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.
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.
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DOI：
10.1038/ijo.2015.177
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Mela DJ
中科院分区：
文献类型：
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作者：
Rogers PJ;Hogenkamp PS;de Graaf C;Higgs S;Lluch A;Ness AR;Penfold C;Perry R;Putz P;Yeomans MR;Mela DJ
通过降低能量密度，低能量甜味剂（LES）可能会降低能量摄入（EI）和体重（BW）。为了评估检验LES暴露（与糖或不加糖的替代品相比）对EI或BW没有影响的零假设的证据的总体性，我们对动物和人类食用LES并随意获取食物能量的相关研究进行了系统性综述。在90项动物研究中，62项暴露于LES未影响或降低BW。在28例报告体重增加的患者中，19例使用特定的“学习”范例将LES与葡萄糖暴露进行比较。12项人类前瞻性队列研究报告了LES使用与体重指数之间的不一致关联（每年-0.002 kg m-2，95%置信区间（CI）-0.009至0.005）。短期随机对照试验的荟萃分析（129项比较）显示，与自由进食前摄入含糖食物或饮料相比，LES的总EI降低（−94 kcal，95% CI −122至−66），与水相比无差异（−2 kcal，95% CI −30至26）。这与持续干预随机对照试验（10项比较）的EI结果一致。持续干预随机对照试验（4周至40个月）的荟萃分析显示，与糖相比，摄入LES导致体重相对降低（9次比较;-1.35 kg，95%CI-2.28至-0.42），与饮水相比，体重相对降低相似（3次比较;-1.24 kg，95%CI-2.22至-0.26）。大多数动物研究没有模拟人类的LES消耗，反向因果关系可能会影响前瞻性队列研究的结果。来自所有人类随机对照试验的优势证据表明，LES不会增加EI或BW，无论是与热量或非热量（例如，水）对照条件相比。总体而言，证据的平衡表明，在儿童和成人中使用LES代替糖，导致EI和BW降低，并且与水相比也可能降低。
By reducing energy density, low-energy sweeteners (LES) might be expected to reduce energy intake (EI) and body weight (BW). To assess the totality of the evidence testing the null hypothesis that LES exposure (versus sugars or unsweetened alternatives) has no effect on EI or BW, we conducted a systematic review of relevant studies in animals and humans consuming LES with ad libitum access to food energy. In 62 of 90 animal studies exposure to LES did not affect or decreased BW. Of 28 reporting increased BW, 19 compared LES with glucose exposure using a specific ‘learning' paradigm. Twelve prospective cohort studies in humans reported inconsistent associations between LES use and body mass index (−0.002 kg m−2 per year, 95% confidence interval (CI) −0.009 to 0.005). Meta-analysis of short-term randomized controlled trials (129 comparisons) showed reduced total EI for LES versus sugar-sweetened food or beverage consumption before an ad libitum meal (−94 kcal, 95% CI −122 to −66), with no difference versus water (−2 kcal, 95% CI −30 to 26). This was consistent with EI results from sustained intervention randomized controlled trials (10 comparisons). Meta-analysis of sustained intervention randomized controlled trials (4 weeks to 40 months) showed that consumption of LES versus sugar led to relatively reduced BW (nine comparisons; −1.35 kg, 95% CI –2.28 to −0.42), and a similar relative reduction in BW versus water (three comparisons; −1.24 kg, 95% CI –2.22 to −0.26). Most animal studies did not mimic LES consumption by humans, and reverse causation may influence the results of prospective cohort studies. The preponderance of evidence from all human randomized controlled trials indicates that LES do not increase EI or BW, whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.