the School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
the Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Nutr Rev. 2021 Sep 7;79(10):1145-1164. doi: 10.1093/nutrit/nuaa123.
Low-calorie sweeteners are increasingly prevalent in the food supply and their consumption has increased in recent decades. Although low-calorie sweeteners approved for use are considered safe from a toxicological perspective, their short- and long-term impacts on chronic disease risk remain uncertain. The aim of this review was to summarize the evidence from systematic reviews on low-calorie sweetener use and chronic conditions and risk factors in children and adults.
MEDLINE and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews of randomized and nonrandomized studies that considered low-calorie sweeteners in relation to type 2 diabetes, cardiovascular disease, cancer, anthropometric measures, hypertension, hyperglycemia, hyperlipidemia, insulin resistance, and dental caries. Data were extracted from 9 reviews deemed of moderate or high quality on the basis of AMSTAR-2.
Narrative synthesis suggested inconsistent evidence on low-calorie sweetener use in relation to chronic conditions and associated risk factors, with nonrandomized studies suggesting positive associations and randomized studies suggesting negative or no associations.
Continued research on the long-term health impacts of low-calorie sweeteners across all life stages is warranted.
低热量甜味剂在食品供应中越来越普遍,近几十年来其消费量也有所增加。尽管从毒理学角度来看,批准使用的低热量甜味剂被认为是安全的,但它们对慢性病风险的短期和长期影响仍不确定。本综述的目的是总结关于低热量甜味剂使用与儿童和成人的慢性疾病及相关风险因素的系统评价证据。
通过 MEDLINE 和 Cochrane 系统评价数据库检索,以确定与 2 型糖尿病、心血管疾病、癌症、人体测量指标、高血压、高血糖、高血脂、胰岛素抵抗和龋齿有关的随机和非随机研究的系统评价,这些研究都考虑了低热量甜味剂。根据 AMSTAR-2,从被认为具有中等或高质量的 9 项综述中提取数据。
叙述性综合分析表明,低热量甜味剂的使用与慢性疾病及相关风险因素之间的证据不一致,非随机研究表明存在正相关,而随机研究则表明存在负相关或无相关。
有必要在所有生命阶段继续研究低热量甜味剂对长期健康的影响。