The effects of non-nutritive sweeteners on energy and macronutrients intake in adults: a grade-assessed systematic review and meta-analyses of randomized controlled trials

Kimia Rostampour; Fatemeh Moghtaderi; AmirHossein Najafi; Behnaz Seyedjafari; Amin Salehi-Abargouei

doi:10.3389/fnut.2024.1475962

The effects of non-nutritive sweeteners on energy and macronutrients intake in adults: a grade-assessed systematic review and meta-analyses of randomized controlled trials

Front Nutr. 2024 Nov 13:11:1475962. doi: 10.3389/fnut.2024.1475962. eCollection 2024.

Authors

Kimia Rostampour^{1

2

3}, Fatemeh Moghtaderi^{1

2

3}, AmirHossein Najafi^{1

2

3}, Behnaz Seyedjafari^{1

2

3}, Amin Salehi-Abargouei^{2

3

4}

Affiliations

¹ Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
² Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
³ Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁴ Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Objectives: The effect of non-nutritive sweeteners (NNSs) on long-term satiety is not well understood. This systematic review and meta-analysis were performed to investigate the effect of NNSs on long-term total energy and macronutrients intake.

Methods: Online databases including Scopus, PubMed, ISI Web of Science, and Google Scholar were searched up to September 2024 to find relevant randomized control trials (RCTs). A random effects model was used for estimating the overall effects.

Results: The results showed a reducing effect of NNSs consumption vs. sugar on total energy intake [total energy intake change = -175.26 kcal/day, 95% confidence interval (CI): -296.47 to -54.06, I² = 61.19%] and carbohydrate intake [Hedges' g = -0.35, 95% CI: -0.63 to -0.06, I² = 58.99%]. While, NNSs intake vs. water was not associated with significant change in total energy intake [total energy intake change = 29.94 kcal/day, 95% CI: -70.37 to 130.24, I² = 34.98%] and carbohydrate intake [Hedges' g = 0.28, 95% CI: -0.02 to 0.58, I² = 65.26%]. The Consumption of NNSs compared to the either sugar or water did not have a significant effect on fat intake [Hedges' g _sugar = 0.08, 95% CI: -0.10 to 0.26, I² = 8.73%/ fat intake change _water = 0.20 g/day, 95% CI: -3.48 to 3.88, I² = 0%] and Protein intake [Hedges' g _sugar = 0.16, 95% CI: -0.11 to 0.42, I _² = 50.83%/Hedges' g _water = 0.00, 95% CI: -0.15 to 0.16, I² = 0%].

Conclusion: In summary, our findings suggest that NNSs consumption may be effective in reducing total energy and carbohydrate intake compared to sugar.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=432816, CRD42023432816.

Keywords: carbohydrate intake; meta-analysis; non-nutritive sweeteners; nutrients intake; total energy intake.

Publication types

Systematic Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Swiss National Science Foundation (Project scheme: SPIRIT, grant number: SNSF IZSTZ0_190277, http://p3.snf.ch/project-190277). Also, we would like to appreciate the Food Hygiene and Safety research center, Shahid Sadoughi University of Medical Sciences for their scientific support. The funding sources had no role in the design of this study or decision to publish results.