The role of low-calorie sweeteners in the prevention and management of overweight and obesity: evidence v. conjecture

Publication Name: Proceedings of the Nutrition Society, 2017 Nov 23: 1-9

Author(s): Rogers P.J. | Publication Year: 2017

Abstract

By virtue of reducing dietary energy density, low-calorie sweeteners (LCS) can be expected to decrease overall energy intake and thereby decrease body weight. Such effects will be limited by the amount of sugar replaced by LCS, and the dynamics of appetite and weight control (e.g., acute compensatory eating, and an increase in appetite and decrease in energy expenditure accompanying weight loss). Consistent with these predictions, short-term intervention studies show incomplete compensation for the consumption of LCS v. sugar, and longer-term intervention studies (from 4 weeks to 40 months duration) show small decreases in energy intake and body weight with LCS v. sugar. Despite this evidence, there are claims that LCS undermine weight management. Three claims are that: (1) LCS disrupt the learned control of energy intake (sweet taste confusion hypothesis); (2) exposure to sweetness increases desire for sweetness (sweet tooth hypothesis); (3) consumers might consciously overcompensate for ‘calories saved’ when they know they are consuming LCS (conscious overcompensation hypothesis). None of these claims stands up to close examination. In any case, the results of the intervention studies comparing LCS v. sugar indicate that the effect of energy dilution outweighs any tendency LCS might conceivably have to increase energy intake.

Summary

Reviewing the available evidence to date, this publication finds little or no evidence in support of claims supporting that low calorie sweeteners undermine weight management. Contrary to these claims, evidence supports that the reduced energy content of low calorie sweetened foods and beverages is not fully compensated, and importantly, intervention studies show that the consumption of low calorie sweeteners in place of sugar in the diet reduces overall calorie intake and thus can help in weight management.

Particularly, Peter Rogers examines in this review paper the published scientific literature to evaluate three hypotheses: 1) if low calorie sweeteners disrupt the learned control of energy intake (sweet taste confusion hypothesis); 2) if exposure to sweetness without calories increases desire for sweet taste (sweet tooth hypothesis); and 3) if consumers might consciously overcompensate for 'calories saved' when they know they are consuming low calorie sweeteners (conscious overconsumption hypothesis). Taken together, evidence from intervention trials does not support the sweetness - energy disruption hypothesis nor that exposure to sweetness without calories in the form of low calorie sweeteners can exacerbate the desire for sweet taste, while some studies have found that the consumption of low calorie sweeteners in beverages may have the advantage of to some extent satisfying desire for sweetness.

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