Benefits in weight management
Consuming a low-calorie sweetened food or beverage instead of the sugar-sweetened version can help reduce overall daily sugar intake. In turn, when used as part of a balanced diet and healthy lifestyle, this can help achieve lower energy (calorie) intake and be a useful tool when addressing excess body weight. In the midst of worrying rates of obesity and overweight, as public health authorities recommend to reduce overall sugar intake in both adults and children1, low/no calorie sweeteners (LNCS) can make a helpful contribution.
This assertion that low/no calorie sweeteners can be helpful in weight management is supported by comprehensive systematic reviews and meta-analyses of randomised controlled trials in humans, which, in contrast, do not support claims suggesting that low/no calorie sweeteners may lead to overeating and weight gain.2-5 Low/no calorie sweeteners’ intake neither promotes nor suppresses appetite, while research suggests that, in many instances, low/no calorie sweeteners may help to satisfy a desire for sweetness.6
The science behind low/no calorie sweeteners and weight management
Comprehensive systematic reviews and meta-analyses of randomised controlled trials (RCTs), which provide the highest quality of evidence for examining the potentially causal effects of low/no calorie sweeteners’ intake, have indicated a beneficial role of substituting sugar with low/no calorie sweeteners in reducing total calorie intake and, in turn, in body weight control.2-5
A recent systematic review and meta-analysis by Laviada-Molina et al found that the use of low/no calorie sweeteners results in clinically appreciable lower body weight/ body mass index (BMI) values.5 This favourable effect was found to be more significant when low/no calorie sweeteners are used as a substitute for sugar, especially in the adult population, in people with overweight or obesity, and in those who follow an unrestricted diet. The results showed that using low/no calorie sweeteners instead of sugar has a benefit of (on average) -1,3kg weight loss for the total population, with the number increasing to about -2,5kg for people with overweight/ obesity.
A systematic review and meta-analysis by Toews et al4, supported by the World Health Organization (WHO), found a small beneficial effect of low/no calorie sweeteners’ use on BMI. When the meta-analysis estimated effects in a subgroup of overweight and obese people, the use of low/no calorie sweeteners resulted in reduced body weight of approximately 2kg, which is in line with findings of the larger meta-analysis by Laviada-Molina et al. Earlier systematic reviews and meta-analyses of RCTs also confirm the beneficial effects on BMI and body weight when low/no calorie sweeteners are used as sugar substitutes, suggesting that sweeteners may be a useful dietary tool to improve compliance with weight loss or weight maintenance plans.2,3
Of course, low/no calorie sweeteners are no magic bullet and cannot, as such and on their own, make us lose weight. Scientific experts explain that the benefit of using low/no calorie sweeteners will depend on the amount of calories and sugars replaced in the diet as well as the overall diet quality.7
Low/no calorie sweeteners and obesity
Evidence from RCTs, the most robust type of study design, supports the assertion that the consumption of low/no calorie sweeteners in place of sugar can help reduce overall calorie intake, and in turn, be a helpful tool in strategies used for weight control. This evidence is in contrast with hypotheses generated from some observational data suggesting that low/no calorie sweeteners may cause weight gain. Experts explain that a positive association between low/no calorie sweeteners’ consumption and obesity reported in some observational studies may be the consequence of and not the reason for overweight and obesity.8 In the WHO-supported review, Toews et al4 state that results of observational studies on the health effects of low/no calorie sweeteners should be interpreted with caution, and attention should focus on plausible residual confounding as well as reverse causality.
At a time of worrying rates of obesity, when there are few tools that can be used by individuals to help them with weight management, low/no calorie sweeteners can be a useful nutritional strategy to help reduce overall calorie intake when used to replace sugar as part of a healthy diet, and there is no evidence from human controlled studies to support the notion that low/no calorie sweeteners can contribute to weight gain or obesity.
