title: Habitual caffeine intake and the risk of hypertension in women. Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women. Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Safety of long-term large doses of aspartame. Long-term dietary compensation for added sugar: effects of supplementary sucrose drinks over a 4-week period. A trial of sugar-free or sugar-sweetened beverages and body weight in children. Case-control study of urinary bladder cancer in metropolitan Nagoya. Beverage consumption patterns of children born at different risk of obesity. [Modification of fasting blood glucose in adults with diabetes mellitus type 2 after regular soda and diet soda intake in the State of Querétaro, Mexico]. The relative reinforcing value of sweet versus savory snack foods after consumption of sugar- or non-nutritive sweetened beverages Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort Caffeinated and caffeine-free beverages and risk of type 2 diabetes. Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight. Comparative effects of fructose, aspartame, glucose, and water preloads on calorie and macronutrient intake. Physical changes in the home environment to reduce television viewing and sugar-sweetened beverage consumption among 5- to 12-year-old children: a randomized pilot study. Sweetened beverage consumption and risk of coronary heart disease in women. Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Tea-induced calmness: Sugar-sweetened tea calms consumers exposed to acute stressor Artificial sweetener use and one-year weight change among women. To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies Hormonal responses to non-nutritive sweeteners in water and diet soda Aspartame ingestion and headaches Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Sweetened Beverages, Coffee, and Tea and Depression Risk among Older US Adults Sucrose compared with artificial sweeteners: a clinical intervention study of effects on energy intake, appetite, and energy expenditure after 10 wk of supplementation in overweight subjects. Effect of Television Viewing at Mealtime on Food Intake After a Glucose Preload in Boys Energy compensation following consumption of sugar-reduced products: a randomized controlled trial Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Postingestive inhibition of food intake by aspartame: Importance of interval between aspartame administration and subsequent eating Dietary factors in relation to weight change among men and women from two southeastern New England communities Effect of aqueous solutions of sucralose on plaque pH. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct Glycemic Effect of a Single High Oral Dose of the Novel Sweetener Sucralose in Patients With Diabetes Does diet-beverage intake affect dietary consumption patterns? Results from the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Effects of oral ingestion of sucralose on gut hormone response and appetite in healthy normal-weight subjects Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension. Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study. Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial Reducing Consumption of Sugar-Sweetened Beverages Is Associated With Reduced Blood Pressure: A Prospective Study Among United States Adults Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis Tasting profile affects adoption of caloric beverage reduction in a randomized weight loss intervention Dental plaque pH variation with regular soft drink, diet soft drink and high energy drink: an in vivo study. Chronic Low-Calorie Sweetener Use and Risk of Abdominal Obesity among Older Adults: A Cohort Study Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies Children's food intake following drinks sweetened with sucrose or aspartame: Time course effects Artificial sweeteners and absence of bladder cancer risk in Copenhagen. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Response to Single Dose of Aspartame or Saccharin by NIDDM Patients Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study Blood glucose and meal patterns in time-blinded males, after aspartame, carbohydrate, and fat consumption, in relation to sweetness perception. Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. Relative importance of risk factors in bladder carcinogenesis: some new results about Mediterranean habits Consuming aspartame with and without taste: Differential effects on appetite and food intake of young adult males The effects of sugar-free vs sugar-rich beverages on feelings of fullness and subsequent food intake. Dietary factors and the incidence of cancer of the urinary bladder. A randomized trial of sugar-sweetened beverages and adolescent body weight. Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized, Controlled Pilot Study Aspartame Use By Persons with Diabetes The influence of mouthrinses with antimicrobial solutions on the inhibition of dental plaque and on the levels of mutans streptococci in children. Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Family Study Administration of aspartame in non-insulin-dependent diabetics. Influence of repeated consumption of beverages containing sucrose or intense sweeteners on food intake In vivo dental plaque pH variation with regular and diet soft drinks. Effect of short-duration physical activity and ventilation threshold on subjective appetite and short-term energy intake in boys Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort Adolescent beverage habits and changes in weight over time: findings from Project EAT. Effects of Sweetness and Energy in Drinks on Food Intake Following Exercise A randomized control trial for reduction of caloric and non-caloric sweetened beverages in young adults: effects in weight, body composition and blood pressure. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure. A case-control study of multiple myeloma nested in the American Cancer Society prospective study. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. The effect of non-caloric sweeteners on cognition, choice, and post-consumption satisfaction The effect of chewing sugar-free gum after meals on clinical caries incidence. Weight control among obese adolescents: A pilot study Use of 'light' foods and drinks in French adults: biological, anthropometric and nutritional correlates. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Aspartame consumption in relation to childhood brain tumor risk: results from a case-control study. Sugar-added beverages and adolescent weight change. Effects of aspartame in young persons during weight reduction. Beverage Intake Among Preschool Children and Its Effect on Weight Status Dietary factors and breast‐cancer risk in Denmark Adverse reactions to aspartame: Double-blind challenge in patients from a vulnerable population Effect of chewing gums on plaque pH after a sucrose challenge. Cyclamate consumption in Catalonia, Spain (1992): relationship with the body mass index. Factors affecting recurrence rates in superficial bladder cancer. An evaluation of the effect of aspartame on weight loss Urinary bladder cancer risk factors: a Lebanese case- control study. Lunch eating behavior of preschool children: Effects of age, gender, and type of beverage served Parents' and children's acceptance of skim chocolate milks sweetened by monk fruit and stevia leaf extracts. The effect of aspartame on migraine headache. Dietary habits and dental caries in a population of Spanish schoolchildren with low levels of caries experience. Effects of sucrose drinks on macronutrient intake, body weight, and mood state in overweight women over 4 weeks Artificially and sugar-sweetened carbonated beverage consumption is not associated with risk of lymphoid neoplasms in older men and women.
abstract: CONTEXT Caffeine acutely increases blood pressure , but the association between habitual consumption of caffeinated beverages and incident hypertension is uncertain . OBJECTIVE To examine the association between caffeine intake and incident hypertension in women . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study conducted in the Nurses ' Health Studies ( NHSs ) I and II of 155,594 US women free from physician-diagnosed hypertension followed up over 12 years ( 1990 - 1991 to 2002 - 2003 question naires ) .  Caffeine intake and possible confounders were ascertained from regularly administered question naires . We also tested the associations with types of caffeinated beverages . MAIN OUTCOME MEASURE Incident physician-diagnosed hypertension . RESULTS During follow-up , 19,541 incident cases of physician-diagnosed hypertension were reported in NHS I and 13,536 in NHS II . In both cohorts , no linear association between  caffeine  consumption and risk of incident hypertension was observed after multivariate adjustment ( NHS I , P for trend = .29 ; NHS II , P for trend = .53 ) . Using categorical analysis , an inverse U-shaped association between caffeine consumption and incident hypertension was found . Compared with participants in the lowest quintile of caffeine consumption , those in the third quintile had a 13 % and 12 % increased risk of hypertension , respectively ( 95 % confidence interval in NHS I , 8%-18 % ; in NHS II , 6%-18 % ) . When study ing individual classes of caffeinated beverages , habitual coffee consumption was not associated with increased risk of hypertension . By contrast , consumption of cola beverages was associated with an increased risk of hypertension , independent of whether it was sugared or diet cola ( P for trend < .001 ) . CONCLUSION No linear association between caffeine consumption and incident hypertension was found . Even though habitual coffee consumption was not associated with an increased risk of hypertension , consumption of sugared or diet cola was associated with it . Further research to eluci date the role of cola beverages in hypertension is warranted BACKGROUND Despite safety reports of the artificial sweetener aspartame , health-related concerns remain . OBJECTIVE We prospect ively evaluated whether the consumption of aspartame- and sugar-containing soda is associated with  risk of hematopoetic cancers .  DESIGN We repeatedly assessed diet in the Nurses ' Health Study ( NHS ) and Health Professionals Follow-Up Study ( HPFS ) . Over 22 y , we identified 1324 non-Hodgkin lymphomas ( NHLs ) , 285 multiple myelomas , and 339 leukemias . We calculated incidence RRs and 95 % CIs by using Cox proportional hazards models . RESULTS When the 2 cohorts were combined , there was no significant association between soda intake and risks of NHL and multiple myeloma . However , in men , ≥1 daily serving of diet soda  increased risks of NHL ( RR : 1.31 ; 95 % CI : 1.01 , 1.72 ) and multiple myeloma ( RR : 2.02 ; 95 % CI : 1.20 , 3.40 ) in comparison with men who did not consume diet soda . We observed no increased risks of NHL and multiple myeloma in women . We also observed an unexpected elevated risk of NHL ( RR : 1.66 ; 95 % CI : 1.10 , 2.51 ) with a higher consumption of regular , sugar-sweetened soda in men but not in women . In contrast , when sexes were analyzed separately with limited power , neither regular nor diet soda  increased risk of leukemia but were associated with increased leukemia risk when data for men and women were combined ( RR for consumption of ≥1 serving of diet soda/d when the 2 cohorts were pooled : 1.42 ; 95 % CI : 1.00 , 2.02 ) . CONCLUSION Although our findings preserve the possibility of a detrimental effect of a constituent of diet soda , such as aspartame , on select cancers , the inconsistent sex effects and occurrence of an apparent cancer risk in individuals who consume regular soda do not permit the ruling out of chance as an explanation BACKGROUND It has been extensively shown , mainly in US population s , that sugar-sweetened beverages ( SSBs ) are associated with increased risk of type 2 diabetes ( T2D ) , but less is known about the effects of artificially sweetened beverages ( ASBs ) . OBJECTIVE We evaluated the association between self-reported SSB , ASB , and 100 % fruit juice consumption and T2D risk over 14 y of follow-up in the French prospect i ve Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospect i ve Investigation into Cancer and Nutrition cohort . DESIGN A total of 66,118 women were followed from 1993 , and 1369 incident cases of T2D were diagnosed during the follow-up . Cox regression models were used to estimate HRs and 95 % CIs for T2D risk . RESULTS The average consumption of sweetened beverages in consumers was 328 and 568 mL/wk for SSBs and ASBs , respectively . Compared with nonconsumers , women in the highest quartiles of SSB and ASB consumers were at increased risk of T2D with HRs ( 95 % CIs ) of 1.34 ( 1.05 , 1.71 ) and 2.21 ( 1.56 , 3.14 ) for women who consumed > 359 and > 603 mL/wk of SSBs and ASBs , respectively . Strong positive trends in T2D risk were also observed across quartiles of consumption for both types of beverage ( P = 0.0088 and P < 0.0001 , respectively ) . In sensitivity analyses , associations were partly mediated by BMI , although there was still a strong significant independent effect . No association was observed for 100 % fruit juice consumption . CONCLUSIONS Both SSB consumption and ASB consumption were associated with increased T2D risk . We can not rule out that factors other than ASB consumption that we did not control for are responsible for the association with diabetes , and r and omized trials are required to prove a causal link between ASB consumption and T2D Safety of long-term administration of 75 mg/kg of aspartame per day was evaluated with the use of a r and omized , double-blind , placebo-controlled , parallel-group design in 108 male and female volunteers aged 18 to 62 years . Subjects received either aspartame or placebo in capsule form three times daily for 24 weeks . No persistent changes over time were noted in either group in vital signs ; body weight ; results of st and ard laboratory tests ; fasting blood levels of aspartame 's constituent amino acids ( aspartic acid and phenylalanine ) , other amino acids , and methanol ; or blood formate levels and 24-hour urinary excretion of formate . There also were no statistically significant differences between groups in the number of subjects experiencing symptoms or in the number of symptoms per subject . These results further document the safety of the long-term consumption of aspartame at doses equivalent to the amount of aspartame in approximately 10 L of beverage per day The long-term physiological effects of refined carbohydrates on appetite and mood remain unclear . Reported effects when subjects are not blind may be due to expectations and have rarely been studied for more than 24 h. The present study compared the effects of supplementary soft drinks added to the diet over 4 weeks on dietary intake , mood and BMI in normal-weight women ( n 133 ) . Subjects were categorised as ' watchers ' or ' non-watchers ' of what they ate then received sucrose or artificially sweetened drinks ( 4 x 250 ml per d ) . Expectancies were varied by labelling drinks ' sugar ' or ' diet ' in a counter-balanced design . Sucrose supplements provided 1800 kJ per d and sweetener supplements provided 67 kJ per d. Food intake was measured with a 7 d diary and mood with ten single Likert scales . By 4 weeks , sucrose supplements significantly reduced total carbohydrate intake ( F(1,129 ) = 53.81 ; P<0.001 ) , fat ( F(2,250 ) = 33.33 ; P<0.001 ) and protein intake ( F(2,250 ) = 28.04 ; P<0 - 001 ) compared with sweetener supplements .  