Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies

Morenga, Lisa Te; Mallard, Simonette R.; Mann, Jim

doi:10.26686/wgtn.12831857

Cited by 130 publications

(161 citation statements)

References 15 publications

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“…Fibre also impacts on bowel health, with decreased risk of constipation (29) . In contrast, the consumption of free sugars (table sugar, fruit juice, honey, sugar-sweetened beverages or sugary snacks) could result in excess energy intake leading to overweight and obesity (32) .…”

Section: Role Of Carbohydrate In the Dietmentioning

confidence: 99%

Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

2020

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Low-carbohydrate diets (LCD) have been promoted for weight control and type 2 diabetes (T2D) management, based on an emerging body of evidence, including meta-analyses with an indication of publication bias. Proposed definitions vary between 50 and 130 g/d, or <10 and <40 % of energy from carbohydrate, with no consensus on LCD compositional criteria. LCD are usually followed with limited consideration for other macronutrients in the overall diet composition, introducing variance in the constituent foods and in metabolic responses. For weight management, extensive evidence supports LCD as a valid weight loss treatment, up to 1–2 years. Solely lowering carbohydrate intake does not, in the medium/long term, reduce HbA1c for T2D prevention or treatment, as many mechanisms interplay. Under controlled feeding conditions, LCD are not physiologically or clinically superior to diets with higher carbohydrates for weight-loss, fat loss, energy expenditure or glycaemic outcomes; indeed, all metabolic improvements require weight loss. Long-term evidence also links the LCD pattern to increased CVD risks and mortality. LCD can lead to micronutrient deficiencies and increased LDL-cholesterol, depending on food selection to replace carbohydrates. Evidence is limited but promising regarding food choices/sources to replace high-carbohydrate foods that may alleviate the negative effects of LCD, demanding further insight into the dietary practice of medium to long term LCD followers. Long-term, high-quality studies of LCD with different food sources (animal and/or plant origins) are needed, aiming for clinical endpoints (T2D incidence and remission, cardiovascular events, mortality). Ensuring micronutrient adequacy by food selection or supplementation should be considered for people who wish to pursue long-term LCD.

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Section: Role Of Carbohydrate In the Dietmentioning

confidence: 99%

Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

2020

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“…The positive associations between consuming SSB and body weight gain are supported by dietary intervention studies in which subjects exhibited increased body weight when they consumed SSB with their usual ad libitum diet [ 14 ]. There are those who suggest this relationship is not unique to SSB and is simply the consequence of consuming any source of palatable energy in excess [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Epidemiological studies demonstrate a positive association between consuming SSB and body weight gain [ 18 , 27 , 28 , 29 ••]. A meta-analysis of dietary intervention studies showed that increased sugar intake was associated with a weight increase (0.75 kg, 95% CI 0.30 to 1.19; P = 0.001) in adults consuming ad libitum diets [ 14 ]. This meta-analysis also showed that reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval (CI) 0.39 to 1.21; P < 0.001).…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, our group has conducted an NIH-funded investigation that showed that subjects gained weight in a dose-dependent manner when provided 0, 10, 17.5, or 25% of energy requirement (Ereq) as SSB to consume with their free choice ad libitum diets [ 30 ]. However, there is an important limitation of this study and of nearly all of the ad libitum studies included in the meta-analysis [ 14 ]. The limitation is that the dietary interventions were not isocaloric.…”

Section: Introductionmentioning

confidence: 99%

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An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

Sigala

Stanhope

2021

Curr Obes Rep

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Purpose of Review The mechanistic role of sugar-sweetened beverage (SSB) in the etiology of obesity is undetermined. We address whether, compared to other foods, does consumption of SSB (1) automatically lead to failure to compensate for the energy it contains? (2) fail to elicit homeostatic hormone responses? (3) promote hedonic eating through activation of the brain's reward pathways? We followed the evidence to address: (4) Would restriction of targeted marketing of SSB and other unhealthy foods to vulnerable populations decrease their prevalence of obesity? Recent Findings The data are lacking to demonstrate that SSB consumption promotes body weight gain compared with isocaloric consumption of other beverages or foods and that this is linked to its failure to elicit adequate homeostatic hormone responses. However, more recent data have linked body weight gain to reward activation in the brain to palatable food cues and suggest that sweet tastes and SSB consumption heightens the reward response to food cues. Studies investigating the specificity of these responses have not been conducted. Nevertheless, the current data provide a biological basis to the body of evidence demonstrating that the targeted marketing (real life palatable food cues) of SSB and other unhealthy foods to vulnerable populations, including children and people of color and low socioeconomic status, is increasing their risk for obesity. Summary While the mechanisms for the association between SSB consumption and body weight gain cannot be identified, current scientific evidence strongly suggests that proactive environmental measures to reduce exposure to palatable food cues in the form of targeting marketing will decrease the risk of obesity in vulnerable populations. Keywords Obesity. Weight gain. Sugar-sweetened beverages. Health disparities. Targeted marketing. Palatable food cues This article is part of the Topical Collection on Etiology of Obesity

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“…Focusing on legumes, one meta-analysis of ten RCT indicated that interventions to increase the intake of legumes were associated with decreased TC and LDL-C levels compared with a control group ( 91 ) , others reported reductions in C-reactive protein, SBP and FG ( 92 , 93 ) , but no effects on body weight ( 92 ) . Evidence from meta-analyses of intervention trials showed that higher consumption of sugar-sweetened beverages (SSB) leads to a considerable increase in body weight ( 94 , 95 ) .…”

Section: Current Evidence For Food-based Dietary Guidelinesmentioning

confidence: 99%

Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines

et al. 2018

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A major advantage of analyses on the food group level is that the results are better interpretable compared with nutrients or complex dietary patterns. Such results are also easier to transfer into recommendations on primary prevention of non-communicable diseases. As a consequence, food-based dietary guidelines (FBDG) are now the preferred approach to guide the population regarding their dietary habits. However, such guidelines should be based on a high grade of evidence as requested in many other areas of public health practice. The most straightforward approach to generate evidence is meta-analysing published data based on a careful definition of the research question. Explicit definitions of study questions should include participants, interventions/exposure, comparisons, outcomes and study design. Such type of meta-analyses should not only focus on categorical comparisons, but also on linear and non-linear dose-response associations. Risk of bias of the individual studies of the meta-analysis should be assessed, rated and the overall credibility of the results scored (e.g. using NutriGrade). Tools such as a measurement tool to assess systematic reviews or ROBIS are available to evaluate the methodological quality/risk of bias of meta-analyses. To further evaluate the complete picture of evidence, we propose conducting network meta-analyses (NMA) of intervention trials, mostly on intermediate disease markers. To rank food groups according to their impact, disability-adjusted life years can be used for the various clinical outcomes and the overall results can be compared across the food groups. For future FBDG, we recommend to implement evidence from pairwise and NMA and to quantify the health impact of diet-disease relationships.

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Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies

Cited by 130 publications

References 15 publications

Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines

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