Nutrition

Artificial Sweeteners Linked to Weight Gain, Cardiometabolic Risk

Use of artificial sweeteners is not associated with reductions in body mass index (BMI) and may even be linked to increased BMI and cardiometabolic risk, according to the results of a recent study.

Although sweeteners like aspartame and stevioside are widely used, their long-term effects on health are not well understood.
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Researchers conducted a meta-analysis of randomized controlled trials and prospective cohort studies evaluating the effects of nonnutritive sweeteners. The primary outcome was BMI, and secondary outcomes included weight, obesity, and cardiometabolic end points.

The researchers included 7 trials and 30 cohort studies in their analysis. Within the randomized controlled trials, nonnutritive sweeteners did not affect BMI, and in the cohort studies their use was associated with modest increases in BMI. Randomized controlled trials reported no effects of sweetener use on secondary outcomes, while cohort studies showed that sweetener consumption was associated with increased weight and waist circumference and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular events.

“Evidence from [randomized controlled trials] does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk. Further research is needed to fully characterize the long-term risks and benefits of nonnutritive sweeteners,” the researchers concluded.

—Michael Potts

Reference:

Azad MB, Abou-Setta AM, Chauhan BF, et al. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies [published online July 17, 2017]. CMAJ. doi: 10.1503/cmaj.161390.