Boxall Lucy R, Eskandari Fatemeh, Wallis Julie, Bielat Aleksandra D, Appleton Katherine M
Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole, United Kingdom.
Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole, United Kingdom.
Adv Nutr. 2025 May 15;16(7):100449. doi: 10.1016/j.advnut.2025.100449.
Aspartame (L-α-aspartyl-L-phenylalanine methyl ester) has been implicated in increased risk of several chronic health conditions, yet underlying mechanisms remain unclear. The objective of this work was to systematically identify and summarize all controlled intervention studies investigating the effects of aspartame consumption on glucose, insulin, and appetite-related hormone responses. Five academic databases, 4 trial registries, and additional resources were searched until June 2024. Search hits were screened, in duplicate, for intervention studies of aspartame compared with comparator, which assessed glucose, insulin, and/or any other appetite-regulating hormone. Results were tabulated, and meta-analyses run where ≥10 studies with similar methodology were found. Risk of bias (RoB) was assessed using RoB-2. Certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. One hundred one articles were identified, detailing 100 experiments: 79 acute (≤1 d), 8 medium term (2-30 d), and 13 long term (>30 d). Experiments involved healthy adults, individuals with aspartame sensitivity, and individuals with compromised glucose metabolism, varied widely in aspartame provision and comparator/s, and although almost all assessed glucose and/or insulin responses, few experiments investigated other appetite-regulating hormones. Meta-analyses (acute cross-over studies) revealed few effects of aspartame on blood glucose/insulin compared with vehicle or low-calorie sweeteners (LCS), and lower blood glucose/insulin concentrations compared with sugars, other carbohydrates, or other nutritive elements. Over the medium term and longterm, few effects of aspartame were found, and high heterogeneity between studies remained. Similar effects were found in other populations, and other outcomes, with few adverse events. RoB assessments suggested "some concerns" for the majority of studies. The certainty of the evidence for all outcomes in all populations was judged to be "very low." Our findings suggest little to no effects of aspartame consumption on glucose metabolism over the short term or the long term. Further studies over the long term, assessing a range of appetite-regulating hormones and comparing aspartame with other LCS, would be of value. This study was registered in PROSPERO as CRD42024540781 on April 29, 2024.
阿斯巴甜(L-α-天冬氨酰-L-苯丙氨酸甲酯)被认为与多种慢性健康状况风险增加有关,但其潜在机制仍不清楚。这项工作的目的是系统地识别和总结所有对照干预研究,这些研究调查了食用阿斯巴甜对葡萄糖、胰岛素和食欲相关激素反应的影响。检索了五个学术数据库、四个试验注册库及其他资源,直至2024年6月。对检索结果进行了重复筛选,以查找与对照物相比的阿斯巴甜干预研究,这些研究评估了葡萄糖、胰岛素和/或任何其他食欲调节激素。将结果制成表格,并在发现≥10项采用相似方法的研究时进行荟萃分析。使用RoB-2评估偏倚风险(RoB)。使用推荐分级评估、制定和评价方法评估证据的确定性。共识别出101篇文章,详细介绍了100项实验:79项急性实验(≤1天)、8项中期实验(2-30天)和13项长期实验(>30天)。实验涉及健康成年人、对阿斯巴甜敏感的个体以及葡萄糖代谢受损的个体,阿斯巴甜的供应方式和对照物差异很大,尽管几乎所有实验都评估了葡萄糖和/或胰岛素反应,但很少有实验研究其他食欲调节激素。荟萃分析(急性交叉研究)显示,与赋形剂或低热量甜味剂(LCS)相比,阿斯巴甜对血糖/胰岛素的影响很小,与糖、其他碳水化合物或其他营养成分相比,血糖/胰岛素浓度较低。在中期和长期,未发现阿斯巴甜有明显影响,研究之间仍存在高度异质性。在其他人群和其他结果中也发现了类似影响,不良事件很少。RoB评估表明大多数研究存在“一些担忧”。所有人群所有结果的证据确定性被判定为“非常低”。我们的研究结果表明,短期或长期食用阿斯巴甜对葡萄糖代谢几乎没有影响。长期进行进一步研究,评估一系列食欲调节激素,并将阿斯巴甜与其他LCS进行比较,将具有重要意义。本研究于2024年4月29日在PROSPERO注册,注册号为CRD42024540781。
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