The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults - PubMed (original) (raw)

The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults

A Drewnowski et al. Nutr Diabetes. 2016.

Abstract

Background: Low-calorie sweeteners (LCSs) are said to be a risk factor for obesity and diabetes. Reverse causality may be an alternative explanation.

Methods: Data on LCS use, from a single 24-h dietary recall, for a representative sample of 22 231 adults were obtained from 5 cycles of the National Health and Nutrition Examination Survey (1999-2008 NHANES). Retrospective data on intent to lose or maintain weight during the prior 12-months and 10-year weight history were obtained from the weight history questionnaire. Objectively measured heights and weights were obtained from the examination. Primary analyses evaluated the association between intent to lose/maintain weight and use of LCSs and specific LCS product types using survey-weighted generalized linear models. We further evaluated whether body mass index (BMI) may mediate the association between weight loss intent and use of LCSs. The association between 10-year weight history and current LCS use was evaluated using restricted cubic splines.

Results: In cross-sectional analyses, LCS use was associated with a higher prevalence of obesity and diabetes. Adults who tried to lose weight during the previous 12 months were more likely to consume LCS beverages (prevalence ratio=1.64, 95% confidence interval (CI) 1.54-1.75), tabletop LCS (prevalence ratio=1.68, 95% CI 1.47-1.91) and LCS foods (prevalence ratio=1.93, 95% CI 1.60-2.33) as compared with those who did not. In mediation analyses, BMI only partially mediated the association between weight control history and the use of LCS beverages, tabletop LCS, but not LCS foods. Current LCS use was further associated with a history of prior weight change (for example, weight loss and gain).

Conclusions: LCS use was associated with self-reported intent to lose weight during the previous 12 months. This association was only partially mediated by differences in BMI. Any inference of causality between attempts at weight control and LCS use is tempered by the cross-sectional nature of these data and retrospective self-reports of prior weight loss/maintenance intent.

PubMed Disclaimer

Conflict of interest statement

Adam Drewnowski has received grants, contracts, honoraria and consulting fees from numerous food and beverage companies and other commercial and nonprofit entities with interests in diet quality and health. The University of Washington has received grants, donations and contracts from both the public and the private sector. Colin D Rehm declares no conflict of interest.

Figures

Figure 1

Figure 1

Multivariable-adjusted prevalence of obesity (a) and diabetes (b) by type of LCS consumed. *** indicates _P_-value<0.001 comparing LCS consumers to non-consumers.

Figure 2

Figure 2

Multivariable-adjusted prevalence ratio between 10-year weight change and consumption of any LCS (a) and LCS beverages (b).

Figure 3

Figure 3

Multivariable-adjusted prevalence ratio between 10-year weight change and consumption of LCS foods (a), tabletop LCS (b) and ⩾2 LCS product types (c).

Similar articles

Cited by

References

    1. Anderson G, Foreyt J, Sigman-Grant M, Allison DB. The use of low-calorie sweeteners by adults: impact on weight management. J Nutr 2012; 142: 1163S–1169S. - PubMed
    1. Peters JC, Wyatt HR, Foster GD, Pan Z, Wojtanowski AC, Vander Veur SS et al. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity (Silver Spring) 2014; 22: 1415–1421. - PubMed
    1. Tate DF, Turner-McGrievy G, Lyons E, Stevens J, Erickson K, Polzien K et al. Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr 2012; 95: 555–563. - PMC - PubMed
    1. Gardner C, Wylie-Rosett J, Gidding SS, Steffen LM, Johnson RK, Reader D et al. Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2012; 126: 509–519. - PubMed
    1. Peters JC, Beck J, Cardel M, Wyatt HR, Foster GD, Pan Z et al. The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: a randomized clinical trial. Obesity (Silver Spring) 2016; 24: 297–304. - PMC - PubMed

MeSH terms

Substances

LinkOut - more resources