The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies

Rogers, Peter J.; Appleton, Katherine

doi:10.1038/s41366-020-00704-2

Cited by 66 publications

(66 citation statements)

References 90 publications

(577 reference statements)

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“…Similar results were obtained by Rogers et al [ 83 ] in a systematic review with meta-analysis. Studies comparing the efficacy of sucrose and NNS found a greater reduction in body weight and BMI, and a more significant reduction in energy intake in the group using NNS.…”

Section: Sweeteners: Implications For Energy Intake and Body Weight R...supporting

confidence: 91%

“…Studies comparing the efficacy of sucrose and NNS found a greater reduction in body weight and BMI, and a more significant reduction in energy intake in the group using NNS. Additionally, weight loss was found to correlate positively with the percentage of sucrose replaced by sweeteners [ 83 ].…”

Section: Sweeteners: Implications For Energy Intake and Body Weight R...mentioning

confidence: 99%

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The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review

et al. 2022

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Excessive consumption of sugar-rich foods is currently one of the most important factors that has led to the development of the global pandemic of obesity. On the other hand, there is evidence that obesity contributes to reduced sensitivity to sweet taste and hormonal changes affecting appetite, leading to an increased craving for sweets. A high intake of sugars increases the caloric value of the diet and, consequently, leads to weight gain. Moreover, attention is drawn to the concept of the addictive properties of sugar and sugary foods. A potential method to reduce the energy value of diet while maintaining the sweet taste is using non-nutritive sweeteners (NNS). NNS are commonly used as table sugar substitutes. This wide group of chemical compounds features high sweetness almost without calories due to its high sweetening strength. NNS include aspartame, acesulfame-K, sucralose, saccharin, cyclamate, neohesperidin dihydrochalcone (neohesperidin DC), neotame, taumatin, and advantame. The available evidence suggests that replacing sugar with NNS may support weight control. However, the effect of NNS on the regulation of appetite and sweet taste perception is not clear. Therefore, the review aimed to summarize the current knowledge about the use of NNS as a potential strategy for weight loss and their impact on sweet taste perception. Most studies have demonstrated that consumption of NNS-sweetened foods does not increase sweetness preference orenergy intake. Nonetheless, further research is required to determine the long-term effects of NNS on weight management.

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Section: Sweeteners: Implications For Energy Intake and Body Weight R...supporting

confidence: 91%

Section: Sweeteners: Implications For Energy Intake and Body Weight R...mentioning

confidence: 99%

The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review

et al. 2022

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“…Specifically, the findings that (1) reduced body weight, BMI, and body fat were associated with the use LNCSBs as a substitute for SSBs with caloric displacement and (2) neutral outcomes were associated with the use of LNCSBs as a substitute for water without caloric displacement are consistent with the results of other systematic reviews and meta-analyses of RCTs. [48][49][50][51] Figure Decreases in body weight, 48,49 body weight and BMI, 50 and a composite of body weight or BMI 51 were observed with the substitution of LNCSs for a caloric comparator (sugars in foods or beverages) predominantly in participants with overweight or obesity. Miller and Perez 50 further showed reductions in fat mass and waist circumference.…”