Mean daily energy intake increased by just under 1000 kJ compared with baseline ( t ( 67 df ) = 3.82 ; P < 0.001 ) and was associated with a non-significant trend for those receiving sucrose to gain weight . There were no effects on appetite or mood . Neither dietary restraint status as measured by the Dutch Eating Behaviour Question naire nor the expectancy procedure had effects . Expectancies influenced mood only during baseline week . It is concluded that sucrose satiates , rather than stimulates , appetite or negative mood in normal-weight subjects BACKGROUND The consumption of beverages that contain sugar is associated with overweight , possibly because liquid sugars do not lead to a sense of satiety , so the consumption of other foods is not reduced . However , data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain . METHODS We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age . Participants were r and omly assigned to receive 250 ml ( 8 oz ) per day of a sugar-free , artificially sweetened beverage ( sugar-free group ) or a similar sugar-containing beverage that provided 104 kcal ( sugar group ) . Beverages were distributed through schools . At 18 months , 26 % of the children had stopped consuming the beverages ; the data from children who did not complete the study were imputed . RESULTS The z score for the body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group ; the 95 % confidence interval ( CI ) of the difference was -0.21 to -0.05 . Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group ( 95 % CI for the difference , -1.54 to -0.48 ) . The skinfold-thickness measurements , waist-to-height ratio , and fat mass also increased significantly less in the sugar-free group . Adverse events were minor . When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study , the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group ( P=0.06 ) . CONCLUSIONS Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children . ( Funded by the Netherl and s Organization for Health Research and Development and others ; DRINK Clinical Trials.gov number , NCT00893529 . ) We conducted a population -based case-control study of patients with bladder cancer and of controls drawn r and omly from the general population of Metropolitan Nagoya and interviewed both groups . The incidence rates of bladder cancer were 2.42 and 7.05/100,000 for females and males , respectively . The analysis , based on 293 patients and 589 controls who were frequency matched for age , sex , and residence , provided the following major findings . Age-adjusted relative risks of 1.89 ( 1.15 - 3.10 ) and 3.53 ( 1.71 - 7.27 ) were found in male and female cigarette smokers , respectively . Significant relative risk was also found in males who drank cocoa . Elevated risk with a dose-response relationship was observed among women who used hair dye and who smoke , but this risk was insignificant , with the disappearance of a dose-response relationship , when it was adjusted for smoking . Age- and smoking-adjusted relative risk of coffee drinking was insignificant with no dose-response relationship . Relative risk of artificial sweetener use was below 1 with adjustment for age and smoking . Intake of alcoholic beverages and cola  was insignificantly associated . Reduced risk of significance was suggested for the intake of black tea and matcha ( powdered green tea ) in females and of fruit juice in males BACKGROUND Increased intake of sugar-sweetened beverages and fruit juice has been associated with overweight in children . OBJECTIVE This study prospect ively assessed beverage consumption patterns and their relationship with weight status in a cohort of children born at different risk for obesity . METHODS AND PROCEDURES Participants were children born at low risk ( n = 27 ) or high risk ( n = 22 ) for obesity based on maternal prepregnancy BMI ( kg/m(2 ) ) . Daily beverage consumption was generated from 3-day food records from children aged 3 - 6 years and coded into seven beverage categories ( milk , fruit juice , fruit drinks , caloric and non-caloric soda , soft drinks including and excluding fruit juice ) . Child anthropometric measures were assessed yearly . RESULTS High-risk children consumed a greater percentage of daily calories from beverages at age 3 , more fruit juice at ages 3 and 4 , more soft drinks ( including fruit juice ) at ages 3 - 5 , and more soda at age 6 compared to low-risk children . Longitudinal analyses showed that a greater 3-year increase in soda intake was associated with an increased change in waist circumference , whereas a greater increase in milk intake was associated with a reduced change in waist circumference . There was no significant association between change in intake from any of the beverage categories and change in BMI z-score across analyses . DISCUSSION Children 's familial predisposition to obesity may differentially affect their beverage consumption patterns . Future research should examine the extent to which dietary factors may play a role in pediatric body fat deposition over time The objective of the study was to compare the modification of fasting blood glucose in adults with diabetes mellitus type 2 after intake of regular soda and diet soda . We conducted a r and omized clinical trial in clinics of Instituto Mexicano del Seguro Social in Querétaro , México . We included 80 patients with diabetes ( mean weight 74.2 + /- 13.66 , BMI 30.5 + /- 4.305 , waist 98.2 + /- 12.9 and time evolution of diabetes 3.8 + /- 3.009 ) who were asked to come with fasting for 8 hours and without taking any medicine before testing . They were divided into two groups of 40 subjects , to whom was measured fasting blood glucose after the ingestion of 200 ml of diet soda ( with aspartame and acesulfame potassium ) or regular soda ( without sweetener ) we measure glucose at 10 , 15 and 30 minutes . For statistical analysis performed we used Student 's t-test for dependent and independent sample s , and paired t-test , and chi square test ( chi2 ) . Capillary glucose levels at 10 minutes were -34.52 and -25.41 % , at 15 minutes -48.8 and -36.2 % and at 30 minutes 57.75 and 43.6 % of absolute and relative differences , with p = 0.000 . In conclusion , according to the observations , diet soda does n't increased blood glucose levels , with a significant difference in fasting decreased at 30 minutes The effects of sugar-sweetened ( SSB ) and non-nutritive sweetened ( NSB ) beverages on the regulation of appetite , energy intake and body weight regulation remain controversial . Using a behavioral choice paradigm , we sought to determine the effects of consuming a SSB or NSB on appetite and the reinforcing value of sweet relative to salty/savory snack foods . In a r and omized crossover study , 21 healthy weight adults consumed 360 ml of SSB ( sucrose ; 31 g ) or NSB ( sucralose ; 4 g ) with a st and ardized meal . Hedonic ratings for the sweet and salty/savory snack foods used for the reinforcement task were assessed prior to the start of the study . Satiety and the desire to eat foods with a specific taste profile were assessed before and every 30 min post-meal for 4 h. The relative reinforcing value of the snack foods was assessed using a computer-based choice task ( operant responding with concurrent schedules of reinforcement ) 4 h post-meal . Hedonic ratings did not differ between the most highly liked sweet and salty/savory snack foods . Beverage type did not influence measures of satiety or the desire to eat foods with a specific taste . However , sweet snacks were more ( p < 0.05 ) reinforcing relative to salty/savory snack foods after consuming a NSB than after a SSB . In conclusion , this is the first study to demonstrate that NSB can increase the motivation to gain access to sweet snacks relative to salty/savory snack foods later in the day Limited evidence exists for an association between  maternal diet  during pregnancy and offspring bone health .  In a prospect i ve study , we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures .  In total , 101,042 pregnancies were recruited to the Danish National Birth Cohort ( DNBC ) during 1996–2002 .  Maternal diet was collected by a food frequency question naire . Associations were analyzed between seven dietary patterns extracted by principal component analysis and  offspring first occurrence of any forearm fracture diagnosis , extracted from the Danish National Patient Register , between time of birth and end of follow-up ( < 16 year ) ( n = 53,922 ) . In multivariable Cox regression models , offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk ( Hazard ratio , 95 % confidence interval : 1.11 , 1.01–1.23 ) of fractures , and there was a borderline significant positive trend ( p = 0.06 ) . The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups , except for the intake of artificially sweetened soft drinks , which was positively associated with offspring forearm fractures ( p = 0.02 ) . In the large prospect i ve DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks , respectively , indicated positive associations with offspring forearm fractures , which provides interesting hypotheses for future research BACKGROUND Consumption of caffeinated beverages such as coffee and tea has been associated with a lower risk of  type 2 diabetes ( T2D ) . Paradoxically , short-term metabolic studies have shown that caffeine impairs postpr and ial glycemic control . OBJECTIVE The objective was to prospect ively examine the association of caffeinated compared with caffeine-free beverages , including coffee , tea , sugar-sweetened beverages ( SSBs ) , and carbonated artificially sweetened beverages ( ASBs ) , with T2D risk . DESIGN We prospect ively observed 74,749 women from the Nurses ' Health Study ( NHS , 1984 - 2008 ) and 39,059 men from the Health Professionals Follow-Up Study ( HPFS , 1986 - 2008 ) who were free of diabetes , cardiovascular diseases , and cancer at baseline . RESULTS We documented 7370 incident cases of T2D during 24 y of follow-up in the NHS and 2865 new cases during 22 y of follow-up in the HPFS . After major lifestyle and dietary risk factors were controlled for , caffeinated and caffeine-free SSB intake was significantly associated with a higher risk of T2D in the NHS ( RR per serving : 13 % for caffeinated SSBs , 11 % for caffeine-free SSBs ; P < 0.05 ) and in the HPFS ( RR per serving : 16 % for caffeinated SSBs , 23 % for caffeine-free SSBs ; P < 0.01 ) . Only  caffeine-free ASB  intake in NHS participants was associated with a higher risk of T2D ( RR : 6 % per serving ; P < 0.001 ) . Conversely , the consumption of caffeinated and decaffeinated coffee was associated with a lower risk of T2D [ RR per serving : 8 % for both caffeinated and decaffeinated coffee in the NHS ( P < 0.0001 ) and 4 % for caffeinated and 7 % for decaffeinated coffee in the HPFS ( P < 0.01 ) ] . Only caffeinated tea was associated with a lower T2D risk among NHS participants ( RR per serving : 5 % ; P < 0.0001 ) . CONCLUSION Irrespective of the caffeine content , SSB intake was associated with a higher risk of T2D , and coffee intake was associated with a lower risk of T2D BACKGROUND Sugar-sweetened soft drinks have been linked to a number of adverse health outcomes such as high weight gain . Therefore , artificially sweetened soft drinks are often promoted as an alternative . However , the safety of artificial sweeteners has been disputed , and consequences of high intakes of artificial sweeteners for pregnant women have been minimally addressed . OBJECTIVE We examined the association between intakes of sugar-sweetened and artificially sweetened soft drinks and preterm delivery . DESIGN We conducted prospect i ve cohort analyses of 59,334 women from the Danish National Birth Cohort ( 1996 - 2002 ) . Soft drink intake was assessed in midpregnancy by using a food-frequency question naire . Preterm delivery ( lt 37 wk ) was the primary outcome measure . Covariate information was assessed by telephone interviews . RESULTS There was an association between intake of artificially sweetened carbonated and noncarbonated soft drinks and an increased risk of preterm delivery ( P for trend : le 0.001 , both variables ) . In comparison with women with no intake of artificially sweetened carbonated soft drinks , the adjusted odds ratio for women who consumed ge 1 serving of artificially sweetened carbonated soft drinks/d was 1.38 ( 95 % CI : 1.15 , 1.65 ) . The corresponding odds ratio for women who consumed ge 4 servings of artificially sweetened carbonated soft drinks/d was 1.78 ( 95 % CI : 1.19 , 2.66 ) . The association was observed for normal-weight and overweight women . A stronger increase in risk was observed for early preterm and moderately preterm delivery than with late-preterm delivery . No association was observed for sugar-sweetened carbonated soft drinks ( P for trend : 0.29 ) or for sugar-sweetened noncarbonated soft drinks ( P for trend : 0.93 ) . CONCLUSIONS Daily intake of artificially sweetened soft drinks may increase the risk of preterm delivery . Further studies are needed to reject or confirm these findings BACKGROUND Artificially sweetened ( AS ) and sugar-sweetened ( SS ) beverages are commonly consumed during pregnancy . A recent Danish study reported that the daily intake of an AS beverage was associated with an increased risk of preterm delivery .  OBJECTIVE We examined the intake of AS and SS beverages in pregnant women to replicate the Danish study and observe whether AS intake is indeed associated with preterm delivery . DESIGN This was a prospect i ve study of 60,761 pregnant women in the Norwegian Mother and Child Cohort Study . Intakes of carbonated and noncarbonated AS and SS beverages and use of artificial sweeteners in hot drinks were assessed by a self-reported food-frequency question naire in midpregnancy . Preterm delivery was the primary outcome , and data were obtained from the Norwegian Medical Birth Registry . RESULTS Intakes of both AS and SS beverages  increased with increasing BMI and energy intake and were higher in women with less education , in daily smokers , and in single women . A high intake of AS beverages was associated with preterm delivery ; the adjusted OR for those drinking > 1 serving/d was 1.11 ( 95 % CI : 1.00 , 1.24 ) . Drinking > 1 serving of SS beverages per day was also associated with an increased risk of preterm delivery ( adjusted OR : 1.25 ; 95 % CI : 1.08 , 1.45 ) . The trend tests were positive for both beverage types . CONCLUSION This study suggests that a high intake of both AS and SS beverages is associated with an increased risk of preterm delivery Background : Substituting sweeteners with non-nutritive sweeteners ( NNS ) may aid in glycaemic control and body weight management . Limited studies have investigated energy compensation , glycaemic and insulinaemic responses to artificial and natural NNS . Objectives : This study compared the effects of consuming NNS ( artificial versus natural ) and sucrose ( 65 g ) on energy intake , blood glucose and insulin responses . Methods : Thirty healthy male subjects took part in this r and omised , crossover study with four treatments : aspartame- , monk fruit- , stevia- and sucrose-sweetened beverages . On each test day , participants were asked to consume a st and ardised breakfast in the morning , and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption . Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day . Results : Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose ( P=0.010 ) . The energy ' saved ' from replacing sucrose with NNS was fully compensated for at subsequent meals ; hence , no difference in total daily energy intake was found between the treatments ( P=0.831 ) . The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour , whereas these responses were higher for all three NNS beverages following the test lunch . Thus , there were no differences in total area under the curve ( AUC ) for glucose ( P=0.960 ) and insulin ( P=0.216 ) over 3 h between the four test beverages . Conclusions : The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake , postpr and ial glucose and insulin compared with a sucrose-sweetened beverage To examine whether artificial sweeteners aid in the control of long-term food intake and body weight , we gave free-living , normal-weight subjects 1150 g soda sweetened with aspartame ( APM ) or high-fructose corn syrup ( HFCS ) per day . Relative to when no soda was given , drinking APM-sweetened soda for 3 wk significantly reduced calorie intake of both females ( n = 9 ) and males ( n = 21 ) and decreased the body weight of males but not of females . However , drinking HFCS-sweetened soda for 3 wk significantly increased the calorie intake and body weight of both sexes . Ingesting either type of soda reduced intake of sugar from the diet without affecting intake of other nutrients . Drinking large volumes of APM-sweetened soda , in contrast to drinking HFCS-sweetened soda , reduces sugar intake and thus may facilitate the control of calorie intake and body weight This study investigated whether the addition of the high-intensity sweetener aspartame to a multidisciplinary weight-control program would improve weight loss and long-term control of body weight .  