Non-nutritive sweeteners exert no positive effect on BMI, adiposity
Non-nutritive sweeteners do not appear to clearly help in weight management and may even result in increased body mass index (BMI) and cardiometabolic risk, according to a new meta-analysis.
The meta-analysis involved 37 studies, of which 30 were cohort studies (n=405,907) and seven were randomized controlled trials (RCTs; n=1,003). According to the Cochrane Collaboration Risk of Bias tool, most of the RCTs had a high or unclear risk of bias. Most cohort studies had moderate quality according to the Newcastle-Ottawa scale.
Pooled data from three RCTs showed that intake of non-nutritive sweeteners had no positive effect on BMI over 6 to 24 months (mean difference [MD], -0.37 kg/m2; 95 percent CI, -1.10 to 0.36 kg/m2).
On the other hand, two cohort studies showed that continuous intake of non-nutritive sweeteners over 3 to 13 years resulted in weight gain in healthy individuals (n=21,256; mean correlation, 0.05; 0.03 to 0.06).
Five RCTs on the effects of non-nutritive sweeteners on obese participants showed no significant impact on weight (standardized MD [SMD], -0.17; -0.54 to 0.21). Moreover, two observational studies showed a positive correlation between non-nutritive sweetener intake and weight gain (n=32,504; weighted mean correlation, 0.06; 0.05 to 0.07).
Three RCTs showed that non-nutritive sweetener intake had an inconsistent effect on waist circumference (SMD, -0.16; -0.56 to 0.25), while a cohort study showed a positive correlation between the two (n=384; MD 2.27; 0.96 to 3.58).
The meta-analysis included RCTs and observational studies that assessed the effects of non-nutritive sweeteners on BMI, body weight and adiposity, among other outcomes. Only those with participants >12 years of age and that had a minimum duration of 6 months were included.