Third Department of Pediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", Athens, Greece.
Third Department of Pediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", Athens, Greece.
J Pediatr. 2018 Jun;197:128-133.e2. doi: 10.1016/j.jpeds.2018.01.081. Epub 2018 Apr 11.
To systematically assess and quantitatively synthesize the literature regarding the association of consumption of non-nutritive sweeteners (NNS) during childhood with negative metabolic health outcomes.
Following the PRISMA guidelines, published literature was systematically reviewed. Eligible studies (N = 13) were identified through the screening of over 2500 publications. Random-effects meta-analyses were conducted on the association of NNS consumption with body mass index (BMI) increase. Sensitivity and subgroup analyses by sex were also undertaken.
Consumption of NNS during childhood and adolescence was associated with an increase in BMI (OR 1.15, 95% CI 1.06-1.25); the OR was similar in sensitivity analyses. The associations were positive but marginally significant in subanalyses by sex. The qualitative assessment of existing literature showed nonsignificant associations with other components of metabolic disease, such as waist circumference, fat mass accumulation, and type 2 diabetes.
Systematic assessment of observational studies showed no association of NNS intake during childhood with fat mass accumulation and waist circumference and a small, but statistically significant association with BMI increase. Inherent methodological weaknesses of to-date published investigations, including mainly underpowered size to explore the hypothesis, call for more research.
系统评估和定量综合有关儿童期摄入非营养性甜味剂（NNS）与负面代谢健康结果之间关联的文献。
根据 PRISMA 指南，系统地审查了已发表的文献。通过筛选超过 2500 篇文献，确定了符合条件的研究（N=13）。对 NNS 消费与体重指数（BMI）增加之间的关联进行了随机效应荟萃分析。还进行了性别敏感性和亚组分析。
儿童期和青春期摄入 NNS 与 BMI 增加相关（OR 1.15，95%CI 1.06-1.25）；敏感性分析中的 OR 相似。按性别进行的亚组分析中，这些关联虽然为阳性但仅具有边缘显著性。对现有文献的定性评估显示，与代谢疾病的其他成分（如腰围、脂肪量积累和 2 型糖尿病）之间无显著关联。
对观察性研究的系统评估表明，儿童期摄入 NNS 与脂肪量积累和腰围之间没有关联，与 BMI 增加之间存在较小但具有统计学意义的关联。迄今为止发表的研究主要存在方法学上的弱点，包括探索假设的能力不足，因此需要更多的研究。