One hundred sixty-three obese women were r and omly assigned to consume or to abstain from aspartame-sweetened foods and beverages during 16 wk of a 19-wk weight-reduction program ( active weight loss ) , a 1-y maintenance program , and a 2-y follow-up period . Women in both treatment groups lost approximately 10 % of initial body weight ( 10 kg ) during active weight loss . Among women assigned to the aspartame-treatment group , aspartame intake was positively correlated with percentage weight loss during active weight loss ( r = 0.32 , P < 0.01 ) . During maintenance and follow-up , participants in the aspartame group experienced a 2.6 % ( 2.6 kg ) and 4.6 % ( 4.6 kg ) regain of initial body weight after 71 and 175 wk , respectively , whereas those in the no-aspartame group gained an average of 5.4 % ( 5.4 kg ) and 9.4 % ( 9.4 kg ) , respectively . The aspartame group lost significantly more weight overall ( P = 0.028 ) and regained significantly less weight during maintenance and follow-up ( P = 0.046 ) than did the no-aspartame group . Percentage weight losses at 71 and 175 wk were also positively correlated with exercise ( r = 0.32 , P < 0.001 ; and r = 0.34 , P < 0.01 , respectively ) and self-reported eating control ( r = 0.37 , P < 0.001 ; and r = 0.33 , P < 0.01 , respectively ) . These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight Using a within-subjects design , we gave over-weight and normal-weight subjects a 500-mL drink of fructose , glucose , or aspartame diluted in lemon-flavored water or plain water in a r and omized fashion at about weekly intervals . Food intake was assessed at a buffet lunch that began 38 min after the preload was completed . Blood was drawn throughout and assayed for concentrations of glucose , insulin , glucagon , and free fatty acid . When subjects drank the fructose preload , they subsequently ate fewer overall calories and fewer grams of fat than when they drank any of the other preloads . The aspartame load did not stimulate intake beyond the plain-water control . The effects of the oxidation of fructose as a possible mechanism for the reduction in food intake is discussed . The effects of insulin in stimulating intake are also discussed This study evaluated the feasibility of a home-based intervention to reduce sugar-sweetened beverage intake and television viewing among children . Lower income parents of overweight children aged 5 - 12 years ( n = 40 ) were r and omized to a home environment intervention to reduce television viewing with locking devices and displace availability of sugar-sweetened beverages with home delivery of non-caloric beverages ( n = 25 ) , or to a no-intervention control group ( n = 15 ) for 6 months . Data were collected at baseline and 6 months . After 6 months , television viewing hours per day was significantly lower in the intervention group compared with the control group ( 1.7 [ SE = .02 ] vs. 2.6 [ SE = .25 ] hours/day , respectively , P < .01 ) .  Sugar-sweetened beverage intake was marginally significantly lower among intervention group compared to control group children ( 0.21 [ SE = .09 ] vs. 0.45 [ SE = .10 ] , respectively , P < .09 ) . Body mass index ( BMI ) z-score was not significantly lower among intervention compared to control children . Among a lower income sample of children , a home-based intervention  reduced television viewing , but not sugar-sweetened beverage intake or BMI z-score BACKGROUND Previous studies have linked full-calorie sugar-sweetened beverages ( SSBs ) with greater weight gain and an increased risk of type 2 diabetes . OBJECTIVE We prospect ively examined the association between consumption of SSBs and the risk of coronary heart disease ( CHD ) in women . DESIGN Women ( n = 88,520 ) from the Nurses ' Health Study aged 34 - 59 y , without previously diagnosed coronary heart disease ( CHD ) , stroke , or diabetes in 1980 , were followed from 1980 to 2004 . Consumption of SSBs was derived from 7 repeated food-frequency question naires administered between 1980 and 2002 . Relative risks ( RRs ) for CHD were calculated by using Cox proportional hazards models and adjusted for known cardiovascular disease risk factors . RESULTS During 24 y of follow-up , we ascertained 3105 incident cases of CHD  ( nonfatal myocardial infa rct ion and fatal CHD ) . After st and ard and dietary risk factors were adjusted for , the RRs ( and 95 % CIs ) of CHD according to categories of cumulative average of SSB consumption ( < 1/mo , 1 - 4/mo , 2 - 6/wk , 1/d , and > or = 2 servings/d ) were 1.0 , 0.96 ( 0.87 , 1.06 ) , 1.04 ( 0.95 , 1.14 ) , 1.23 ( 1.06 , 1.43 ) , and 1.35 ( 1.07 , 1.69 ) ( P for trend < 0.001 ) . Additional adjustment for body mass index , energy intake , and incident diabetes attenuated the associations , but they remained significant . Artificially sweetened beverages were not associated with CHD . CONCLUSION Regular consumption of SSBs is associated with a higher  risk of CHD in women , even after other unhealthful lifestyle or dietary factors are accounted for OBJECTIVES To examine the relationship between  diet soda ( DS ) intake ( DSI )  and long-term waist circumference ( WC ) change ( ΔWC ) in the biethnic San Antonio Longitudinal Study of Aging ( SALSA ) . DESIGN Prospect i ve cohort study . SETTING San Antonio , Texas , neighborhoods . PARTICIPANTS SALSA examined 749 Mexican-American and European-American individuals aged 65 and older at baseline ( baseline , 1992 - 96 ) ; 474 ( 79.1 % ) survivors completed follow-up 1 ( FU1 , 2000 - 01 ) , 413 ( 73.4 % ) completed FU2 ( 2001 - 03 ) , and 375 ( 71.0 % ) completed FU3 ( 2003 - 04 ) . Participants completed a mean of 2.64 follow-up intervals , for 9.4 total follow-up years . MEASUREMENTS DSI , WC , height , and weight were measured at outset and at the conclusion of each interval : baseline , FU1 , FU2 , and FU3 . RESULTS Adjusted for initial WC , demographic characteristics , physical activity , diabetes mellitus , and smoking , mean interval ΔWC  of DS users ( 2.11 cm , 95 % confidence interval ( CI ) = 1.45 - 2.76 cm ) was almost triple that of nonusers ( 0.77 cm , 95 % CI = 0.29 - 1.23 cm ) ( P < .001 ) . Adjusted interval ΔWCs were 0.77 cm ( 95 % CI = 0.29 - 1.23 cm ) for nonusers , 1.76 cm ( 95 % CI = 0.96 - 2.57 cm ) for occasional users , and 3.04 cm ( 95 % CI = 1.82 - 4.26 cm ) for daily users ( P = .002 for trend ) . This translates to ΔWCs of 0.80 inches for nonusers , 1.83 inches for occasional users , and 3.16 for daily users over the total SALSA follow-up . In subanalyses stratified for selected covariates , ΔWC point estimates were consistently higher in DS users . CONCLUSION In a striking dose-response relationship , increasing DSI was associated with escalating abdominal obesity , a potential pathway for cardiometabolic risk in this aging population BACKGROUND Consumption of liquid calories from beverages has increased in parallel with the obesity epidemic in the US population , but their causal relation remains unclear . OBJECTIVE The objective of this study was to examine how changes in beverage consumption affect  weight change among adults . DESIGN This was a prospect i ve study of 810 adults participating in the PREMIER trial , an 18-mo r and omized , controlled , behavioral intervention trial .  Measurements ( weight , height , and 24-h dietary recall ) were made at baseline , 6 mo , and 18 mo . RESULTS Baseline mean intake of liquid calories was 356 kcal/d ( 19 % of total energy intake ) . After potential confounders and intervention assignment were controlled for , a reduction in liquid calorie intake of 100 kcal/d was associated with a weight loss of 0.25 kg ( 95 % CI : 0.11 , 0.39 ; P < 0.001 ) at 6 mo and of 0.24 kg ( 95 % CI : 0.06 , 0.41 ; P = 0.008 ) at 18 mo . A reduction in liquid calorie intake had a stronger effect than did a reduction in solid calorie intake on weight loss . Of the individual beverages , only intake of sugar-sweetened beverages ( SSBs ) was significantly associated with weight change . A reduction in SSB intake of 1 serving/d was associated with a weight loss of 0.49 kg ( 95 % CI : 0.11 , 0.82 ; P = 0.006 ) at 6 mo and of 0.65 kg ( 95 % CI : 0.22 , 1.09 ; P = 0.003 ) at 18 mo . CONCLUSIONS These data support recommendations to limit liquid calorie intake among adults and to reduce SSB consumption as a means to accomplish weight loss or avoid excess weight gain . This trial was registered at clinical trials.gov as NCT00000616 The food and beverage industry has been increasingly replacing sugar with non-nutritive sweeteners in their sweetened products to control or reduce total calories . Research comparing the effect of nutritive and non-nutritive sweeteners on emotional state of participants exposed to acute stressors is still limited . This study aim ed to determine the effect of drinking tea sweetened with either a nutritive sweetener ( sugar ) or a non-nutritive sweetener ( sucralose or stevia ) on emotional state , in terms of calmness and pleasantness , of participants exposed to an acute stressor . Effects of acute stress on sweetness intensity and overall liking of tea beverages were also determined . Results showed that the possibility of tea-induced calmness , calculated as the difference between calmness ratings after and before drinking a tea sample , was established on stress session in the sugar-sweetened tea .  Overall liking , but not the sweetness intensity , of the sugar-sweetened tea was affected by acute stress . In conclusion , this study provides empirical evidence that the consumption of tea sweetened with nutritive sweetener , but not with non-nutritive sweetener , has calming effect on consumers with acute stress , suggesting that this effect may not be due to the sweet taste of sugar , but due to the caloric nature of the sweetener Weight change over a 1-year period was examined in a highly homogeneous group of 78,694 women ages 50 - 69 enrolled in a prospect i ve mortality study .  Artificial sweetener usage increased with relative weight and decreased with age . Users were significantly more likely than nonusers to gain weight , regardless of initial weight . Average weight gains or losses by artificial sweetener users differed by less than 2 pounds from gains or losses among nonusers . These results were not explicable by differences in food consumption patterns . The data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain Objective : The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking ( NNS ) for analgesia in newborn infants undergoing heel-stick procedures . Study Design : This r and omized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year . One hundred and eighty full-term neonates with birth weight > 2200 g and age > 24 h were r and omized to one of four interventions administered 2 min before the procedure : 2 ml of 30 % sucrose ( group I , n=45 ) or NNS ( group II , n=45 ) or both ( group III , n=45 ) or none ( group IV , n=45 ) . Primary outcome was composite score based on Premature Infant Pain Profile ( PIPP ) score . Result : Baseline variables were comparable among the groups . Median ( interquartile range ) PIPP score was 3 ( 2 to 4 ) in group III as compared with 7 ( 6.5 to 8) in group I , 9 ( 7 to 11 ) in group II and 13 ( 10.5 to 15 ) in group IV . Group III had significant decrease in the median PIPP score compared with other groups ( P=0.000 ) . Median PIPP score also decreased significantly with any intervention as compared with no intervention ( P=0.000 ) . Conclusion : Sucrose and /or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures , with the combined intervention being more effective compared with any single intervention OBJECTIVE : To examine the long-term relationship between changes in water and beverage intake and weight change . SUBJECTS : Prospect i ve cohort studies of 50 013 women aged 40–64 years in the Nurses ’ Health Study ( NHS , 1986–2006 ) , 52 987 women aged 27–44 years in the NHS II ( 1991–2007 ) and 21 988 men aged 40–64 years in the Health Professionals Follow-up Study ( 1986–2006 ) without obesity and chronic diseases at baseline . MEASURES : We assessed the association of weight change within each 4-year interval , with changes in  beverage intakes and other  lifestyle behaviors  during the same period . Multivariate linear regression with robust variance and accounting for within-person repeated measures were used to evaluate the association . Results across the three cohorts were pooled by an inverse-variance-weighted meta- analysis . RESULTS : Participants gained an average of 1.45 kg ( 5th to 95th percentile : −1.87 to 5.46 ) within each 4-year period . After controlling for age , baseline body mass index and changes in other lifestyle behaviors ( diet , smoking habits , exercise , alcohol , sleep duration , TV watching ) , each 1 cup per day increment of water intake was inversely associated with weight gain within each 4-year period ( −0.13 kg ; 95 % confidence interval ( CI ) : −0.17 to −0.08 ) . The associations for other beverages were : sugar-sweetened beverages ( SSBs ) ( 0.36 kg ; 95 % CI : 0.24–0.48 ) , fruit juice ( 0.22 kg ; 95 % CI : 0.15–0.28 ) , coffee ( −0.14 kg ; 95 % CI : −0.19 to −0.09 ) , tea ( −0.03 kg ; 95 % CI : −0.05 to −0.01 ) , diet beverages ( −0.10 kg ; 95 % CI : −0.14 to −0.06 ) , low-fat milk ( 0.02 kg ; 95 % CI : −0.04 to 0.09 ) and whole milk ( 0.02 kg ; 95 % CI : −0.06 to 0.10 ) . We estimated that replacement of 1 serving per day of SSBs by 1 cup per day of water was associated with 0.49 kg ( 95 % CI : 0.32–0.65 ) less weight gain over each 4-year period , and the replacement estimate of fruit juices by water was 0.35 kg ( 95 % CI : 0.23–0.46 ) . Substitution of SSBs or fruit juices by other beverages ( coffee , tea , diet beverages , low-fat and whole milk ) were all significantly and inversely associated with weight gain . CONCLUSION : Our results suggest that increasing water intake in place of SSBs or fruit juices is associated with lower long-term weight gain Background Non-nutritive sweeteners ( NNS ) , especially in form of diet soda , have been linked to metabolic derangements ( e.g. obesity and diabetes ) in epidemiologic studies . We aim ed to test acute metabolic effects of NNS in isolation ( water or seltzer ) and in diet sodas . Methods We conducted a four-period , cross-over study at the National Institutes of Health Clinical Center ( Bethesda , Maryl and ) . Thirty healthy adults consumed 355 mL water with 0 mg , 68 mg , 170 mg , and 250 mg sucralose , and 31 individuals consumed 355 mL caffeine-free Diet Rite Cola ™ , Diet Mountain Dew ™ ( 18 mg sucralose , 18 mg acesulfame-potassium , 57 mg aspartame ) , and seltzer water with NNS ( 68 mg sucralose and 41 mg acesulfame-potassium , equivalent to Diet Rite Cola ™ ) in r and omized order , prior to oral glucose tolerance tests . Blood sample s were collected serially for 130 min . Measures included GLP-1 , GIP , glucose , insulin , C-peptide , glucose absorption , gastric emptying , and subjective hunger and satiety ratings . Results Diet sodas  augmented active GLP-1 ( Diet Rite Cola ™ vs. seltzer water , AUC , p = 0.039 ; Diet Mountain Dew ™ vs. seltzer water , AUC , p = 0.07 ) , but gastric emptying and satiety were unaffected . Insulin concentrations were nominally higher following all NNS conditions without altering glycemia . Sucralose alone ( at any concentration ) did not affect metabolic outcomes . Conclusions Diet sodas but not NNS in water augmented GLP-1 responses to oral glucose . Whether the trends toward higher insulin concentrations after NNS are of clinical importance remains to be determined . Our findings emphasize the need to test metabolic effects of NNS after chronic consumption . Trial registration The data for this manuscript were gathered from clinical trial # NCT01200940 To examine whether ingestion of aspartame is associated with headaches , we conducted a double-blind crossover study using volunteers with self-identified headaches after using aspartame .  