Low-calorie and artificial sweeteners do not seem to help individuals manage their weight, and routine consumption might be associated with diabetes, cardiovascular problems, and weight gain, according to a systematic review of scientific evidence published Monday in the Canadian Medical Association Journal.
For the review, researchers from the University of Manitoba reviewed 37 studies, including:
- Seven randomized controlled trials, involving a total of about 1,000 individuals, that evaluated interventions for low-calorie sweeteners; and
- 30 longitudinal observational studies, involving a total of about 406,000 individuals, that reported on adult and adolescent consumption of low-calorie sweeteners.
According to the review, evidence from the randomized controlled trials did not show that consuming artificial and low-calorie sweeteners had a significant effect on an individual's weight. However, the meta-analysis of observational studies showed a small but significant association between weight gain and regular consumption of artificial and low-calorie sweeteners.
In addition, researchers found individuals who regularly consumed low-calorie sweeteners were more likely to develop cardiovascular issues and diabetes. According to the researchers, individuals who consumed the most low-calorie sweeteners had a 14 percent higher chance of developing Type 2 diabetes when compared with individuals who consumed the least low-calorie sweeteners. Further, the researchers found individuals who consumed the highest amounts of low-calorie sweeteners had a 32 percent higher probability of experiencing a cardiovascular event when compared with individuals who consumed the least amounts of such sweeteners.
Meghan Azad, the research review's lead author, said, "There's no clear evidence for benefit from the artificial sweeteners, and there is a potential that they have a negative impact, but we need more research to figure it out for sure."
Kristina Rother, a pediatric endocrinologist at NIH who was not involved in the review, said the findings highlight the need for better-designed research on low-calorie sweeteners, adding, "We need to know what the artificial sweeteners do."
Allison Sylvetsky, a nutrition scientist at George Washington University, said she thinks the review's "main takeaway is really just that we need more understanding of what might be going on physiologically." She said she would like to see additional randomized controlled trials focused on health markers other than body weight, such as lipid and insulin levels (Caruso, STAT News, 7/17; Hobson, "Shots," NPR, 7/17; Azad et al., Canadian Medical Association Journal, 7/17).
Key considerations for launching an outpatient diabetes program
As obesity and diabetes rates rise across the country, many hospitals have developed outpatient diabetes centers. Projections estimate that by 2050, one in three Americans will have diabetes. The most progressive hospitals have combined diabetes treatment, education, wound care, ophthalmology, and other services into comprehensive programs.
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