Journal
INTERNATIONAL JOURNAL OF OBESITY
Volume 45, Issue 3, Pages 464-478Publisher
SPRINGERNATURE
DOI: 10.1038/s41366-020-00704-2
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Funding
- School of Psychological Science, University of Bristol
- Department of Psychology, Faculty of Science and Technology, Bournemouth University
- NIHR (National Institute for Health Research) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust
- University of Bristol
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The study found that low-calorie sweeteners have a favorable effect on body weight, BMI, and energy intake when compared to sugar, with the effect increasing as more sugar is replaced by sweeteners. However, there was no significant difference in effects when comparing sweeteners with water/nothing or consumed in capsule form.
Previous meta-analyses of intervention studies have come to different conclusions about effects of consumption of low-calorie sweeteners (LCS) on body weight. The present review included 60 articles reporting 88 parallel-groups and cross-over studies >= 1 week in duration that reported either body weight (BW), BMI and/or energy intake (EI) outcomes. Studies were analysed according to whether they compared (1) LCS with sugar, (2) LCS with water or nothing, or (3) LCS capsules with placebo capsules. Results showed an effect in favour of LCS vs sugar for BW (29 parallel-groups studies, 2267 participants: BW change, -1.06 kg, 95% CI -1.50 to -0.62, I-2 = 51%), BMI and EI. Effect on BW change increased with 'dose' of sugar replaced by LCS, whereas there were no differences in study outcome as a function of duration of the intervention or participant blinding. Overall, results showed no difference in effects of LCS vs water/nothing for BW (11 parallel-groups studies, 1068 participants: BW change, 0.10 kg, 95% CI -0.87 to 1.07, I-2 = 82%), BMI and EI; and inconsistent effects for LCS consumed in capsules (BW change: -0.28 kg, 95% CI -0.80 to 0.25, I-2 = 0%; BMI change: 0.20 kg/m(2), 95% CI 0.04 to 0.36, I-2 = 0%). Occurrence of adverse events was not affected by the consumption of LCS. The studies available did not permit robust analysis of effects by LCS type. In summary, outcomes were not clearly affected when the treatments differed in sweetness, nor when LCS were consumed in capsules without tasting; however, when treatments differed in energy value (LCS vs sugar), there were consistent effects in favour of LCS. The evidence from human intervention studies supports the use of LCS in weight management, constrained primarily by the amount of added sugar that LCS can displace in the diet.
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