Of the 32 subjects r and omized to receive aspartame ( approximately 30 mg/kg/d ) and placebo in a two-treatment , four-period crossover design , 18 completed the full protocol , seven completed part of the protocol before withdrawing due to adverse effects , three withdrew for other reasons , two were lost to follow-up , one was withdrawn due to noncompliance , and one withdrew and gave no reason . Each experimental period was 7 days long . Subjects reported headaches on 33 % of the days during aspartame treatment , compared with 24 % on placebo treatment ( p = 0.04 ) . Subjects who were “ very sure ” prior to the study that aspartame triggered some of their headaches reported larger treatment differences  ( aspartame = 0.37 headache-days , placebo = 0.18 headache-days ; p < 0.001 ) than subjects who were “ somewhat sure ” ( aspartame = 0.29 headache-days , placebo = 0.22 headache-days ; p = 0.51 ) or " not sure " ( aspartame = 0.33 headache-days , placebo = 0.39 headache-days ; p = 0.51 ) . There was no significant treatment difference in the length or intensity of headaches or in the occurrence of side effects associated with the headaches . This experiment provides evidence that , among individuals with self-reported headaches after ingestion of aspartame , a subset of this group report more headaches when tested under controlled conditions . It appears that some people are particularly susceptible to headaches caused by aspartame and may want to limit their consumption BACKGROUND The consumption of sucrose-sweetened soft drinks ( SSSDs ) has been associated with obesity , the metabolic syndrome , and cardiovascular disorders in observational and short-term intervention studies . Too few long-term intervention studies in humans have examined the effects of soft drinks . OBJECTIVE We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition ( in liver and muscle tissue ) . DESIGN Overweight subjects ( n = 47 ) were r and omly assigned to 4 different test drinks ( 1 L/d for 6 mo ) : SSSD ( regular cola ) , isocaloric semiskim milk , aspartame-sweetened diet cola , and water . The amount of intrahepatic fat and intramyocellular fat was measured with (1)H-magnetic resonance spectroscopy . Other endpoints were fat mass , fat distribution ( dual-energy X-ray absorptiometry and magnetic resonance imaging ) , and metabolic risk factors . RESULTS The relative changes between baseline and the end of 6-mo intervention were significantly higher in the regular cola group than in the 3 other groups for liver fat ( 132 - 143 % , sex-adjusted mean ; P < 0.01 ) , skeletal muscle fat ( 117 - 221 % ; P < 0.05 ) , visceral fat ( 24 - 31 % ; P < 0.05 ) , blood triglycerides ( 32 % ; P < 0.01 ) , and total cholesterol ( 11 % ; P < 0.01 ) . Total fat mass was not significantly different between the 4 beverage groups . Milk and diet cola reduced systolic blood pressure by 10 - 15 % compared with regular cola ( P < 0.05 ) . Otherwise , diet cola had effects similar to those of water . CONCLUSION Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk , diet cola , and water . Thus , daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases . This trial is registered at clinical trials.gov as NCT00777647 Sweetened beverages , coffee , and tea are the most consumed non-alcoholic beverages and may have important health consequences . We prospect ively evaluated the consumption of various types of beverages assessed in 1995–1996 in relation to self-reported depression diagnosis after 2000 among 263,923 participants of the NIH-AARP Diet and Health Study .  Odds ratios ( OR ) and 95 % confidence intervals ( CI ) were derived from multivariate logistic regressions . The OR ( 95 % CI ) comparing ≥4 cans/cups per day with none were 1.30 ( 95%CI : 1.17–1.44 ) for soft drinks , 1.38 ( 1.15–1.65 ) for fruit drinks , and 0.91 ( 0.84–0.98 ) for coffee ( all P for trend<0.0001 ) . Null associations were observed for  iced-tea  and hot tea . In stratified analyses by drinkers of primarily diet versus regular beverages , the ORs were 1.31 ( 1.16–1.47 ) for diet versus 1.22 ( 1.03–1.45 ) for regular soft drinks , 1.51 ( 1.18–1.92 ) for diet versus 1.08 ( 0.79–1.46 ) for regular fruit drinks , and 1.25 ( 1.10–1.41 ) for diet versus 0.94 ( 0.83–1.08 ) for regular sweetened iced-tea . Finally , compared to nondrinkers , drinking coffee or tea without any sweetener was associated with a lower risk for depression , adding artificial sweeteners , but not sugar or honey , was associated with higher risks . Frequent consumption of sweetened beverages , especially diet drinks , may increase depression risk among older adults , whereas coffee consumption may lower the risk BACKGROUND There is a lack of appetite studies in free-living subjects supplying the habitual diet with either sucrose or artificially sweetened beverages and foods . Furthermore , the focus of artificial sweeteners has only been on the energy intake ( EI ) side of the energy-balance equation . The data are from a subgroup from a 10-wk study , which was previously published . OBJECTIVE The objective was to investigate changes in EI and energy expenditure ( EE ) as possible reasons for the changes in body weight during 10 wk of supplementation of either sucrose or artificial sweeteners in overweight subjects . DESIGN Supplements of sucrose-sweetened beverages and foods ( 2 g/kg body weight ; n = 12 ) or similar amounts containing artificial sweeteners ( n = 10 ) were given single-blind in a 10-wk parallel design . Beverages accounted for 80 % and solid foods for 20 % by weight of the supplements . The rest of the diet was free choice . Indirect 24-h whole-body calorimetry was performed at weeks 0 and 10 . At week 0 the diet was a weight-maintaining st and ardized diet . At week 10 the diet consisted of the supplements and ad libitum choice of foods .  Visual analog scales were used to record appetite . RESULTS Body weight increased in the sucrose group and decreased in the sweetener group during the intervention . The sucrose group had a 3.3-MJ higher EI but felt less full and had higher ratings of prospect i ve food consumption than did the sweetener group at week 10 . Basal metabolic rate was increased in the sucrose group , whereas 24-h EE was increased in both groups at week 10 . Energy balance in the sucrose group was more positive than in the sweetener group at the stay at week 10 . CONCLUSION The changes in body weight in the 2 groups during the 10-wk intervention seem to be attributable to changes in EI rather than to changes in EE Television viewing ( TVV ) is considered a contributing factor to the development of childhood obesity yet it is unclear whether obesity results , in part , from increased energy intake during TVV . The objective of this study was to determine the effect of TVV on food intake ( FI ) of boys at a meal and its effect on caloric compensation at the test meal after a premeal glucose drink . On four separate mornings and in r and om order , boys received equally sweetened preloads containing Splenda sucralose or glucose [ 1.0 g/kg body weight ( BW ) ] in 250 mL of water 2 h after a st and ard breakfast . Food intake from a pizza meal was measured 30 min later with or without TVV . Both preload treatment ( p < 0.01 ) and TVV ( p < 0.001 ) affected FI ( kcal ) .  TVV  increased lunchtime FI by an average of 228 kcal . Glucose suppressed FI in the no TVV condition compared with control , but the effect was not statistically significant during TVV .  Body composition and subjective appetite scores were positively associated with FI at the test lunch . In conclusion , TVV while eating a meal contributes to increased energy intake by delaying normal mealtime satiation and reducing satiety signals from previously consumed foods Purpose Consumption of sugar-reformulated products ( commercially available foods and beverages that have been reduced in sugar content through reformulation ) is a potential strategy for lowering sugar intake at a population level . The impact of sugar-reformulated products on body weight , energy balance ( EB ) dynamics and cardiovascular disease risk indicators has yet to be established . The REFORMulated foods ( REFORM ) study examined the impact of an 8-week sugar-reformulated product exchange on body weight , EB dynamics , blood pressure , arterial stiffness , glycemia and lipemia . Methods A r and omized , controlled , double-blind , crossover dietary intervention study was performed with fifty healthy normal to overweight men and women ( age 32.0 ± 9.8 year , BMI 23.5 ± 3.0 kg/m2 ) who were r and omly assigned to consume either regular sugar or sugar-reduced foods and beverages for 8 weeks , separated by 4-week washout period . Body weight , energy intake ( EI ) , energy expenditure and vascular markers were assessed at baseline and after both interventions . Results We found that carbohydrate ( P < 0.001 ) , total sugars ( P < 0.001 ) and non-milk extrinsic sugars ( P < 0.001 ) ( % EI ) were lower , whereas fat ( P = 0.001 ) and protein ( P = 0.038 ) intakes ( % EI ) were higher on the sugar-reduced than the regular diet . No effects on body weight , blood pressure , arterial stiffness , fasting glycemia or lipemia were observed . Conclusions Consumption of sugar-reduced products , as part of a blinded dietary exchange for an 8-week period , result ed in a significant reduction in sugar intake . Body weight did not change significantly , which we propose was due to energy compensation CONTEXT Sugar-sweetened beverages like soft drinks and fruit punches contain large amounts of readily absorbable sugars and may contribute to weight gain and an increased risk of type 2 diabetes , but these relationships have been minimally addressed in adults . OBJECTIVE To examine the association between consumption of sugar-sweetened beverages and weight change and  risk of type 2 diabetes in women . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort analyses conducted from 1991 to 1999 among women in the Nurses ' Health Study II . The diabetes analysis included 91,249 women free of diabetes and other major chronic diseases at baseline in 1991 . The weight change analysis included 51,603 women for whom complete dietary information and body weight were ascertained in 1991 , 1995 , and 1999 . We identified 741 incident cases of confirmed type 2 diabetes during 716,300 person-years of follow-up . MAIN OUTCOME MEASURES Weight gain and incidence of type 2 diabetes . RESULTS Those with stable consumption patterns had no difference in weight gain , but weight gain over a 4-year period was highest among women who increased their sugar-sweetened soft drink consumption from 1 or fewer drinks per week to 1 or more drinks per day ( multivariate-adjusted means , 4.69 kg for 1991 to 1995 and 4.20 kg for 1995 to 1999 ) and was smallest among women who decreased their intake ( 1.34 and 0.15 kg for the 2 periods , respectively ) after adjusting for lifestyle and dietary confounders . Increased consumption of fruit punch was also associated with greater weight gain compared with decreased consumption . After adjustment for potential confounders , women consuming 1 or more sugar-sweetened soft drinks per day had a relative risk [ RR ] of type 2 diabetes of 1.83 ( 95 % confidence interval [ CI ] , 1.42 - 2.36 ; P<.001 for trend ) compared with those who consumed less than 1 of these beverages per month . Similarly , consumption of fruit punch was associated with increased diabetes risk ( RR for > or = 1 drink per day compared with < 1 drink per month , 2.00 ; 95 % CI , 1.33 - 3.03 ; P = .001 ) . CONCLUSION Higher consumption of sugar-sweetened beverages is associated with a greater magnitude of weight gain and an increased risk for development of  type 2 diabetes in women , possibly by providing excessive calories and large amounts of rapidly absorbable sugars Aspartame administered in capsules ( i.e. , without tasting ) 1 h before a meal significantly reduces the amount eaten in that meal . In the present study 36 young men and women were divided into 3 groups of 12 to receive aspartame ( 400 mg ) or placebo ( 400 mg starch ) on separate occasions either 5 min ( Group A ) , 30 min ( Group B ) or 60 min ( Group C ) before beginning an ad lib test meal . Compared with placebo , aspartame reduced food intake in Group C ( by 18.5 % , p < 0.01 ) , but did not reliably affect intake in Groups A or B. There were , in contrast , no significant effects of aspartame on premeal ratings of hunger , desire to eat or fullness for any of the groups . These results confirm a postingestive inhibitory action of aspartame on appetite , which may involve the amplification of the satiating effects of food . The lack of effect of aspartame administered at the shorter intervals before eating suggests a postgastric or even postabsorptive mechanism of action . This observation is also important in its implication s for the possible therapeutic exploitation of the anorexic effect of capsulated aspartame OBJECTIVE : Dietary factors , independent of total energy , may be important in promoting obesity . We examined prospect ively the relationship between baseline diet composition and weight gain among adult men and women from southeastern New Engl and . DESIGN : The prospect i ve association of nutrient consumption and weight change was examined in a r and omly selected cohort examined four years apart . SUBJECTS : Adults aged 18 through 64 years from two communities in Southeastern New Engl and were r and omly selected for the study after being interviewed in their homes . The present investigation is based on a subgroup of 465 individuals who completed a food-frequency question naire in 1986 or 1987 and were reinterviewed four years later . STATISTICAL ANALYSES : Multiple regression analyses were used to determine the association of weight change with different nutrients and food groups after adjusting for age , smoking status , baseline body mass index , physical activity level , and total energy . RESULTS : Total energy was positively associated with weight gain and age was inversely associated with weight gain . None of the nutrients or food groups were significantly related to weight gain . CONCLUSIONS : These findings indicate that weight gain increased with increasing baseline total energy intake , particularly in the young . Future research is required to determine ways of decreasing energy intake in younger individuals PURPOSE To compare the effect on in vivo plaque pH of rinsing with an aqueous solution of sucralose ( alone or in combination with maltodextrin or maltodextrin and dextrose ) to the effect of rinsing with an aqueous solution of sucrose . MATERIAL S AND METHODS Each solution ( four in total ) had a sweetness equivalent to two teaspoons of sucrose in 6 oz . of water . The four test solutions were administered r and omly over four test visits ( one solution per visit ) to 10 subjects presenting 2-day resting plaque . Before , and at specified time intervals over 60 minutes following the rinse , in vivo plaque pH was monitored at six design ated sites using a Beckman 3500 digital pH meter . Data were analyzed by ANOVA . RESULTS The mean pH minimum for the sucralose rinse ( 6.56 ) was significantly higher than the sucralose/maltodextrin ( SM ) , sucralose/maltodextrin/dextrose ( SMD ) , and sucrose rinses ( 6.15 , 5.84 , and 5.29 , respectively ) . The mean delta pH ( difference between resting and minimum pH ) for the sucralose rinse ( 0.45 ) was significantly lower when compared to the SM ( 0.79 ) , SMD ( 1.14 ) , and sucrose ( 1.69 ) rinses . The differences seen in mean pH minimum and mean delta pH for the SM and SMD groups vs. the sucrose group were also statistically significant . Mean areas under the pH vs. time curve for the sucralose , SM and SMD rinses were all significantly less compared to the sucrose rinse . Rinsing with aqueous solutions of sucralose , or of sucralose in combination with maltodextrin and /or dextrose ( commercially