Non-calorie artificial sweeteners affect body weight: a meta-analysis of randomised controlled trials

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Chen C1
1Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taiwan

Background: Over the past decades, the worldwide prevalence of obesity has increased dramatically. Poor diet and physical inactivity are some of the most common cause of obesity. Free sugars contribute to promotion of a positive energy balance. Therefore, replacement of calorific sweeteners with non-calorie artificial sweetener (NAS) alternatives may boost weight loss by reducing energy intake. This is a common strategy for weight management in clinical nutrition. However, past research examining sugar substitutes and body weight has inconsistent results.

Objectives: The objective of the study was to review and evaluate randomized controlled trials (RCTs), that examined the relationship between non-calorie artificial sweeteners (NAS) and body weight systemically.

Methods: A systematic literature research identified 11 RCTs that examined NAS from food or beverages or consumed as sweeteners. Control groups that consumed water were excluded. Meta-analysis generated weighted mean differences in body weight between the NAS group and control group.

Results: Overall, the NAS group showed significantly reduced body weight -1.07 kg (95% confidence interval (CI) 0.41 to 1.72). Subgroup analyses in children (aged < 18 years) revealed that the NAS group showed significantly reduced body weight 1.18 kg (95% CI 0.44 to 1.93). However, adults did not have association between NAS and weight. Subgroup analysis of duration showed for the short term that the NAS group had significantly reduced body weight 0.69 kg (95% CI 0.34 to 1.04); and even in long term, the NAS group had significantly reduced body weight 1.32 kg (95% CI 0.32 to 2.31).

Conclusions: The current results provide an evaluation of the evidence on NAS and body weight. Substituting NAS for regular-calorie options results in modest weight loss. It may be a useful dietary intervention alternative to improve compliance with weight management.