Abstract
Purpose: Results of prospective studies investigating associations between low/no-calorie sweeteners (LNCS) and body weight-related outcomes are inconclusive. We conducted dose–response and theoretical replacement individual patient data meta-analyses using harmonised prospective data to evaluate associations between sugar-sweetened beverage (SSB) consumption, low/no-calorie sweetened beverage (LNCB) consumption, and changes in body weight and waist circumference.
Methods: Individual participant data were obtained from five European studies, i.e., Lifelines Cohort Study, NQplus study, Alpha Omega Cohort, Predimed-Plus study, and Feel4diabetes study, including 82,719 adults aged 18–89 with follow-up between 1 and 9 years. Consumption of SSB and LNCB was assessed using food-frequency questionnaires. Multiple regression analyses adjusting for major confounders and including substitution models were conducted to quantify associations in individual cohorts; random-effects meta-analyses were performed to pool individual estimates.
Results: Overall, pooled results showed weak adverse associations between SSB consumption and changes in body weight (+ 0.02 kg/y, 95%CI 0.00; 0.04) and waist circumference (+ 0.03 cm/y, 95%CI 0.01; 0.05). LNCB consumption was associated with higher weight gain (+ 0.06 kg/y, 95%CI 0.04; 0.08) but not with waist circumference. No clear associations were observed for any theoretical replacements, i.e., LNCB or water for SSB or water for LNCB.
Conclusion: In conclusion, this analysis of five European studies found a weak positive association between SSB consumption and weight and waist change, whilst LNCB consumption was associated with weight change only. Theoretical substitutions did not show any clear association. Thus, the benefit of LNCBs as an alternative to SSBs remains unclear.
Originalsprog | Engelsk |
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Tidsskrift | European Journal of Nutrition |
Vol/bind | 62 |
Sider (fra-til) | 2905-2918 |
ISSN | 1436-6207 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
CURIS 2023 NEXS 166Funding Information:
JCGH is on the International Sweeteners and Mars Scientific Advisory Boards and together with JoH are also conducting the SWITCH trial funded by the American Beverage Association. AR has received honoraria from Unilever and the International Sweeteners Association and Nestlé. EJMF has received an unrestricted grant from Friesland Campina and European Beer Institute and conducted a study on added sugar and individual sugars partly funded by Kenniscentrum Suiker en Gezondheid. SSM has received recent research funding for epidemiological studies on dairy products and cardiometabolic diseases from the Dutch Dairy Association and the Danish Dairy Research Foundation. Other authors report no conflict of interest. The funding sponsors had no role in the design of the study; in the collection, analyses, interpretation of data, writing of the manuscript, and nor in the decision to publish the results.
Funding Information:
This EU-project under the acronym “SWEET” has received funding from the European Union’s Horizon 2020 research and innovation programme, grant agreement No 774293.
Publisher Copyright:
© 2023, The Author(s).