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Permanent link (DOI): https://doi.org/10.7939/R3K64B64G

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A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes Open Access

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Author or creator
Wiebe, Natasha
Padwal, Raj
Field, Catherine J.
Marks, Seth
Jacobs, Rene
Tonelli, Marcello
Additional contributors
Subject/Keyword
Blood-Glucose
Fructose Corn Syrup
Body-Weight
Diabetic Subjects
Dietary Fructose
Hydrogenated Starch Hydrolysate
Food-Intake
Short-Chain Fructooligosaccharides
Healthy-Subjects
Hepatic Glucose-Production
Type of item
Journal Article (Published)
Language
English
Place
Time
Description
Background The major metabolic complications of obesity and type 2 diabetes may be prevented and managed with dietary modification. The use of sweeteners that provide little or no calories may help to achieve this objective. Methods We did a systematic review and network meta-analysis of the comparative effectiveness of sweetener additives using Bayesian techniques. MEDLINE, EMBASE, CENTRAL and CAB Global were searched to January 2011. Randomized trials comparing sweeteners in obese, diabetic, and healthy populations were selected. Outcomes of interest included weight change, energy intake, lipids, glycated hemoglobin, markers of insulin resistance and glycemic response. Evidence-based items potentially indicating risk of bias were assessed. Results Of 3,666 citations, we identified 53 eligible randomized controlled trials with 1,126 participants. In diabetic participants, fructose reduced 2-hour blood glucose concentrations by 4.81 mmol/L (95% CI 3.29, 6.34) compared to glucose. Two-hour blood glucose concentration data comparing hypocaloric sweeteners to sucrose or high fructose corn syrup were inconclusive. Based on two ≤10-week trials, we found that non-caloric sweeteners reduced energy intake compared to the sucrose groups by approximately 250-500 kcal/day (95% CI 153, 806). One trial found that participants in the non-caloric sweetener group had a decrease in body mass index compared to an increase in body mass index in the sucrose group (-0.40 vs 0.50 kg/m2, and -1.00 vs 1.60 kg/m2, respectively). No randomized controlled trials showed that high fructose corn syrup or fructose increased levels of cholesterol relative to other sweeteners. Conclusions Considering the public health importance of obesity and its consequences; the clearly relevant role of diet in the pathogenesis and maintenance of obesity; and the billions of dollars spent on non-caloric sweeteners, little high-quality clinical research has been done. Studies are needed to determine the role of hypocaloric sweeteners in a wider population health strategy to prevent, reduce and manage obesity and its consequences.
Date created
2011
DOI
doi:10.7939/R3K64B64G
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Attribution 4.0 International
Citation for previous publication
Wiebe, N., Padwal, R., Field, C. J., Marks, S., Jacobs, R., & Tonelli, M. (2011). A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes. BMC Medicine, 9(123), [18 pages].  http://dx.doi.org/10.1186/1741-7015-9-123

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Last modified: 2017:09:06 16:12:28-06:00
Filename: BMCMed_9_123.pdf
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Copyright note: © 2011 Wiebe et al; licensee BioMed Central Ltd.
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File title: Abstract
Page count: 18
File language: EN
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