available formulations , of sucralose ) was less acidogenic than rinsing with a sucrose solution of equivalent sweetness Consumption of sugar-sweetened beverages has been shown , largely in American population s , to increase type 2 diabetes incidence . We aim ed to evaluate the association of consumption of sweet beverages ( juices and nectars , sugar-sweetened soft drinks and artificially sweetened soft drinks ) with  type 2 diabetes incidence in European adults . We established a case – cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study . After exclusions , the final sample size included 11,684 incident cases and a subcohort of 15,374 participants . Cox proportional hazards regression models ( modified for the case – cohort design ) and r and om-effects meta-analyses were used to estimate the association between sweet beverage consumption ( obtained from vali date d dietary question naires ) and type 2 diabetes incidence . In adjusted models , one 336 g ( 12 oz ) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 ( 95 % CI 1.09 , 1.38 ) and 1.52 ( 95 % CI 1.26 , 1.83 ) , respectively . After further adjustment for energy intake and BMI , the association of sugar-sweetened soft drinks with type 2 diabetes persisted ( HR 1.18 , 95 % CI 1.06 , 1.32 ) , but the association of artificially sweetened soft drinks became statistically not significant ( HR 1.11 , 95 % CI 0.95 , 1.31 ) . Juice and nectar consumption was not associated with type 2 diabetes incidence . This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults OBJECTIVE To examine the effect of a single high oral dose of the novel noncaloric sweetener sucralose on short-term glucose homeostasis in patients with IDDM or NIDDM . RESEARCH DESIGN AND METHODS A total of 13 IDDM and 13 NIDDM patients with glycosylated hemoglobin levels < 10 % completed this double-blind cross-over study . After an overnight fast , patients were administered opaque capsules containing either 1,000 mg sucralose or cellulose placebo , followed by a st and ardized 360-kcal liquid breakfast . Plasma glucose and serum C-peptide levels were measured over the next 4 h. RESULTS Regardless of the type of diabetes , areas under the curves for changes of plasma glucose and serum C-peptide levels after sucralose administration were not significantly different from those after placebo . During test meals with sucralose , one episode of symptomatic hypoglycemia occurred in each of three IDDM patients , but these episodes were not considered the result of sucralose administration . CONCLUSIONS The present results support the conclusion that sucralose consumption does not adversely affect short-term blood glucose control in patients with diabetes BACKGROUND Little is understood about the effect of increased consumption of low-calorie sweeteners in diet beverages on dietary patterns and energy intake . OBJECTIVE We investigated whether energy intakes and dietary patterns were different in subjects who were r and omly assigned to  substitute caloric beverages with either water or diet beverages ( DBs ) . DESIGN Participants from the Choose Healthy Options Consciously Everyday r and omized clinical trial ( a 6-mo , 3-arm study ) were included in the analysis [ water groups : n = 106 ( 94 % women ) ; DB group : n = 104 ( 82 % women ) ] . For energy , macronutrient , and food and beverage intakes , we investigated the main effects of time , treatment , and the treatment-by-time interaction by using mixed models . RESULTS Overall , the macronutrient composition changed in both groups without significant differences between groups over time . Both groups reduced absolute intakes of total daily energy , carbohydrates , fat , protein , saturated fat , total sugar , added sugar , and other carbohydrates . The DB group decreased energy from all beverages more than the water group did only at month 3 ( P-group-by-time < 0.05 ) . Although the water group had a greater reduction in grain intake at month 3 and a greater increase in fruit and vegetable intake at month 6 ( P-group-by-time < 0.05 ) , the DB group had a greater reduction in dessert intake than the water group did at month 6 ( P-group-by-time < 0.05 ) . CONCLUSIONS Participants in both intervention groups showed positive changes in energy intakes and dietary patterns . The DB group showed decreases in most caloric beverages and specifically reduced more desserts than the water group did . Our study does not provide evidence to suggest that a short-term consumption of DBs , compared with water , increases preferences for sweet foods and beverages . This trial was registered at clinical trials.gov as NCT01017783 Background / Objective : The sweet-taste receptor ( T1r2+T1r3 ) is expressed by enteroendocrine L-cells throughout the gastrointestinal tract . Application of sucralose ( a non-calorific , non-metabolisable sweetener ) to L-cells in vitro stimulates glucagon-like peptide (GLP)-1 secretion , an effect that is inhibited with co-administration of a T1r2+T1r3 inhibitor . We conducted a r and omised , single-blinded , crossover study in eight healthy subjects to investigate whether oral ingestion of sucralose could stimulate L-cell-derived GLP-1 and peptide YY ( PYY ) release in vivo . Methods : Fasted subjects were studied on 4 study days in r and om order . Subjects consumed 50 ml of either water , sucralose ( 0.083 % w/v ) , a non-sweet , glucose-polymer matched for sweetness with sucralose addition ( 50 % w/v maltodextrin+0.083 % sucralose ) or a modified sham-feeding protocol ( MSF = oral stimulation ) of sucralose ( 0.083 % w/v ) . Appetite ratings and plasma GLP-1 , PYY , insulin and glucose were measured at regular time points for 120 min . At 120 min , energy intake at a buffet meal was measured . Results : Sucralose ingestion did not increase plasma GLP-1 or PYY . MSF of sucralose did not elicit a cephalic phase response for insulin or GLP-1 .  Maltodextrin ingestion significantly increased insulin and glucose compared with water ( P<0.001 ) . Appetite ratings and energy intake were similar for all groups . Conclusions : At this dose , oral ingestion of sucralose does not increase plasma GLP-1 or PYY concentrations and hence , does not reduce appetite in healthy subjects . Oral stimulation with sucralose had no effect on GLP-1 , insulin or appetite The antihypertensive effect of crude stevioside obtained from the leaves of Stevia rebaudiana ( Bertoni ) Bertoni ( Compositae ) on previously untreated mild hypertensive patients was examined . Patients with essential hypertension were su bmi tted to a placebo phase for 4 weeks . The volunteers selected in this phase were r and omly assigned to receive either capsules containing placebo during 24 weeks or crude stevioside 3.75 mg/kg/day ( 7 weeks ) , 7.5 mg/kg/day ( 11 weeks ) and 15.0 mg/kg/day ( 6 weeks ) . All capsules were prescribed twice a daily ( b.i.d . ) , i.e. before lunch and before dinner . After the placebo phase and after each dose of crude stevioside , body mass index , electrocardiogram and laboratory tests were performed . During the investigation blood pressure ( BP ) was measured biweekly and the remaining data were collected at the end of each stevioside dose step . All adverse events were prospect ively recorded but no major adverse clinical effects were observed during the trial . Systolic and diastolic BP decreased ( p < 0.05 ) during the treatment with crude stevioside , but a similar effect was observed in the placebo group . Therefore , crude stevioside up to 15.0 mg/kg/day did not show an antihypertensive effect . Moreover , the results suggest that oral crude stevioside is safe and supports the well-established tolerability during long term use as a sweetener in Brazil OBJECTIVE To examine the effects of non-alcoholic beverage and caffeine consumption on  all-cause mortality in older adults . METHODS The Leisure World Cohort Study is a prospect i ve study of residents of a California retirement community . A baseline postal health survey included details on coffee , tea , milk , soft drink , and chocolate consumption .  Participants were followed for 23 years ( 1981 - 2004 ) . Risk ratios ( RRs ) of death were calculated using Cox regression for 8644 women and 4980 men ( median age at entry , 74 years ) and adjusted for age , gender , and multiple potential confounders . RESULTS Caffeine consumption exhibited a U-shaped mortality curve . Moderate caffeine consumers had a significantly reduced risk of death ( multivariable-adjusted RR=0.94 , 95 % CI : 0.89 , 0.99 for 100 - 199 mg/day and RR=0.90 , 95 % CI : 0.85 , 0.94 for 200 - 399 mg/day compared with those consuming < 50 mg/day ) . Individuals who drank more than 1 can/week of artificially sweetened ( but not sugar-sweetened ) soft drink ( cola and other ) had an 8 % increased risk ( 95 % CI : 1.01 - 1.16 ) . Neither milk nor tea had a significant effect on mortality after multivariable adjustment . CONCLUSIONS Moderate caffeine consumption appeared beneficial in reducing risk of death . Attenuation in the observed associations between mortality and intake of tea and milk with adjustment for potential confounders suggests that such consumption identifies those with other mortality-associated lifestyle and health risks . The increased death risk with consumption of artificially sweetened , but not sugar-sweetened , soft drinks suggests an effect of the sweetener rather than other components of the soft drinks , although residual confounding remains a possibility Background The importance of exchanging sucrose for artificial sweeteners on risk factors for developing diabetes and cardiovascular diseases is not yet clear . Objective To investigate the effects of a diet high in sucrose versus a diet high in artificial sweeteners on fasting and postpr and ial metabolic profiles after 10 weeks . Design Healthy overweight subjects were r and omised to consume drinks and foods sweetened with either sucrose ( ∼2 g/kg body weight ) ( n = 12 ) or artificial sweeteners ( n = 11 ) as supplements to their usual diet . Supplements were similar on the two diets and consisted of beverages ( ∼80 weight% ) and solid foods ( yoghurts , marmalade , ice cream , stewed fruits ) . The rest of the diet was free of choice and ad libitum . Before ( week 0 ) and after the intervention ( week 10 ) fasting blood sample s were drawn and in week 10 , postpr and ial blood was sample d during an 8-hour meal test ( breakfast and lunch ) . Results After 10 weeks postpr and ial glucose , insulin , lactate , triglyceride , leptin , glucagon , and GLP-1 were all significantly higher in the sucrose compared with the sweetener group . After adjusting for differences in body weight changes and fasting values ( week 10 ) , postpr and ial glucose , lactate , insulin , GIP , and GLP-1 were significantly higher and after further adjusting for differences in energy and sucrose intake , postpr and ial lactate , insulin , GIP , and GLP-1 levels were still significantly higher on the sucrose-rich diet . Conclusion A sucrose-rich diet consumed for 10 weeks result ed in significant elevations of postpr and ial glycaemia , insulinemia , and lipidemia compared to a diet rich in artificial sweeteners in slightly overweight healthy subjects Background — Increased consumption of sugar-sweetened beverages ( SSBs ) has been associated with an elevated risk of obesity , metabolic syndrome , and type II diabetes mellitus . However , the effects of SSB consumption on blood pressure ( BP ) are uncertain . The objective of this study was to determine the relationship between changes in SSB consumption and changes in  BP among adults . Methods and Results — This was a prospect i ve analysis of 810 adults who participated in the PREMIER Study ( an 18-month behavioral intervention trial ) .  BP and dietary intake  ( by two 24-hour recalls ) were measured at baseline and at 6 and 18 months . Mixed-effects models were applied to estimate the changes in BP in responding to changes in SSB consumption . At baseline , mean SSB intake was 0.9±1.0 servings per day ( 10.5±11.9 fl oz/d ) , and mean systolic BP/diastolic BP was 134.9±9.6/84.8±4.2 mm Hg . After potential confounders were controlled for , a reduction in SSB of 1 serving per day was associated with a 1.8-mm Hg ( 95 % confidence interval , 1.2 to 2.4 ) reduction in systolic BP and 1.1-mm Hg ( 95 % confidence interval , 0.7 to 1.4 ) reduction in diastolic BP over 18 months . After additional adjustment for weight change over the same period , a reduction in SSB intake was still significantly associated with reductions in systolic and diastolic BPs  ( P<0.05 ) . Reduced intake of sugars was also significantly associated with reduced BP . No association was found for diet beverage consumption or caffeine intake and BP . These findings suggest that sugars may be the nutrients that contribute to the observed association between SSB and BP . Conclusions — Reduced consumption of SSB and sugars was significantly associated with reduced BP . Reducing SSB and sugar consumption may be an important dietary strategy to lower BP . Clinical Trial Registration — URL : http:// clinical trials.gov . Unique identifier : NCT00000616 BACKGROUND The rising prevalence of obesity in children has been linked in part to the consumption of sugar-sweetened drinks . Our aim was to examine this relation . METHODS We enrolled 548 ethnically diverse schoolchildren ( age 11.7 years , SD 0.8 ) from public schools in four Massachusetts communities , and studied them prospect ively for 19 months from October , 1995 , to May , 1997 . We examined the association between baseline and change in consumption of sugar-sweetened drinks ( the independent variables ) , and difference in measures of obesity , with linear and logistic regression analyses adjusted for potentially confounding variables and clustering of results within schools . FINDINGS For each additional serving of sugar-sweetened drink consumed , both body mass index ( BMI ) ( mean 0.24 kg/m2 ; 95 % CI 0.10 - 0.39 ; p=0.03 ) and frequency of obesity ( odds ratio 1.60 ; 95 % CI 1.14 - 2.24 ; p=0.02 ) increased after adjustment for anthropometric , demographic , dietary , and lifestyle variables . Baseline consumption of sugar-sweetened drinks was also independently associated with change in BMI ( mean 0.18 kg/m2 for each daily serving ; 95 % CI 0.09 - 0.27 ; p=0.02 ) . INTERPRETATION Consumption of sugar-sweetened drinks is associated with obesity in children Summary Objective The aim of this study was to examine differences in rates of non‐caloric beverage adoption by participants classified as sweet likers ( SLs ) or sweet dislikers ( measured using a behavioural tasting task ) . Methods Data are a sub‐ study from a 6‐month , three‐group , r and omized weight loss trial ( CHOICE ) ( body mass index 36.3 ± 5.8 kg m−2 , 84 % female , aged 42.2 ± 10.9 years , 53 % African‐American ) comparing the replacement of caloric beverages with either non‐caloric sweetened beverages ( diet ) or water ( water ) compared with a control group . This sub‐ study , which included participants within the water ( n = 106 ) and diet ( n = 103 ) groups only , examined whether SLs ( n = 33 water ; n = 37 diet ) varied in their adherence to caloric beverage recommendations compared with sweet dislikers ( n = 73 water ; n = 76 diet ) over the 6‐month study . Results Diet intake and sweet‐liking data collected on 190 ( 3 months ) and 169 participants ( 6 months ) were used for analysis . The interaction between SL status and beverage group ( diet vs. water ) approached significance ( P = 0.06 ) at 3 months but not 6 months . Caloric beverage intake ( % energy ) at 3 months was significantly higher in SLs within the water group ( 9.7 ± 1.4 % ) compared with SLs in the diet group ( 5.4 ± 1.0 % , P = 0.03 ) . Conclusions Results suggest that SL status may affect the rate in reduction of caloric beverages when water is the recommended substitution . Future studies should explore tailoring beverage recommendations to tasting profile BACKGROUND A high incidence of dental caries and dental erosion associated with frequent consumption of soft drinks has been reported . The purpose of this study was to evaluate the pH response of