Study: Do Low-Calorie Sweeteners Increase Body Weight?

Low-calorie sweeteners (LCSs) have differing effects on body weight, and as such, should be grouped as “distinct entities”, according to a recent study published in The American Journal of Clinical Nutrition.

In a randomized controlled trial with a parallel-arm design, researchers recruited 154 participants from the Greater Lafayette, Indiana area from January 2016 through March 2018. All eligible participants were between 18-60 years of age, with an overweight or obese body mass index (BMI) between 25 and 40 kg/m² , were low consumers of LCSs and considered in good health (e.g. no history of diabetes, or hypertension), had maintained a stable weight in the three months preceding the study, and had a Three Factor Eating Questionnaire dietary restraint score of less than 14.

Participants were arbitrarily assigned to drink 1.25-1.75 L of a beverage sweetened with one of four of the most commonly used LCSs in the US: saccharin (n=29), aspartame (n=30), rebaudioside A [rebA] (n=28), and sucralose (n=28), or sucrose (sugar [n=39]) daily over the duration of 12 weeks. At baseline, the researchers measured anthropometric indexes, energy intake, energy expenditure (EE), appetite, and glucose tolerance. During the study, they measured the participants’ body weight once every two weeks and assessed energy intake, expenditure, and appetite once every four weeks. Moreover, they collected urine samples once every four weeks to monitor compliance. Of the total number of participants originally enrolled, 123 completed the 12-week intervention.

Results Have Implications for Food Industry

Results of the study indicate that participants who consumed sucrose and saccharin experienced an increased body weight (Δweight = +1.85 ± 0.36 kg and +1.18 ± 0.36 kg, respectively; P ≤ 0.02) with no variation. Moreover, compared to baseline measurements, the results suggest no discernible change in body weight among participants who consumed the other LCSs, but that change in body weight for sucralose was negative and notably less juxtaposed with all other LCSs at the trial’s conclusion (weight difference ≥ 1.37 ± 0.52 kg, P ≤ 0.008). Furthermore, energy intake diminished among participants who consumed sucralose (P = 0.02) and ingestive frequency was less for sucralose than for saccharin (P = 0.045).

“If substantiated through additional testing and confirmed through mechanistic studies, findings from this trial have implications for consumers, clinicians, policy makers, and the food industry,” the study’s authors wrote.

“Some LCSs may not hold the anticipated beneficial effects on body weight (e.g., saccharin) and beneficial effects of one LCS (e.g., sucralose) may be attenuated if combined with selected other LCSs. Going forward it will be important to consider each LCS as a distinct entity with respect to its potential health effects.”