Low/no calorie sweeteners, appetite and sweetness preference
Human studies show that low/no calorie sweeteners neither promote nor suppress appetite or hunger in humans.6,9,10 Also, several studies show that consuming a low/no calorie sweetened drink may help control food cravings and/ or lower the desire for consuming, and the actual intake of, sweet foods in some individuals.11-14 For example, the recent study by Maloney et al13 found that low/no calorie sweetened drinks can help some individuals to eat less by controlling food cravings and to feel greater meal enjoyment, more in control and less guilty about their eating. By doing so, low/no calorie sweeteners may help people who are following a weight loss diet in adhering to their weight-management plan while maintaining a greater palatability of, and pleasure from, the diet.
A recent systematic review of the literature by Appleton et al15 found that exposure to sweet taste tends to acutely decrease the desire for sweet foods and lead to reduced preferences for sweetness in the following hours. This is attributed to sensory-specific satiety, a phenomenon where food-related liking and pleasantness declines more for foods with the same taste that have been eaten recently. Thus, current evidence supports the assertion that consumption of foods sweetened with low/no calorie sweeteners may help satisfy our desire for sweetness, and hence reduce the intake of sugar-sweetened foods, and do not encourage a “sweet tooth”.
For more information on the role of low/no calorie sweeteners in calorie reduction and in weight management you can download the ISA factsheet ‘Weight control & management: The role of low calorie sweeteners‘ and the ISA infographic ‘Low/no calorie sweeteners in calorie and sugar reduction‘.
- Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
- Miller P, Perez V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohorts (391.1). Am J Clin Nutr. 2014; 100(3): 765-77
- Rogers PJ, Hogenkamp PS, de Graaf C, et al. Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes (Lond) 2016; 40: 381-94
- Toews I, Lohner S, de Gaudry DK, Sommer J, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ 2019;363: k4718
- Laviada-Molina H, Molina-Segui F, Pérez-Gaxiola G, et al. Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: Systematic review and meta-analysis. Obes Rev 2020; 21(7) :e13020.
- Bellisle F. Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management. Curr Obes Rep 2015; 4(1): 106-110
- Ashwell MA, Gibson S, Bellisle F, Buttriss J, Drewnowski A, Fantino M, Gallagher AM, de Graaf K, Goscinny S, Hardman CA, Laviada-Molina H, López-García R, Magnuson B, Mellor D, Rogers P, Rowland I, Russell W, Sievenpiper J, la Vecchia C. Expert consensus on low calorie sweeteners: facts, research gaps and suggested actions. Nutr Res Rev. 2020; 33(1): 1-10.
- Mela DJ, McLaughlin J, Rogers PJ. Perspective: Standards for Research and Reporting on Low-Energy (“Artificial”) Sweeteners. Adv Nutr 2020; 11(3): 484-491
- Public Health England. Sugar Reduction: The Evidence for Action. 2015 Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/470179/Sugar_reduction_The_evidence_for_action.pdf
- Fantino M, Fantino A, Matray M, Mistretta F. Beverages containing low energy sweeteners do not differ from water in their effects on appetite, energy intake and food choices in healthy, non-obese French adults. Appetite 2018; 129: 103-112
- Piernas, C., Tate, D. F., Wang, X., & Popkin, B. M. (2013). Does diet-beverage intake affect dietary consumption patterns? Results from the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr, 97(3), 604-611
- de Ruyter, J. C., Katan, M. B., Kuijper, L. D., Liem, D. G., & Olthof, M. R.. The effect of sugar-free versus sugar-sweetened beverages on satiety, liking and wanting: An 18 month randomized double-blind trial in children. PlosOne 2013; 8(10): e78039.
- Maloney NG, Christiansen P, Harrold JA, Halford JCG, Hardman CA. Do low-calorie sweetened beverages help to control food cravings? Two experimental studies. Physiol & Behav 2019; 208: 112500
- Rogers PJ, Ferriday D, Irani B, et al. Sweet satiation: Acute effects of consumption of sweet drinks on appetite for and intake of sweet and non-sweet foods. Appetite. 2020; 149: 104631
- Appleton KM, Tuorila H, Bertenshaw EJ, de Graaf C and Mela DJ. Sweet taste exposure and the subsequent acceptance and preference for sweet taste in the diet: systematic review of the published literature. Am J Clin Nutr 2018; 107: 405–419