: Discussionmentioning

confidence: 99%

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia

Pase

Himali

Beiser

et al. 2017

Stroke

147

112

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Background and purpose Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially-sweetened beverage consumption were associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort. Methods We studied 2888 participants aged over 45 for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged over 60 for incident dementia (mean age 69 [SD, 6] years; 46% men). Beverage intake was quantified using a food frequency questionnaire at cohort examinations 5 (1991–1995), 6 (1995–1998) and 7 (1998–2001). We quantified recent consumption at examination 7 and cumulative consumption by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 10-years. We observed 97 cases of incident stroke (82 ischemic) and 81 cases of incident dementia (63 consistent with Alzheimer’s disease [AD]). Results After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity and smoking, higher recent and higher cumulative intake of artificially-sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and AD dementia. When comparing daily cumulative intake to <1 per week (reference), the hazard ratios were 2.96 (95% CI, 1.26–6.97) for ischemic stroke and 2.89 (95% CI, 1.18–7.07) for AD. Sugar-sweetened beverages were not associated with stroke or dementia. Conclusions Artificially-sweetened soft drink consumption was associated with a higher risk of stroke and dementia.

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Section: Discussionmentioning

confidence: 99%

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia

Pase

Himali

Beiser

et al. 2017

Stroke

147

112

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“…However, they can provide an alternative to full-calorie sodas. 78,79 Because there is no evidence of benefits of these products over plain water, artificially sweetened beverages currently have a limited place in a child's diet. An example would be advising their use during a limited period of time to transition between full-calorie sodas and plain water, or when water is not available.…”

Section: Artificially Sweetened Drinksmentioning

confidence: 99%

The Role of the Pediatrician in Primary Prevention of Obesity

Daniels¹,

Hassink²,

Abrams³

et al. 2015

Pediatrics

322

248

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The adoption of healthful lifestyles by individuals and families can result in a reduction in many chronic diseases and conditions of which obesity is the most prevalent. Obesity prevention, in addition to treatment, is an important public health priority. This clinical report describes the rationale for pediatricians to be an integral part of the obesity-prevention effort. In addition, the 2012 Institute of Medicine report “Accelerating Progress in Obesity Prevention” includes health care providers as a crucial component of successful weight control. Research on obesity prevention in the pediatric care setting as well as evidence-informed practical approaches and targets for prevention are reviewed. Pediatricians should use a longitudinal, developmentally appropriate life-course approach to help identify children early on the path to obesity and base prevention efforts on family dynamics and reduction in high-risk dietary and activity behaviors. They should promote a diet free of sugar-sweetened beverages, of fewer foods with high caloric density, and of increased intake of fruits and vegetables. It is also important to promote a lifestyle with reduced sedentary behavior and with 60 minutes of daily moderate to vigorous physical activity. This report also identifies important gaps in evidence that need to be filled by future research.

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“…By contrast, a large majority (19 out of 22) of studies, mainly from the same research group, which used a specific procedure of intermittent exposure to food supplemented with glucose or LCS (25) , found that weight increased more in the rats receiving LCS (19) . This research on intermittent exposure to LCS in rats has been widely cited by critics questioning the usefulness of LCS for weight management (e.g., 26,27,28) . In the next section I examine the rationale for these studies and summarise very recent work that contradicts the original authors' conclusions.…”

Section: Evidence From Human and Animal Studiesmentioning

confidence: 99%

The role of low-calorie sweeteners in the prevention and management of overweight and obesity: evidence v. conjecture

Rogers

2017

Proc. Nutr. Soc.

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By virtue of reducing dietary energy density, low-calorie sweeteners (LCS) can be expected to decrease overall energy intake and thereby decrease body weight. Such effects will be limited by the amount of sugar replaced by LCS, and the dynamics of appetite and weight control (e.g., acute compensatory eating, and an increase in appetite and decrease in energy expenditure accompanying weight loss). Consistent with these predictions, short-term intervention studies show incomplete compensation for the consumption of LCS v. sugar, and longer-term intervention studies (from 4 weeks to 40 months duration) show small decreases in energy intake and body weight with LCS v. sugar. Despite this evidence, there are claims that LCS undermine weight management. Three claims are that: (1) LCS disrupt the learned control of energy intake (sweet taste confusion hypothesis); (2) exposure to sweetness increases desire for sweetness (sweet tooth hypothesis); (3) consumers might consciously overcompensate for ‘calories saved’ when they know they are consuming LCS (conscious overcompensation hypothesis). None of these claims stands up to close examination. In any case, the results of the intervention studies comparing LCS v. sugar indicate that the effect of energy dilution outweighs any tendency LCS might conceivably have to increase energy intake.

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Artificially Sweetened Beverages

Cited by 62 publications

References 11 publications

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia

The Role of the Pediatrician in Primary Prevention of Obesity

The role of low-calorie sweeteners in the prevention and management of overweight and obesity: evidence v. conjecture

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