dental plaque to a regular , diet and high energy drink . METHODOLOGY Twenty subjects were recruited for this study . All subjects were between the ages of 20 and 25 and had at least four restored tooth surfaces present . The subjects were asked to refrain from brushing for 48 hours prior to the study . At baseline , plaque pH was measured from four separate locations using harvesting method . Subjects were asked to swish with 15 ml of the respective soft drink for 1 minute . Plaque pH was measured at the four design ated tooth sites at 5 , 10 and 20 minutes intervals . Subjects then repeated the experiment using the other two soft drinks . RESULTS pH was minimum for regular soft drink ( 2.65 ± 0.026 ) followed by high energy drink ( 3.39 ± 0.026 ) and diet soft drink ( 3.78 ± 0.006 ) . The maximum drop in plaque pH was seen with regular soft drink followed by high energy drink and diet soft drink . CONCLUSION Regular soft drink possesses a greater acid challenge potential on enamel than diet and high energy soft drinks . However , in this clinical trial , the pH associated with either soft drink did not reach the critical pH which is expected for enamel demineralization and dissolution Introduction Low-calorie sweetener use for weight control has come under increasing scrutiny as obesity , especially abdominal obesity , remain entrenched despite substantial low-calorie sweetener use . We evaluated whether chronic low-calorie sweetener use is a risk factor for abdominal obesity . Participants and Methods We used 8268 anthropometric measurements and 3096 food diary records with detailed information on low-calorie sweetener consumption in all food products , from 1454 participants ( 741 men , 713 women ) in the Baltimore Longitudinal Study of Aging collected from 1984 to 2012 with median follow-up of 10 years ( range : 0–28 years ) . At baseline , 785 were low-calorie sweetener non-users ( 51.7 % men ) and 669 participants were low-calorie sweetener users ( 50.1 % men ) . Time-varying low-calorie sweetener use was operationalized as the proportion of visits since baseline at which low-calorie sweetener use was reported . We used marginal structural models to determine the association between baseline and time-varying low-calorie sweetener use with longitudinal outcomes —body mass index , waist circumference , obesity and abdominal obesity — with outcome status assessed at the visit following low-calorie sweetener ascertainment to minimize the potential for reverse causality . All models were adjusted for year of visit , age , sex , age by sex interaction , race , current smoking status , dietary intake ( caffeine , fructose , protein , carbohydrate , and fat ) , physical activity , diabetes status , and Dietary Approaches to Stop Hypertension score as confounders . Results With median follow-up of 10 years , low-calorie sweetener users had 0.80 kg/m2 higher body mass index ( 95 % confidence interval [ CI ] , 0.17–1.44 ) , 2.6 cm larger waist circumference ( 95 % CI , 0.71–4.39 ) , 36.7 % higher prevalence ( prevalence ratio = 1.37 ; 95 % CI , 1.10–1.69 ) and 53 % higher incidence ( hazard ratio = 1.53 ; 95 % CI 1.10–2.12 ) of abdominal obesity than low-calorie sweetener non-users . Conclusions Low-calorie sweetener use is independently associated with heavier relative weight , a larger waist , and a higher prevalence and incidence of abdominal obesity suggesting that low-calorie sweetener use may not be an effective means of weight control Stevioside is present in the plant Stevia rebaudiana Bertoni ( SrB ) . Extracts of SrB have been used for the treatment of diabetes in , for example , Brazil , although a positive effect on glucose metabolism has not been unequivocally demonstrated . We studied the acute effects of stevioside in type 2 diabetic patients . We hypothesize that supplementation with stevioside to a test meal causes a reduction in postpr and ial blood glucose .  Twelve type 2 diabetic patients were included in an acute , paired cross-over study . A st and ard test meal was supplemented with either 1 g of stevioside or 1 g of maize starch ( control ) . Blood sample s were drawn at 30 minutes before and for 240 minutes after ingestion of the test meal . Compared to control , stevioside reduced the incremental area under the glucose response curve by 18 % ( P = .013 ) . The insulinogenic index ( AUC(i , insulin)/AUC(i , glucose ) ) was increased by approximately 40 % by stevioside compared to control ( P < .001 ) . Stevioside tended to decrease glucagon levels , while it did not significantly alter the area under the insulin , glucagon-like peptide 1 , and glucose-dependent insulinotropic polypeptide curves . In conclusion , stevioside reduces postpr and ial blood glucose levels in type 2 diabetic patients , indicating beneficial effects on the glucose metabolism . Stevioside may be advantageous in the treatment of type 2 diabetes Background : In a few animal experiments , aspartame has been linked to hematopoietic and brain cancers . Most animal studies have found no increase in the risk of these or other cancers . Data on humans are sparse for either cancer . Concern lingers regarding this widely used artificial sweetener . Objective : We investigated prospect ively whether aspartame consumption is associated with the risk of hematopoietic cancers or gliomas ( malignant brain cancer ) . Methods : We examined 285,079 men and 188,905 women ages 50 to 71 years in the NIH-AARP Diet and Health Study cohort . Daily aspartame intake was derived from responses to a baseline self-administered food frequency question naire that queried consumption of four aspartame-containing beverages ( soda , fruit drinks , sweetened iced tea , and aspartame added to hot coffee and tea ) during the past year . Histologically confirmed incident cancers were identified from eight state cancer registries .  Multivariable-adjusted relative risks ( RR ) and 95 % confidence intervals ( CI ) were estimated using Cox proportional hazards regression that adjusted for age , sex , ethnicity , body mass index , and history of diabetes . Results : During over 5 years of follow-up ( 1995 - 2000 ) , 1,888 hematopoietic cancers and 315 malignant gliomas were ascertained . Higher levels of aspartame intake were not associated with the risk of overall hematopoietic cancer ( RR for ≥600 mg/d , 0.98 ; 95 % CI , 0.76 - 1.27 ) , glioma ( RR for ≥400 mg/d , 0.73 ; 95 % CI , 0.46 - 1.15 ; P for inverse linear trend = 0.05 ) , or their subtypes in men and women . Conclusions : Our findings do not support the hypothesis that aspartame  increases hematopoietic or brain cancer risk . ( Cancer Epidemiol Biomarkers Prev 2006;15(9):1654–9 In two experiments , 2 - 5-year-old children 's responsiveness to caloric density cues was examined . In a preloading protocol , consumption of fixed volumes of drinks ( 205 ml in Experiment 1 ; 150 ml in Experiment 2 ) , sweetened with sucrose , aspartame , aspartame plus low glucose maltodextrin , or a water control , was followed by ad lib consumption from among a variety of foods . Caloric drinks had about 90 kcal in Experiment 1 , 65 kcal in Experiment 2 . The delay interval between the preload and the ad lib consumption was 0 , 30 or 60 minutes . In Experiment 1 , 24 4- and 5-year-old children participated in only one delay interval , while in Experiment 2 , all 20 2- and 3-year-old children were seen in all conditions . Results revealed evidence of caloric compensation , but no evidence of preload x time delay interaction . In both experiments , aspartame also produced a significant suppression of intake relative to water , primarily due to the pattern at 30 min following the preload . Across conditions , the suppression following aspartame was usually significantly less than that produced by the caloric sweet drinks , providing evidence for postingestive effects . In Experiment 1 , suppression of intake was related to the children 's preferences for the foods , not to macronutrient content ; consumption of nonpreferred foods was most suppressed . Consumption of sweetened drinks as long as 1 hour prior to eating suppressed food intake , and this common feeding practice may also reduce dietary variety During the years 1979 to 1981 a population -based case-control study of bladder cancer including papillomas was performed in Greater Copenhagen . After exclusions some 388 patients ( 290 males ; 98 females ) and an age- and sex-matched group of 787 controls ( 592 males ; 195 females ) remained for analysis . Controls were selected at r and om from the general population of the study area . All persons were interviewed concerning use of artificial sweeteners in addition to their exposure to a number of other known or suspected risk factors for bladder cancer . Fifty-five male bladder cancer patients ( 19.4 % ) and 150 controls ( 25.7 % ) had at some time used artificial sweeteners regularly . Among females 27.1 % of cases and 25.9 % of controls regularly used sweeteners . In neither sex was the relative risk significantly increased in users compared with non-users of artificial sweeteners . The relative risk of 0.78 in the two sexes combined was not significantly different from 1.0 ( 95 % C.I. : 0.58 - 1.05 ) . There was no indication of a regular increase in risk with increasing daily consumption of table-top sweeteners nor was there any indication of an increase in risk with a duration of regular use of artificial sweeteners . Taking into account a possible latency period between first regular use and bladder cancer development did not change the finding of an absence of association between use of artificial sweeteners and the risk of bladder cancer . Neither saccharine nor cyclamate users had an increased risk of bladder cancer . This population -based case-control investigation provides further evidence that it is highly unlikely that the consumption of artificial sweeteners has contributed to current bladder cancer rates in man BACKGROUND Sugar-sweetened beverages are risk factors for type 2 diabetes ; however , the role of artificially sweetened beverages is unclear . OBJECTIVE The objective was to examine the associations of sugar- and artificially sweetened beverages with  incident type 2 diabetes .  DESIGN An analysis of healthy men ( n = 40,389 ) from the Health Professionals Follow-Up Study , a prospect i ve cohort study , was performed . Cumulatively averaged intakes of sugar-sweetened ( sodas , fruit punches , lemonades , fruit drinks ) and artificially sweetened ( diet sodas , diet drinks ) beverages from food-frequency question naires were tested for associations with type 2 diabetes by using Cox regression . RESULTS There were 2680 cases over 20 y of follow-up . After age adjustment , the hazard ratio ( HR ) for the comparison of the top with the bottom quartile of sugar-sweetened beverage intake was 1.25 ( 95 % CI : 1.11 , 1.39 ; P for trend < 0.01 ) . After adjustment for confounders , including multivitamins , family history , high triglycerides at baseline , high blood pressure , diuretics , pre-enrollment weight change , dieting , total energy , and body mass index , the HR was 1.24 ( 95 % CI : 1.09 , 1.40 ; P for trend < 0.01 ) . Intake of artificially sweetened beverages was significantly associated with type 2 diabetes in the age-adjusted analysis ( HR : 1.91 ; 95 % CI : 1.72 , 2.11 ; P for trend < 0.01 ) but not in the multivariate-adjusted analysis ( HR : 1.09 ; 95 % CI : 0.98 , 1.21 ; P for trend = 0.13 ) . The replacement of one serving of sugar-sweetened beverage with 1 cup ( ≈237 mL ) of coffee was associated with a risk reduction of 17 % . CONCLUSION Sugar-sweetened beverage consumption is associated with a significantly elevated risk of type 2 diabetes , whereas the association between artificially sweetened beverages and type 2 diabetes was largely explained by health status , pre-enrollment weight change , dieting , and body mass index Twelve normal subjects and 10 subjects with non-insulin-dependent diabetes mellitus were given , in r and om order at intervals of ≥ 1 wk , three drinks of the same beverage : one unsweetened , one sweetened with 400 mg aspartame , and one sweetened with 135 mg saccharin . The amount of sweetener approximated that in 1 L of sugar-free soft drink . Plasma glucose , insulin , and glucagon were measured for 3 h after ingestion of the test beverage . Plasma glucose declined slightly throughout the test period , probably due to fasting , with no differences between the three treatments . Neither sweetener affected peak insulin levels in subjects with or without diabetes . Analysis of area under the curve showed that mean insulin levels were statistically significantly higher after aspartame than after saccharin or unsweetened beverage in normal subjects only , but the magnitude of the difference was small and unlikely to be of physiological importance in the absence of differences in glucose levels . Furthermore , the differences could largely be accounted for by a decrease in insulin values after both unsweetened beverage and saccharin , with no change from baseline after aspartame . Glucagon levels showed time-to-time variation but no overall differences . We conclude that ingestion of aspartame- or saccharin-sweetened beverages by fasting subjects , with or without diabetes , did not affect blood glucose homeostasis Background : The influence of artificial sweeteners on metabolic diseases is controversial . Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes ( T2D ) but biases and reverse causation have been suspected to have influenced the observed association . In addition , it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary . Methods : We used data from 61,440 women in the prospect i ve E3N-European Prospect i ve Investigation into Cancer and Nutrition study , conducted between 1993 and 2011 . We estimated hazards ratios ( HRs ) and 95 % CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets . Results : Compared to “ never or rare ” consumers of artificial sweeteners , those using them “ always or almost always ” had an increased risk of T2D ( HR = 1.83 [ 95 % CI 1.66 - 2.02 ] in the multivariate model [ MM ] , HR = 1.33 [ 95 % CI 1.20 - 1.47 ] when further adjusted for body mass index , BMI ) . Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users ( HR = 2.10 [ 95 % CI 1.83 - 2.40 ] in the MM and HR = 1.15 [ 95 % CI 1.00 - 1.33 ] when adjusted for BMI , respectively ) . Conclusions : Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk , independently of major T2D risk factors , but partially mediated by adiposity . A pre caution ary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes In a study of the impact of aspartame , fat , and carbohydrate on appetite , we monitored blood glucose continuously for 431 ( SE 16 ) min . Ten healthy males ( 19 - 31 years ) participated in three time-blinded visits . As blood glucose was monitored , appetite ratings were scored at r and omized times . On the first meal initiation , volunteers consumed one of three isovolumetric drinks ( aspartame , 1 MJ simple carbohydrate , and 1 MJ high-fat ; r and omized order ) . High-fat and high-carbohydrate foods were available ad libitum subsequently . Blood glucose patterns following the carbohydrate drink ( + 1.78 ( SE 0.28 ) mmol/l in 38 ( SE 3 ) min ) and high-fat drink ( + 0.83 ( SE 0.28 ) mmol/l in 49 ( SE 6 ) min ) were predictive of the next intermeal interval ( R 0.64 and R 0.97 respectively ) . Aspartame ingestion was followed by blood glucose declines ( 40 % of subjects ) , increases ( 20 % ) , or stability ( 40 % ) . These patterns were related to the volunteers ' perception of sweetness of the drink ( R 0.81 , P = 0.014 ) , and were predictive of subsequent intakes ( R -0.71 , P = 0.048 ) . For all drinks combined , declines in blood glucose and meal initiation were significantly associated ( chi 2 16.8 , P < 0.001 ) , the duration of blood glucose responses and intermeal intervals correlated significantly ( R 0.715 , P = 0.0001 ) , and sweetness perception correlated negatively with hunger suppression ( R -0.471 , P = 0.015 ) . Effects of fat , carbohydrate , and aspartame on meal initiation , meal size , and intermeal interval relate to blood glucose patterns . Varied blood glucose responses after aspartame support the controversy over its effects , and may relate to sweetness perception OBJECTIVE To investigate the effect of 3-months ' daily administration of high doses of sucralose , a non-nutritive sweetener , on glycemic control in subjects with type 2 diabetes . DESIGN A multicenter , double-blind , placebo-controlled , r and omized study , consisting of a 6-week screening phase , a 13-week test phase , and a 4-week follow-up phase . SUBJECTS/ SETTING Subjects with type 2 diabetes ( age range 31 to 70 years ) entered the test phase of this study ; 128 subjects completed the study . The subjects were recruited from 5 medical centers across the United States and were , on average , obese . INTERVENTION Subjects were r and omly assigned to receive either placebo ( cellulose ) capsules ( n=69 ) or 667 mg encapsulated sucralose ( n=67 ) daily for the 13-week test phase . All subjects blindly received placebo capsules during the last 4 weeks of the screening phase and for the entire 4-week follow-up phase . MAIN OUTCOME MEASURES Glycated hemoglobin ( HbA1c ) , fasting plasma glucose , and fasting serum C-peptide were measured approximately every 2 weeks to evaluate blood glucose homeostasis . Data were analyzed by analysis of variance using repeated measures . RESULTS There were no significant differences between the sucralose and placebo groups in HbA1c , fasting plasma glucose , or fasting serum C-peptide changes from baseline . There were no clinical ly meaningful differences between the groups in any safety measure . CONCLUSIONS This study demonstrated that , similar to cellulose , sucralose consumption for 3 months at doses of 7.5 mg/kg/day , which is approximately three times the estimated maximum intake , had no effect on glucose homeostasis in individuals with type 2 diabetes . Additionally , this study showed that sucralose was as well-tolerated by the study subjects as was the placebo In the Mediterranean region of France where bladder cancer mortality and incidence are high , a case-control study with 219 male incident cases and 794 r and omized , male population -controls was carried out in 1987–89 to investigate bladder cancer risk factors and more specifically , regional factors . A stepwise logistic regression was applied to the data . This investigation confirms the role of tobacco and of certain occupational exposures in bladder carcinogenesis . There was a significant dose-response relationship with lifelong coffee drinking and alcohol consumption ; however the risk estimates were only significantly elevated for the heaviest drinkers . The intake of saccharin was not associated with risk of bladder cancer . Infrequent consumption of carrots , spinach , and marrows conferred an increased risk , suggesting a protective effect of vitamin A. Finally , this investigation results in some new hypotheses . The study of residences and birthplaces has revealed a lower risk for those who have lived in a non-Mediterranean area and a higher risk for those born in a Mediterranean area . These features might be explained by some Mediterranean dietary habits , such as a high consumption of spices ( odds ratio = 3.64 , 95 percent confidence interval=2.21–5.98 ) Despite some reports that aspartame (APM)-sweetened beverages may increase subjective appetite , previously we demonstrated that drinking 280 ml of an APM-sweetened soft drink ( 170 mg APM ) had no effect on appetite , and 560 ml of the same soft drink ( 340 mg APM ) reduced appetite . The present study examined this appetite reduction to determine its cause . Eighteen normal weight young adult males received five treatments ( beverage preloads ) at 1100 h in a r and omized order , one per week : 280 ml of carbonated mineral water ( CMW ) ( control ) , 560 ml of CMW , 280 ml of CMW with 340 mg of encapsulated APM , 280 ml of CMW sweetened with 340 mg APM , 560 ml of an APM-sweetened soft drink ( 340 mg APM ) . Subjective hunger and food appeal were measured from 0930 a.m. to 1230 h , and food intake from a buffet lunch offered at 1205 h was measured . Treatment had no effect on food intake or macronutrient selection . Both 560 ml of CMW or soft drink suppressed appetite , although 280 ml of APM-sweetened mineral water significantly increased subjective appetite relative to the control . Encapsulated APM had no effect on appetite . Therefore , appetite reduction following consumption of an APM-sweetened drink is likely due to drink volume and not the APM content . In addition , consuming APM-sweetened CMW produces a short-term increase in subjective appetite This study compared the effects of equal volumes of sugar-rich and sugar-free beverages on feelings of hunger and fullness and the ad libitum consumption of a palatable , fat-rich snack .  Eleven healthy males consumed equal volumes ( 375 mL ) of three drinks ( sugar-rich cola , sugar-free cola , mineral water ) in r and om order on separate mornings . After 20 min , the subjects were able to snack freely on potato crisps during the next 90 min . Each subject 's individual bowl of potato crisps was covertly replenished at 15 min intervals while the subjects were completing appetite and mood ratings . After the 110 min experimental period , the subjects ' ad libitum food intake from a buffet-style lunch was covertly recorded . On leaving the laboratory , the subjects filled in a weighed food dairy for the rest of the day . The equal-volume preloads initially decreased hunger to a similar degree and potato crisp intake during the first 15 min interval was not significantly different among the three preloads . On average , total energy intakes from the crisps and lunch were not significantly different among the preloads , and by the end of the day , total energy intakes were similar for the three test conditions . Therefore , the low-calorie/low-sugar drinks did not facilitate a reduced energy intake by the lean , non-dieting male subjects A case-control study of diet and bladder cancer was conducted during 1979 - 1982 in Edmonton , Calgary , Toronto , and Kingston , Canada . A total of 826 histologically verified cancer cases were individually matched by age , sex , and area of residence to 792 r and omly selected population controls . Subjects were interviewed concerning their histories of exposure to a number of dietary factors , including table-top artificial sweeteners , low calorie foods and drinks , beverages containing caffeine or ethanol , and certain other food items . Also , subjects provided information on their past medical , occupational , and residential histories , in addition to their exposures to tobacco and other life-style factors . For the analysis , conditional logistic regression methods were used . Under adjustment for cumulative lifetime amount of cigarette smoking , the dietary factors , with little exception , were not associated with significant alteration of risk for bladder cancer . In particular , ever regular use of artificial sweeteners did not appear to be associated with increased risk , either among men ( odds ratio = 0.95 , p = 0.70 ) or among women ( odds ratio = 1.15 , p = 0.53 ) . However , daily intake of cholesterol , calculated from reported frequencies of consumption of nine relevant food items , suggested a mild increase in risk ; the odds ratio estimate of trend was 1.07/100 mg average daily intake ( i.e. , 1.07(5.5 ) = 1.45 for 550 mg cholesterol per day , as might be consumed in one egg ; p = 0.009 ) . A history of diabetes mellitus of onset after age 20 years also seemed to be associated with increased risk of bladder cancer ( odds ratio = 1.65 , p = 0.019 ) , but this increase did not appear to be the result of use of insulin or other medications , or use of artificial sweeteners or low calorie foods . Thus , this study tends to confirm reports of a lack of association between use of artificial sweeteners and subsequent risk of bladder cancer BACKGROUND Consumption of sugar-sweetened beverages may cause excessive weight gain . We aim ed to assess the effect on weight gain of an intervention that included the provision of noncaloric beverages at home for overweight and obese adolescents . METHODS We r and omly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups . The experimental group received a 1-year intervention design ed to decrease consumption of sugar-sweetened beverages , with follow-up for an additional year without intervention . We hypothesized that the experimental group would gain weight at a slower rate than the control group . RESULTS Retention rates were 97 % at 1 year and 93 % at 2 years . Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups ( 1.7 servings per day ) , declined to nearly 0 in the experimental group at 1 year , and remained lower in the experimental group than in the control group at 2 years . The primary outcome , the change in mean body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) at 2 years , did not differ significantly between the two groups ( change in experimental group minus change in control group , -0.3 ; P=0.46 ) . At 1 year , however , there were significant between-group differences for changes in BMI ( -0.57 , P=0.045 ) and weight ( -1.9 kg , P=0.04 ) . We found evidence of effect modification according to ethnic group at 1 year ( P=0.04 ) and 2 years ( P=0.01 ) . In a prespecified analysis according to ethnic group , among Hispanic participants ( 27 in the experimental group and 19 in the control group ) , there was a significant between-group difference in the change in BMI at 1 year ( -1.79 , P=0.007 ) and 2 years ( -2.35 , P=0.01 ) , but not among non-Hispanic participants ( P>0.35 at years 1 and 2 ) . The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years ( -0.5 % , P=0.40 ) . There were no adverse events related to study participation . CONCLUSIONS Among overweight and obese adolescents , the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention design ed to reduce consumption of sugar-sweetened beverages , but not at the 2-year follow-up ( the prespecified primary outcome ) . ( Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others ; Clinical Trials.gov number , NCT00381160 . ) OBJECTIVE . The role of sugar-sweetened beverages ( SSBs ) in promoting obesity is controversial . Observational data link SSB consumption with excessive weight gain ; however , r and omized , controlled trials are lacking and necessary to resolve the debate . We conducted a pilot study to examine the effect of decreasing SSB consumption on body weight . METHODS . We r and omly assigned 103 adolescents aged 13 to 18 years who regularly consumed SSBs to intervention and control groups . The intervention , 25 weeks in duration , relied largely on home deliveries of noncaloric beverages to displace SSBs and thereby decrease consumption . Change in  SSB consumption was the main process measure , and change in body mass index ( BMI ) was the primary end point . RESULTS . All of the r and omly assigned subjects completed the study . Consumption of SSBs  decreased by 82 % in the intervention group and did not change in the control group . Change in BMI , adjusted for gender and age , was 0.07 ± 0.14 kg/m2 ( mean ± SE ) for the intervention group and 0.21 ± 0.15 kg/m2 for the control group . The net difference , −0.14 ± 0.21 kg/m2 , was not significant overall . However , baseline BMI was a significant effect modifier . Among the subjects in the upper baseline- BMI tertile , BMI change differed significantly between the intervention ( −0.63 ± 0.23 kg/m2 ) and control ( + 0.12 ± 0.26 kg/m2 ) groups , a net effect of −0.75 ± 0.34 kg/m2 . The interaction between weight change and baseline BMI was not attributable to baseline consumption of SSBs . CONCLUSIONS . A simple environmental intervention almost completely eliminated SSB consumption in a diverse group of adolescents . The beneficial effect on body weight of reducing SSB consumption increased with increasing baseline body weight , offering additional support for American Academy of Pediatrics guidelines to limit SSB consumption Sixty-two subjects having either insulin-dependent or non-insulin-dependent diabetes completed a r and omized , double-blind study comparing effects of aspartame or a placebo on blood glucose control . Twenty-nine subjects consumed 2.7 g aspartame per day for 18 wk , given as aspartame-containing capsules with meals , while 33 subjects took identical appearing placebo capsules . After 18 wk , no changes were seen in fasting or 2-h postpr and ial blood glucose levels or glycohemoglobin levels in either the aspartame- or placebo-treated groups . Adverse reactions were no more common in the group taking aspartame . We conclude that use of aspartame as a low-calorie sweetener does not adversely affect glycemic control of persons with diabetes The effect of daily mouthrinses on  dental plaque accumulation and on salivary mutans streptococci was investigated in 200 children . The utilized solutions were : a placebo solution composed of mentholated deionized water ( group I ) ; 0.12 % chlorhexidine gluconate associated to 0.05 % sodium fluoride ( group II ) ; 0.2 % chlorhexidine digluconate ( group III ) , and 0.5 % stevioside mixed with 0.05 % sodium fluoride , with pH 3.4 ( group IV ) . In order to verify the effect on plaque formation , the accumulation of plaque was assessed by means of the Löe12 index , at the beginning and at the end of the experiment , whereas the quantification of cariogenic streptococci was accomplished on three saliva sample s collected at 3 different moments : before the first mouthrinse , 24 hours after the first mouthrinse and 1 week after the last mouthrinse . The mouthrinsing routine was carried out on a daily basis during 4 weeks . Five milliliters of solution were rinsed during 1 minute . The results revealed 4.10 , 26.75 , 41.20 , and 5.91 % of reduction in plaque accumulation for groups I , II , III , and IV , respectively . Comparisons between the groups as to plaque reduction revealed that groups II and III were significantly different from groups I ( control ) and IV ( p < 0.05 ) , but did not differ from each other . The solution utilized by group III was the least accepted by children and , as the solution utilized by group II , caused mild dental pigmentation . There were no statistically significant differences as to the levels of mutans streptococci , probably due to the low initial levels observed in each one of the four groups OBJECTIVES . The intent of this study was to evaluate whether small changes in diet and physical activity , as promoted by the America on the Move initiative , could prevent excessive weight gain in overweight children . METHODS . In this family-intervention study , the America on the Move small-changes approach for weight-gain prevention was evaluated in families with at least 1 child ( 7–14 years old ) who was overweight or at risk for overweight . These children were the primary target of the intervention , and parents were the secondary target . Families were r and omly assigned to either the  America on the Move group ( n = 100 ) or the  self-monitor – only group ( n = 92 ) . Families who were assigned to the America on the Move group were asked to make 2 small lifestyle changes : ( 1 ) to walk an additional 2000 steps per day above baseline as measured by pedometers and ( 2 ) to eliminate 420 kJ/day ( 100 kcal/day ) from their typical diet by replacing dietary sugar with a noncaloric sweetener .  