Nutritional and Health Aspects of Sweeteners - Sweeteners: Nutritional Aspects, Applications, and Production Technology - page 343

nor weight loss. They achieve an uncoupling of sensory and caloric characteristics and can sweeten
food without adding calories. Consumers can use this saving in calories to reduce or control weight
or as an excuse to ingest calories in other forms (Maffeis 2009).
Most studies investigating the role of low-calorie sweeteners in weight control have shown that
replacing foods in the diet with low-calorie versions containing low-calorie sweeteners reduces
the overall caloric intake. Caloric intake in studies using the covert replacement of sugar with
low-calorie sweeteners has shown that compensation is incomplete, although sometimes an initial
rapid fall that tended to revert toward normal later was found, indicating that people are unlikely
to lose weight by using low-calorie sweeteners without intentional control of their total caloric
intake. Studies on subjects in weight control programs have shown that low-calorie sweeteners can
be helpful in making the regime more acceptable and successful (Bellisle and Drewnowski 2007).
Several studies on aspartame have suggested that it may facilitate the control of body weight and
enhances weight maintenance over the long term. In 2007, Bellisle and Drewnowski examined and
challenged the hypothesis that low-calorie sweeteners and the products that contain them may cause
weight gain. Although their review of a variety of studies indicated that intense sweeteners may
assist weight loss efforts, it did stress that low-calorie sweeteners are not a “silver bullet” solution
to weight management, are not appetite suppressants, and will not result in automatic weight loss.
They concluded that the ultimate effect of low-calorie sweeteners on weight loss is dependent on
their integration into a whole lifestyle approach.
In earlier reviews by Barbara Rolls, the effects of low-calorie sweeteners and low-calorie prod-
ucts on hunger, appetite, and food intake were examined. In 1991, she published a review in which
she evaluated low-calorie sweeteners' role on hunger, appetite, and food intake. In this comprehen-
sive review, Rolls concluded that, “If low-calorie sweeteners are part of a weight control program,
they could aid calorie control by providing palatable foods with reduced energy.” It needs to be
stressed that there are no data suggesting that the consumption of foods and drinks with low-calorie
sweeteners promotes food intake and weight gain in dieters (Rolls 1991).
A meta-analysis of studies by de la Hunty et al. (2006) demonstrated that “using foods and
drinks sweetened with aspartame instead of sucrose (sugar) results in a signiicant reduction in both
energy intakes and body weight. Also, the meta-analyses both of energy intake and of weight loss
produced an estimated rate of weight loss of about 0.2 kg/week. This corresponds to a weight loss
of 10 kg over a one-year period” (de la Hunty et al. 2006).
A recent review paper by Mattes and Popkin (2009) analyzed indings from 224 studies on the
effects of intense sweeteners on appetite, food intake, and weight. They concluded that short-term
trials provide mixed evidence of reduced energy intake with intense sweetener use but that “longer-
term trials—arguably the more nutritionally relevant studies—consistently indicate that the use of
intense sweeteners results in slightly lower energy intakes.” With regard to the impact on body mass
index (BMI), the study noted that “reverse causality remains a likely explanation” for at least a por-
tion of recent epidemiological indings linking intense sweetener use to weight gain. The research-
ers stated that, “Taken together, the evidence summarized by us and others suggests that if intense
sweeteners are used as substitutes for higher-energy-yielding sweeteners, they have the potential
to aid in weight management.” Furthermore, it should be pointed out that low-calorie sweeteners
offer people with diabetes the pleasure of a sweet taste without negative side effects. On the one
hand, sweeteners have no impact on insulin and blood sugar levels, and on the other hand, they do
not provide calories. Moreover, low-calorie foods help this group of people in the important task of
controlling their weight (Maffeis 2009).
11.5.1 artiicial Sweetener Intake in Children
Beverages have been identiied as a major source of artiicial sweeteners in the diet (Morgan
et al. 1982; Ilback et al. 2003); hence, estimates of artiicial sweetener consumption are typically