Artificial Sweetners

Objective:
To assess the association between intake of non-sugar sweeteners (NSS) and important health outcomes in generally healthy or overweight/obese adults and children.

Design:
Systematic review following standard Cochrane review methodology.
Data sources Medline (Ovid), Embase, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and reference lists of relevant publications.

Eligibility criteria for selecting studies:
Studies including generally healthy adults or children with or without overweight or obesity were eligible. Included study designs allowed for a direct comparison of no intake or lower intake of NSS with higher NSS intake. NSSs had to be clearly named, the dose had to be within the acceptable daily intake, and the intervention duration had to be at least seven days.

Main outcome measures:
Body weight or body mass index, glycaemic control, oral health, eating behaviour, preference for sweet taste, cancer, cardiovascular disease, kidney disease, mood, behaviour, neurocognition, and adverse effects.

Results:
The search resulted in 13 941 unique records. Of 56 individual studies that provided data for this review, 35 were observational studies. In adults, evidence of very low and low certainty from a limited number of small studies indicated a small beneficial effect of NSSs on body mass index (mean difference −0.6, 95% confidence interval −1.19 to −0.01; two studies, n=174) and fasting blood glucose (−0.16 mmol/L, −0.26 to −0.06; two, n=52). Lower doses of NSSs were associated with lower weight gain (−0.09 kg, −0.13 to −0.05; one, n=17 934) compared with higher doses of NSSs (very low certainty of evidence). For all other outcomes, no differences were detected between the use and non-use of NSSs, or between different doses of NSSs. No evidence of any effect of NSSs was seen on overweight or obese adults or children actively trying to lose weight (very low to moderate certainty). In children, a smaller increase in body mass index z score was observed with NSS intake compared with sugar intake (−0.15, −0.17 to −0.12; two, n=528, moderate certainty of evidence), but no significant differences were observed in body weight (−0.60 kg, −1.33 to 0.14; two, n=467, low certainty of evidence), or between different doses of NSSs (very low to moderate certainty).

Conclusions:
Most health outcomes did not seem to have differences between the NSS exposed and unexposed groups. Of the few studies identified for each outcome, most had few participants, were of short duration, and their methodological and reporting quality was limited; therefore, confidence in the reported results is limited. Future studies should assess the effects of NSSs with an appropriate intervention duration. Detailed descriptions of interventions, comparators, and outcomes should be included in all reports.

More Than Two-Thirds of U.S. Adults Now Overweight or Obese

Fewer than one-third of Americans are currently at a healthy weight, with the rest of the population either overweight or obese, a new report finds.

About 35% of men and 37% of women are obese. Another 40% of men and 30% of women are overweight, researchers said in the June 22 issue of JAMA Internal Medicine.

“Obesity is not getting better. It’s getting worse, and it’s really scary. It’s not looking pretty,” said Lin Yang, a postdoctoral research associate at Washington University School of Medicine in St. Louis.

Obesity has been linked to a number of chronic health conditions, including type 2 diabetes, heart disease, certain cancers, and arthritis, Yang said.

“This generation of Americans is the first that will have a shorter life expectancy than the previous generation, and obesity is one of the biggest contributors to this shortened life expectancy because it is driving a lot of chronic health conditions,” she said.

The new report used data from the National Health and Nutritional Examination Survey gathered between 2007 and 2012, involving more than 15,000 men and women age 25 and older.

Based on the data, researchers estimate than more than 36 million men and nearly 29 million women in the United States are currently overweight. About 32 million men and 36 million women are obese, the researchers found.