Evaluation of Conflicts of Financial Interest in Publications on the Consumption of High-Intensity Sweeteners and Body-Weight Changes: A Systematic Review

Context: Diseases related to excessive sugar consumption have become a public health concern. However, there may be a direct association between the consumption of artificial sweeteners and changes in body weight.

Objective: The aim was to evaluate potential industry financial conflicts of interest in publications on the relationship between high-intensity sweetener consumption and changes in body weight in observational and intervention studies.

Data sources: The systematic review used the Medline, Embase, Cochrane, Scopus, and the VHL (Virtual Health Library) Regional Portal, including the LILACS databases. The PICOS strategy were used in the search strategy for intervention studies and for observational studies used the exposure factor as the criterion.

Data extraction: Inclusion criteria were observational and intervention studies in adults, without population or health status restrictions, without restriction on the year of publication, but restricted to full articles in Portuguese, English, and Spanish. Exclusion criteria were humans younger than 18 years, cross-sectional studies, and animal and in vitro studies.

Data analysis: There were extracted effect estimates, odds ratios, and linear associations, quantifying the effects per unit of intake of high-intensity sweeteners. The risk of bias in the intervention studies was assessed using the Cochrane Collaboration Risk of Bias tool (RoB). The Newcastle Ottawa Scale was used for observational studies (case-control and cohort).

Conclusion: Most clinical trials favor using artificial sweeteners and receive contributions from the food industry. Observational studies, for the most part, show that the use of artificial sweeteners is unfavorable. In these studies, there was no sponsorship from the food industry, only from regulatory bodies. This result suggests that studies that had the support of the food industry had their influence on their outcomes.

Systematic review registration: PROSPERO registration no: CRD42016036204.