Drewnowski Adam, Fulgoni Victor L
Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
Nutrition Impact LLC, Battle Creek, MI 49014, USA.
Nutrients. 2025 Aug 8;17(16):2581. doi: 10.3390/nu17162581.
: Findings from the NutriNet-Santé studies have been used to drive public health policy in France, the European Union, and globally. The fact that NutriNet-Santé studies are not generalizable is a matter of concern. : We aimed to compare the characteristics and diet quality of consumers and non-consumers of low-calorie sweeteners (LCS) within the National Health and Nutrition Examination Survey (NHANES) sample to published within-cohort findings from NutriNet Santé. : Dietary intake data for the US from two 24 h dietary recalls in 4 cycles of the NHANES 2011-18 study ( = 17,252) were used to identify LCS consumers and non-consumers. : LCS consumers in NHANES were more likely to be overweight, were of higher education and incomes, and had lower intakes of added sugar and higher HEI 2020 diet quality scores compared to LCS non-consumers. Based on published reports, higher LCS consumers in NutriNet Santé were normal weight, did not differ in education, did not consume less added sugar, and had lower quality diets overall. Whereas LCS consumers in NHANES were likely to be current smokers, higher LCS consumers in NutriNet Santé were likely to be current smokers. Based on published estimates, mean aspartame intake in NutriNet Santé was only 3 mg/day (0.045 mg/kg/day) for lower consumers and 47 mg/day (0.71 mg/kg/day) for higher consumers. : Minimal LCS exposure and likely floor effects can be sources of statistical biases in studies of diet and health. NutriNet Santé is a large volunteer cohort of thin, educated, weight conscious French women who diet and smoke. Extreme caution is warranted when findings from atypical and non-representative samples are used to support policies in global public health.
NutriNet-Santé研究的结果已被用于推动法国、欧盟乃至全球的公共卫生政策制定。然而，NutriNet-Santé研究结果缺乏普遍性这一事实令人担忧。我们旨在比较美国国家健康与营养检查调查（NHANES）样本中低热量甜味剂（LCS）消费者和非消费者的特征及饮食质量，并与NutriNet Santé已发表的队列内研究结果进行对比。利用NHANES 2011 - 18研究4个周期中两次24小时饮食回顾的美国饮食摄入数据（n = 17,252）来确定LCS消费者和非消费者。与LCS非消费者相比，NHANES中的LCS消费者更有可能超重，受教育程度和收入更高，添加糖摄入量更低，2020年健康饮食指数（HEI）饮食质量得分更高。根据已发表的报告，NutriNet Santé中LCS摄入量较高的消费者体重正常，教育程度无差异，添加糖消费量没有减少，总体饮食质量较低。NHANES中的LCS消费者更有可能是当前吸烟者，而NutriNet Santé中LCS摄入量较高的消费者则不太有可能成为现吸烟者。根据已发表的估计数据，NutriNet Santé中下水平LCS消费者的阿斯巴甜平均摄入量仅为3毫克/天（0.045毫克/千克/天），高水平消费者为47毫克/天（0.
