Differential Effects of Chronic Low Calorie Sweetener Consumption on Body Weight, Glycemia, and Ingestive Behavior

Abstract

Low\ncalorie sweeteners (LCS) provide sweetness with little to no energy. Each\nsweetener has a unique chemical structure that possesses unique sensory and\nfunctional characteristics. While LCS are generally considered in aggregate,\nthese unique chemical structures have potential implications for sensory,\nmetabolic, and behavioral differences that may impact body weight and glycemia.\n Therefore, two, twelve-week experiments were\nconducted to determine the effect of chronic LCS consumption on body weight,\nglycemia, and ingestive behaviors. \n\nThe first experiment\ninvestigated the differential effects of four LCS (saccharin, aspartame,\nrebaudioside A, and sucralose) and sucrose consumed for twelve weeks on body\nweight, glycemia, and ingestive behaviors among healthy adults with overweight\nor obesity (body mass index (BMI) between 25 and 40 kg/m2). In a parallel-arm design, 154\nparticipants were randomly assigned to consume 1.25 to 1.75L of beverage sweetened\nwith 1 of the 5 sweeteners daily for 12 weeks. Body weight was measured every\ntwo weeks; energy intake, energy expenditure, and appetite were assessed every\n4 weeks; and glucose tolerance was measured at baseline and week 12. Every four\nweeks, participants completed 24-hour urine collections to determine study\ncompliance via PABA excretion. Sucrose and saccharin consumption led to\nincreased body weight across the 12-week intervention (Δ weight = +1.85 and\n+1.18kg, p ≤ 0.02) and did not differ from each other. While there was no significant change in body\nweight with consumption of the other LCS treatments compared to baseline,\nchanges in weight in comparison to the sucrose treatment (sucrose – LCS) were\nsignificantly different for aspartame, rebA, and sucralose after 12 weeks\n(weight difference = 1.13, 1.25, 2.63kg, respectively; p ≤ 0.03). In addition,\nchange in body weight at week 12 was significantly lower between sucralose and\nall other LCS (weight difference ≥ - 1.37 kg, p=0.008).\n\nThe second experiment investigated\nthe effect of daily aspartame ingestion on glycemia, body weight, and\nappetite. One hundred lean (BMI between 18 and 25 kg/m2) adults were\nrandomly assigned to consume 0, 350, or 1050 mg aspartame/day for twelve weeks\nin a parallel-arm design. This experiment followed a similar protocol but\nmeasured body weight and blood pressure weekly and contained a 240-min glucose-tolerance\ntest (OGTT) with measurements of selected hormones at baseline and week 12.\nParticipants also collected 24-h urine samples every four weeks. There were no\ngroup differences for glucose, insulin, resting leptin, glucagon-like peptide\n1, or gastric inhibitory peptide at baseline or week 12. There also were no\neffects of aspartame ingestion on appetite, body weight, or body composition. \n\nThese\ntrials demonstrate that all\nLCS contribute negligible energy but should not be aggregated because of their differing\neffects on body weight. Sucrose and saccharin\nconsumption significantly increased body weight compared to aspartame, rebA,\nand sucralose. This differential change in body weight among LCS indicates individual\nLCS likely exert different physiological responses beyond the contribution of\nsweetness with negligible energy. Saccharin, rebA, sucralose, and\naspartame (ingested at three doses) for twelve weeks had no effect on glycemia.\nThese data do not support the view that LCS are problematic for the management\nof glycemia. If substantiated through additional\ntesting, findings from this trial have implications for consumers, food\nindustry, clinicians, and policy makers. Some LCS may not hold the anticipated\nbeneficial effects on body weight (e.g., saccharin) and positive effects of one\nLCS (sucralose) may be attenuated if combined with select other LCS. Going\nforward it will be important to consider each LCS as a distinct entity with\nrespect to its potential health effects.