Departments of Food Science and Nutrition Science, Purdue University, West Lafayette, IN.
Departments of Nutrition Science, Purdue University, West Lafayette, IN.
Am J Clin Nutr. 2019 May 1;109(5):1288-1301. doi: 10.1093/ajcn/nqy381.
Low-calorie sweeteners (LCSs) provide sweetness with little or no energy. However, each LCS's unique chemical structure has potential to elicit different sensory, physiological, and behavioral responses that affect body weight.
The purpose of this trial was to compare the effects of consumption of 4 LCSs and sucrose on body weight, ingestive behaviors, and glucose tolerance over a 12-wk intervention in adults (18-60 y old) with overweight or obesity (body mass index 25-40 kg/m2).
In a parallel-arm design, 154 participants were randomly assigned to consume 1.25-1.75 L of beverage sweetened with sucrose (n = 39), aspartame (n = 30), saccharin (n = 29), sucralose (n = 28), or rebaudioside A (rebA) (n = 28) daily for 12 wk. The beverages contained 400-560 kcal/d (sucrose treatments) or <5 kcal/d (LCS treatments). Anthropometric indexes, energy intake, energy expenditure, appetite, and glucose tolerance were measured at baseline. Body weight was measured every 2 wk with energy intake, expenditure, and appetite assessed every 4 wk. Twenty-four-hour urine collections were completed every 4 wk to determine study compliance via para-aminobenzoic acid excretion.
Of the participants enrolled in the trial, 123 completed the 12-wk intervention. Sucrose and saccharin consumption led to increased body weight across the 12-wk intervention (Δweight = +1.85 ± 0.36 kg and +1.18 ± 0.36 kg, respectively; P ≤ 0.02) and did not differ from each other. There was no significant change in body weight with consumption of the other LCS treatments compared with baseline, but change in body weight for sucralose was negative and significantly lower compared with all other LCSs at week 12 (weight difference ≥ 1.37 ± 0.52 kg, P ≤ 0.008). Energy intake decreased with sucralose consumption (P = 0.02) and ingestive frequency was lower for sucralose than for saccharin (P = 0.045). Glucose tolerance was not significantly affected by any of the sweetener treatments.
Sucrose and saccharin consumption significantly increase body weight compared with aspartame, rebA, and sucralose, whereas weight change was directionally negative and lower for sucralose compared with saccharin, aspartame, and rebA consumption. LCSs should be categorized as distinct entities because of their differing effects on body weight. This trial was registered at clinicaltrials.gov as NCT02928653.
低卡路里甜味剂（LCS）提供甜味，几乎或根本不提供能量。然而，每种 LCS 的独特化学结构都有可能引起不同的感官、生理和行为反应，从而影响体重。
本试验的目的是比较 4 种 LCS 和蔗糖在超重或肥胖（体重指数 25-40 kg/m2）成年人中 12 周干预期间对体重、摄食行为和葡萄糖耐量的影响。
采用平行臂设计，将 154 名参与者随机分配至每天饮用 1.25-1.75 L 蔗糖（n=39）、阿斯巴甜（n=30）、糖精（n=29）、三氯蔗糖（n=28）或甜菊糖甙 A（rebA）（n=28）的饮料，持续 12 周。饮料中含有 400-560 kcal/d（蔗糖处理）或 <5 kcal/d（LCS 处理）。在基线时测量人体测量指标、能量摄入、能量消耗、食欲和葡萄糖耐量。每 2 周测量一次体重，每 4 周评估一次能量摄入、支出和食欲。每 4 周完成一次 24 小时尿液收集，通过对氨基苯甲酸排泄来确定研究依从性。
在参加试验的参与者中，有 123 人完成了 12 周的干预。蔗糖和糖精的摄入导致体重在 12 周的干预期间增加（Δ体重分别为+1.85±0.36 kg 和+1.18±0.36 kg；P≤0.02），且两者之间无差异。与基线相比，其他 LCS 处理对体重无明显变化，但与其他所有 LCS 相比，三氯蔗糖的体重变化为负值，在第 12 周时显著更低（体重差异≥1.37±0.52 kg，P≤0.008）。三氯蔗糖的能量摄入减少（P=0.02），而三氯蔗糖的摄食频率低于糖精（P=0.045）。葡萄糖耐量不受任何甜味剂处理的显著影响。
与阿斯巴甜、甜菊糖甙 A 和三氯蔗糖相比，蔗糖和糖精的摄入显著增加体重，而三氯蔗糖的体重变化方向为负，且低于糖精、阿斯巴甜和甜菊糖甙 A 的摄入。由于 LCS 对体重的影响不同，应将它们归类为不同的实体。本试验在 clinicaltrials.gov 上注册为 NCT02928653。