Section: Findings In the Context Of Existing Studiesmentioning

confidence: 99%

Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk

et al. 2022

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IMPORTANCE There are concerns that low-and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water and not LNCSBs to replace sugar-sweetened beverages (SSBs). Whether LNCSB as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for SSBs is unclear. OBJECTIVETo assess the association of LNCSBs (using 3 prespecified substitutions of LNCSBs for SSBs, water for SSBs, and LNCSBs for water) with body weight and cardiometabolic risk factors in adults with and without diabetes. DATA SOURCES Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through December 26, 2021. STUDY SELECTION Randomized clinical trials (RCTs) with at least 2 weeks of interventions comparing LNCSBs, SSBs, and/or water were included.DATA EXTRACTION AND SYNTHESIS Data were extracted and risk of bias was assessed by 2 independent reviewers. A network meta-analysis was performed with data expressed as mean difference (MD) or standardized mean difference (SMD) with 95% CIs. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to assess the certainty of the evidence. MAIN OUTCOMES AND MEASURESThe primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid. RESULTSA total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults (mean [SD] age, 33.1 [6.6] years; 1341 women [77.4%]) with overweight or obesity who were at risk for or had diabetes. Overall, LNCSBs were a substitute for SSBs in 12 RCTs (n = 601 participants), water was a substitute for SSBs in 3 RCTs (n = 429), and LNCSBs were a substitute for water in 9 RCTs (n = 974). Substitution of LNCSBs for SSBs was associated with reduced body weight (MD, −1.06 kg; 95% CI, −1.71 to -0.41 kg), body mass index (MD, −0.32; 95% CI, −0.58 to -0.07), percentage of body fat (MD, −0.60%; 95% CI, −1.03% to -0.18%), and intrahepatocellular lipid (SMD, −0.42; 95% CI, −0.70 to -0.14). Substituting water for SSBs was not associated with any outcome. There was also no association found between substituting LNCSBs for water with any outcome except glycated (continued) Key Points Question Are low-and no-calorie sweetened beverages (LNCSBs) as the intended substitute for sugarsweetened beverages (SSBs) associated with improved body weight and cardiometabolic risk factors similar to water replacement? Findings In this systematic review and meta-analysis of 17 randomized clinical trials, LNCSBs as a substitute for SSBs were associated with reduced body weight, body mass index, percentage of body fat, and intrahepatocellular lipid, providing benefits that were similar to those of water, the standard-of-care substitution.Meaning The findings of this study suggest that over the moderate term, LNCSBs are a viable alternative to water as a replacemen...

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“…LNCS provide the pleasure of sweet taste without the energy content of sugar [24], and the safety and use of many LNCS in humans have been approved [24][25][26]. Consistent with work demonstrating benefits for weight management [27,28], LNCS use continues to be predominantly associated with concerns over bodyweight [14,16,[29][30][31]. Consumers, however, also cite concerns over safety [32], poor taste [16], their artificial or chemical nature [14,16,31] and possible health implications [14,16], and similar concerns have been expressed by dietitians [23].…”

Section: Introductionmentioning

confidence: 79%

Sweet Talk: A Qualitative Study Exploring Attitudes towards Sugar, Sweeteners and Sweet-Tasting Foods in the United Kingdom

Tang

Mars

James

et al. 2021

Foods

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Worldwide initiatives currently aim to reduce free sugar intakes, but success will depend on consumer attitudes towards sugar and the alternatives. This work aimed to explore attitudes towards sugar, sweeteners and sweet-tasting foods, towards consumption and related policies, in a sample of the general public of the UK. Focus groups and interviews were conducted with 34 adults (7 males, ages: 18–65 years). Thematic analysis identified six themes: ‘Value’ (e.g., pleasure, emotions), ‘Angle’ (e.g., disinterest), ‘Personal Relevance’ (to be concerned and/or change one’s own behavior), ‘Personal Responsibility’ (one has an active relationship with these food items), ‘Understanding’ (the acquisition, comprehension and application of information) and ‘It’s Not Up to Me’ (a passive approach, because intake is subjected to other factors). Both positive and negative attitudes towards sugar, sweeteners and sweet-tasting foods were expressed in all themes. Participants also reported varied engagement with and motivations towards all food items, with implications for intakes. Suggested challenges and potential strategies for reducing free sugar intakes highlighted the need for differing approaches. Future work should assess associations between attitudes and intakes. For greatest population benefit, evidence of the dominant attitudes in those in greatest need of reduced free sugar intakes would be of value.

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The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies

Abstract: The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies

Cited by 66 publications

References 90 publications

The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review

The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review

Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk

Sweet Talk: A Qualitative Study Exploring Attitudes towards Sugar, Sweeteners and Sweet-Tasting Foods in the United Kingdom

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