Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies , ,

Abstract

Background: Replacement of caloric sweeteners with lower- or no-calorie alternatives may facilitate weight loss or weight maintenance by helping to reduce energy intake; however, past research examining low-calorie sweeteners (LCSs) and body weight has produced mixed results.Objective: The objective was to systematically review and quantitatively evaluate randomized controlled trials (RCTs) and prospective cohort studies, separately, that examined the relation between LCSs and body weight and composition.Design: A systematic literature search identified 15 RCTs and 9 prospective cohort studies that examined LCSs from foods or beverages or LCSs consumed as tabletop sweeteners. Meta-analyses generated weighted mean differences in body weight and composition values between the LCS and control groups among RCTs and weighted mean correlations for LCS intake and these parameters among prospective cohort studies.Results: In RCTs, LCSs modestly but significantly reduced all outcomes examined, including body weight (−0.80 kg; 95% CI: −1.17, −0.43), body mass index [BMI (in kg/m2): −0.24; 95% CI: −0.41, −0.07], fat mass (−1.10 kg; 95% CI: −1.77, −0.44), and waist circumference (−0.83 cm; 95% CI: −1.29, −0.37). Among prospective cohort studies, LCS intake was not associated with body weight or fat mass, but was significantly associated with slightly higher BMI (0.03; 95% CI: 0.01, 0.06).Conclusions: The current meta-analysis provides a rigorous evaluation of the scientific evidence on LCSs and body weight and composition. Findings from observational studies showed no association between LCS intake and body weight or fat mass and a small positive association with BMI; however, data from RCTs, which provide the highest quality of evidence for examining the potentially causal effects of LCS intake, indicate that substituting LCS options for their regular-calorie versions results in a modest weight loss and may be a useful dietary tool to improve compliance with weight loss or weight maintenance plans.

Predictors of Good Glycemic Control Among Type Ii Diabetes Patients in Palestine

“…The proportion of participants with HbA1c levels ≤7% in this study was lower than that of the studies done in France and Spain [31,32]. In terms of comparison of the study results with that of the Al-Rowais' study of type II diabetes patients conducted in the Kingdom of Saudi Arabia [33], the percentage of participants who obtained acceptable HbA1c levels (6-8%) was almost the same.…”

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

“…Systematic reviews, including meta-analyses, of these studies show that LCS compared to sugar reliably reduces energy intake and body weight (18,19) . For the most recent meta-analysis of effects on body weight participants were adults and children (n = 1332) and the duration of the intervention and any follow-up varied from 4 weeks to 40 months (19) .…”

Early Exposure to Nonnutritive Sweeteners and Long-term Metabolic Health: A Systematic Review

“…A recent meta-analysis of NNS studies in both adults and children reported that RCTs demonstrated potential health benefits, including modest weight loss and weight maintenance, whereas observational studies showed a small but significant association with increasing BMI. 12 That review was conducted in the absence of an a priori protocol, and the published search strategy was incomplete. 29 Our review addressed these limitations and aimed to evaluate a broader scope of metabolic health outcomes (beyond weight gain and body composition) focusing on long-term effects and including prenatal exposures.…”

“…10,11 Sugar replacements or nonnutritive sweeteners (NNSs) have thus gained enormous popularity owing to their low caloric value and perceived health benefits. 10,12 The consumption of beverages and foods containing NNSs has increased markedly in recent decades, 10 particularly in children, 13 yet their long-term impact on human health is unclear, and current recommendations for NNS use during pregnancy and childhood are conflicting. Although the American Dietetic Association maintains that NNSs are safe in pregnant women and children within acceptable daily intakes, 14 the Institute of Medicine does not support NNS use in children, citing "a paucity of evidence on longterm health effects … from [NNSs], particularly resulting from exposure initiated in childhood."…”