Effects of aspartame-, monk fruit-, Stevia-, and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake.

Publication Name: Int J Obes 2016; Dec 13. doi: 10.1038/ijo.2016.225. [Epub ahead of print].

Author(s): Tey S, Salleh NB, Henry J, Forde CG. | Publication Year: 2016


BACKGROUND: Substituting sweeteners with non-nutritive sweeteners (NNS) may aid in glycaemic control and body weight management. Limited studies have investigated energy compensation, glycaemic and insulinaemic responses to artificial and natural NNS.
OBJECTIVES: This study compared the effects of consuming NNS (artificial vs. natural) and sucrose (65?g) on energy intake, blood glucose and insulin responses.
METHODS: Thirty healthy males took part in this randomised, crossover study with four treatments: aspartame-, monk fruit-, Stevia-, and sucrose-sweetened beverages. On each test day, participants were asked to consume a standardised breakfast in the morning and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption. Blood glucose and insulin concentrations were measured every 15?min within the first hour of preload consumption and every 30?min for the subsequent two hours. Participants left the study site three hours after preload consumption and completed a food diary for the rest of the day.
RESULTS: Ad libitum lunch intake was significantly higher for the NNS treatments compared to sucrose (P=0.010). The energy "saved" from replacing sucrose with NNS was fully compensated for at subsequent meals, hence no difference in total daily energy intake was found between the treatments (P=0.831). The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour whereas these responses were higher for all three NNS beverages following the test lunch. Thus, there were no differences in total area under the curve (AUC) for glucose (P=0.960) and insulin (P=0.216) over three hours between the four test beverages.
CONCLUSIONS: The consumption of calorie free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake, postprandial glucose and insulin compared to a sucrose-sweetened beverage.


Contrary to a large number of randomised clinical trials published over the last three decades, which have consistently shown that when consuming low calorie sweeteners preloads, participants do not compensate by eating more at either their lunch or dinner meal compared to a sucrose preload, the study by Tey et al supports that in this small group of 30 healthy male participants the energy "saved" from replacing sucrose with low calorie sweeteners was compensated for at subsequent meals, hence no difference in total daily energy intake was found between the treatments. However, this finding is based on uncontrolled measurements and therefore cannot lead to any concrete conclusions due to an important limitation of the study, which is the self-reported dietary data for subsequent meals after participants left the study site (after lunch). In fact, and in line with other studies, only partial energy compensation (22-32%) was observed at lunch time (the only meal that volunteers consumed under supervision at the study site), which actually shows that replacing sugar with low calorie sweeteners led to reduced energy intake at the following meal. For more information please read the ISA comments by clicking here.