Families who were assigned to the self-monitor  group were asked to use pedometers to record physical activity but were not asked to change their diet or physical activity level . RESULTS . During a 6-month period , both groups of children showed significant decreases in BMI for age . However , the America on the Move group compared with the self-monitor group had a significantly higher percentage of target children who maintained or reduced their BMI for age and , consistently , a significantly lower percentage who increased their BMI for age . There was no significant weight gain during the 6-month intervention in parents of either group . CONCLUSIONS . The small-changes approach advocated by America on the Move could be useful for addressing childhood obesity by preventing excess weight gain in families A study was design ed to determine the effect of the consumption of the nutritive sweetener aspartame on non-insulin-dependent diabetics . Forty-three adult diabetics between the ages of 21 and 70 completed a 90-day study ; all were diabetics whose conditions were managed by diet and /or hypoglycemic agents . Participants in the blind study were instructed to continue their usual diet and to take two capsules of an assigned preparation three times daily with meals , either the aspartame or the placebo . The 1.8 g of aspartame administered is approximately three times the expected daily consumption of aspartame if used as a sweetener to replace sugar . Throughout the study subjects were examined for ( 1 ) symptoms of intolerance , ( 2 ) fasting plasma phenylalanine levels exceeding 4 mg/100 ml , and ( 3 ) deterioration of diabetic control . At the conclusion of the study subjects exhibited no symptoms that could be traced to the administration of aspartame or the placebo , and diabetic control was unaffected by the chronic administration of these substances . Aspartame seems to be well tolerated by non-insulin-dependent diabetics Objective : To investigate the influence of ingestion of beverages with sucrose or with intense sweeteners on food intake ( FI ) and on hunger ratings in before and after a month of daily consumption of beverages . Design : Experimental study . Setting : Department of Physiology , University Hospital , Dijon , France . Subjects : In all , 12 men and 12 women , aged 20–25 y. Interventions : Four beverages contained either sucrose ( E+:100 g/l , 1672 kJ ) or intense sweeteners ( E− : null energy content ) and were flavoured with either orange ( O ) or raspberry ( R ) . FI was measured in the lab during two 2-consecutive-day periods , carried out on 2 successive weeks ( session 1 ) . The subjects drank 2 l of either E+ or E− beverages on the first day of both weekly periods , according to a balanced r and omised design . E+ was paired with O for 50 % of subjects and with R for the other 50 % . Subjects were then habituated over a 4-week period to both beverages , consuming 1 l of E+ beverage on odd days and 1 l of E– drink on even days . After this period , the measurements of session 1 were repeated ( session 2 , weeks 7–8 ) . Finally , FI was measured for two more 2-day periods ( weeks 9–10 ) after the association between flavour and energy content was reversed ( session 3 ) . Results : The E– drinks were less palatable than the E+ drinks . Besides , we observed that FI was not reduced in response to a liquid extra caloric load and there was no change in hunger ratings after the beverages in any of the sessions . Conclusion : Ingestion of caloric beverages induced a positive energy balance and the continuous exposure phase to these beverages over 1 month did not improve FI adaptation in response to the extra energy provided by the beverages . Sponsorship : This study was sponsored by SEV , Bourg la Reine , France ; the French Ministère de la Recherche et de la Technologie ( Programme AGROBIO-Aliments Demain ) and the Regional Council of Burgundy ( Dijon , France ) PURPOSE Despite the presence or absence of artificial sweeteners in cola drinks , both regular and diet soft drinks still contain phosphoric and citric acid , which contributes to the total acidic challenge potential on enamel . The purpose of this study was to assess the plaque pH , in vivo , after a substrate challenge of diet and regular soft drinks . METHODS Seventeen subjects were recruited for this study . All subjects were between the ages of 12 and 15 and had at least 4 restored tooth surfaces present . The subjects were given consent by their parents and were asked to refrain from brushing for 48 hours prior to the study . At baseline , plaque pH was measured from 4 separate locations using touch electrode methodology . Each subject was then r and omly assigned to one of two groups . The first group was exposed to regular Coke followed by Diet Coke , while the second group was exposed to Diet Coke followed by regular Coke . Subjects were asked to swish with 15 ml of the respective soft drink for one minute . Plaque pH was measured at the 4 design ated tooth sites at 5- , 10- and 20-minute intervals . Subjects then repeated the experiment using the other soft drink . RESULTS The results showed that regular Coke had significantly more acidic plaque pH values at the 5- , 10- and 20-minute intervals compared to Diet Coke , ( P = < .001 ) , when subjected to a t test . The mean pH at 5 minutes for Coke and Diet Coke was 5.5 + /- 0.5 and 6.0 + /- 0.7 , respectively . At 10 minutes , the pH for Coke and Diet Coke was 5.6 + /- 0.6 and 6.2 + /- 0.7 , respectively . The pH at 20 minutes for Coke and Diet Coke was 5.7 + /- 0.7 and 6.5 + /- 0.5 , respectively . CONCLUSIONS These data suggest that regular Coke possesses a greater acid challenge potential on enamel than Diet Coke . However , in this clinical trial , the pH associated with either soft drink did not reach the critical pH which is expected for enamel demineralization and dissolution The purpose of this investigation was twofold : ( 1 ) to examine the role of low- to moderate-intensity , short- duration physical activity on subjective appetite and ( 2 ) to identify the role of and associations between ventilation threshold ( VeT ) and energy intake at a pizza lunch 30 min after glucose and whey protein drinks in normal weight boys . In 14 boys ( age : 12.5+/-0.4 years )  subjective appetite was measured before and after a 12 min walking protocol design ed to determine physical fitness based on the VeT. On a separate occasion food intake ( FI ) and subjective appetite were measured in response to sweetened preloads of either a SPLENDA Sucralose control , glucose or whey protein made up to 250 ml with water , given in r and om order to each boy , 2h after a st and ardized breakfast . Subjective average appetite and prospect i ve food consumption scores increased after physical activity . VeT was positively associated with FI at a pizza lunch consumed 30 min after glucose and whey protein drinks . Glucose and whey protein reduced FI similarly at lunch compared with control . In conclusion , appetite is increased by low- to moderate-intensity , short- duration physical activity and FI following glucose and protein preloads is positively associated with fitness levels in boys Abstract Purpose The aim of the study was to assess associations between intake of combined soft drinks ( sugar sweetened and artificially sweetened ) and fruit and vegetable juices and the risk of hepatocellular carcinoma ( HCC ) , intrahepatic bile duct ( IHBC ) and biliary tract cancers ( GBTC ) using data from the European Prospect i ve Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries . Methods After 11.4 years of follow-up , 191 HCC , 66 IHBC and 236 GBTC cases were identified .  Hazard ratios and 95 % confidence intervals ( HR ; 95 % CI ) were estimated with Cox regression models with multivariable adjustment ( baseline total energy intake , alcohol consumption and intake pattern , body mass index , physical activity , level of educational attainment and self-reported diabetes status ) . Results No risk associations were observed for IHBC or GBTC . Combined soft drinks consumption of > 6 servings/week was positively associated with HCC risk : HR 1.83 ; 95 % CI 1.11–3.02 , ptrend = 0.01 versus non-consumers . In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment ( HR 1.06 , 95 % CI 1.03–1.09 , ncases = 101 ) ; for sugar-sweetened soft drinks , this association was null ( HR 1.00 , 95 % CI 0.95–1.06 ; ncases = 127 , pheterogeneity = 0.07 ) . Juice consumption was not associated with HCC risk , except at very low intakes ( < 1 serving/week : HR 0.60 ; 95 % CI 0.38–0.95 ; ptrend = 0.02 vs. non-consumers ) . Conclusions Daily intake of combined soft drinks is positively associated with HCC , but a differential association between sugar and artificially sweetened can not be discounted . This study provides some insight into possible associations of HCC with sugary drinks intake . Further exploration in other setting s is required BACKGROUND Obesity in adolescence has been increasing in the past several decades . Beverage habits among adolescents include increased consumption of sugar-sweetened beverages and decreased consumption of milk . OBJECTIVE This study aim ed to examine the association between beverage consumption and 5-y body weight change  in 2294 adolescents . DESIGN Project EAT ( Eating Among Teens ) is a 5-y longitudinal study of eating patterns among adolescents . Surveys were completed in 1998 - 1999 ( time 1 ) and in 2003 - 2004 ( time 2 ) . Multivariable linear regression was used to examine the association between beverage consumption at time 2 and change in body mass index from time 1 to time 2 , with adjustments for age , socioeconomic status , race , cohort , physical activity , sedentary behavior , coffee , tea , time 1 body mass index , and beverage variables . RESULTS In prospect i ve analyses , consumption of beverages was not associated with weight gain , except for consumption of low-calorie soft drinks ( positive association , P = 0.002 ) and white milk ( inverse association , P = 0.03 ) , but these associations did not appear to be a monotonic linear dose-response relation . The positive association with low-calorie soft drinks was no longer present after adjustment for dieting and parental weight-related concerns , which suggests that the use of low-calorie soft drinks is a marker for more general dietary behaviors and weight concerns . CONCLUSIONS We showed no association between sugar-sweetened beverage consumption , juice consumption , and adolescent weight gain over a 5-y period . A direct association between diet beverages and weight gain appeared to be explained by dieting practice s. Adolescents who consumed little or no white milk gained significantly more weight than their peers who consumed white milk . Future research that examines beverage habits and weight among adolescents should address portion sizes , adolescent maturation , and dieting behaviors Exercise is known to cause physiological changes that could affect the impact of nutrients on appetite control . This study was design ed to assess the effect of drinks containing either sucrose or high-intensity sweeteners on food intake following exercise . Using a repeated- measures design , three drink conditions were employed : plain water ( W ) , a low-energy drink sweetened with artificial sweeteners aspartame and acesulfame-K ( L ) , and a high-energy , sucrose-sweetened drink ( H ) . Following a period of challenging exercise ( 70 % VO2 max for 50 min ) , subjects consumed freely from a particular drink before being offered a test meal at which energy and nutrient intakes were measured . The degree of pleasantness ( palatability ) of the drinks was also measured before and after exercise . At the test meal , energy intake following the artificially sweetened ( L ) drink was significantly greater than after water and the sucrose ( H ) drinks ( p < 0.05 ) . Compared with the artificially sweetened ( L ) drink , the high-energy ( H ) drink suppressed intake by approximately the energy contained in the drink itself . However , there was no difference between the water ( W ) and the sucrose ( H ) drink on test meal energy intake . When the net effects were compared ( i.e. , drink + test meal energy intake ) , total energy intake was significantly lower after the water ( W ) drink compared with the two sweet ( L and H ) drinks . The exercise period brought about changes in the perceived pleasantness of the water , but had no effect on either of the sweet drinks . The remarkably precise energy compensation demonstrated after the higher energy sucrose drink suggests that exercise may prime the system to respond sensitively to nutritional manipulations . The results may also have implication s for the effect on short-term appetite control of different types of drinks used to quench thirst during and after exercise INTRODUCTION Recently has been documented that the consumption of sweetened non-caloric beverages has increased as an option to weight control , however r and omized control trials have demonstrated a modest weight loss . OBJECTIVE To evaluate the effect of reducing consumption of beverage with caloric and non-caloric sweeteners on weight , body composition and blood pressure  in young Mexican adults . METHODS In an experimental study 148 nursing students were r and omly assigned to one of 3 groups : 1 ) no sweetened beverages were permitted , only plain water , tea or coffee without sugar ; 2 ) consumption of beverages with non-caloric sweeteners was allowed ; and 3 ) no restriction of sweetened beverages was imposed . All groups were given individualized isocaloric diets monitored by a 24-hour record of consumption and food frequency question naire and blood pressure , weight , waist circumference and body composition by tetrapolar bioelectric impedance were taken at the beginning of the study and three and six months later . RESULTS Differences between groups were found in body mass index at 3 months that decrease in group 1 and 2 and increase in group 3 ( -1.75 vs.-0.61 vs.0.54 % of change , p < 0.001 ) . At six months there were also statistical differences in waist circumference ( -4.07 vs.-1.23 vs. 0.62 % of change , p < 0.001 ) and sugar consumption ( -62.0 vs.-54.61 vs.11.08 % of change , p < 0.001 ) in groups 1 , 2 and 3 respectively . CONCLUSIONS The reduction in consumption of both caloric and non-caloric sweetened beverages contributes to signifi ca nt body mass index loss and waist circumference Steviol glycosides , isolated from the plant Stevia rebaudiana ( Bertoni ) Bertoni , have been used as safe sweetening agents for more than 30 years . Beneficial effects of high doses of steviol glycosides on hyperglycemia and hypertension have been previously described when these abnormalities are present . This study was design ed to evaluate the effects of steviol glycosides on blood glucose and on blood pressure ( BP ) in 3 groups of individuals . This was a r and omized , double-blind , placebo-controlled , long-term study in three groups of patients : Group 1 : subjects with Type 1 diabetes ; Group 2 : subjects with Type 2 diabetes ; and Group 3 : subjects without diabetes and with normal/low-normal BP levels . The subjects in each group were r and omly allocated to active treatment ( the steviol glycoside stevioside : 250 mg t.d.s . ) or to placebo treatment and followed-up for 3 months . Post-treatment systolic BP , diastolic BP , glucose and glycated hemoglobin ( HbA1c ) were not significantly different from baseline measurements , except for the placebo Type 1 diabetics group where a significant difference was observed for systolic BP and glucose . No side effects were observed in the two treatment groups . This study shows that oral steviol glycosides , taken as sweetener are well tolerated and have no pharmacological effect Rebaudioside A and stevioside are steviol glycosides extracted from the plant Stevia rebaudiana Bertoni and are used in several countries as food and beverage sweeteners . This r and omized , double-blind trial evaluated the hemodynamic effects of 4weeks consumption of 1000mg/day rebaudioside A vs. placebo in 100 individuals with normal and low-normal systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) . Subjects were predominantly female ( 76 % , rebaudioside A and 82 % , placebo ) with a mean age of approximately 41 ( range 18 - 73 ) years . At baseline , mean resting , seated SBP/DBP was 110.0/70.3mmHg and 110.7/71.2mmHg for the rebaudioside A and placebo groups , respectively . Compared with placebo , rebaudioside A did not significantly alter resting , seated SBP , DBP , mean arterial pressure ( MAP ) , heart rate ( HR ) or 24-h ambulatory blood pressures responses . These results indicate that consumption of as much as 1000mg/day of rebaudioside A produced no clinical ly important changes in blood pressure in healthy adults with normal and low-normal blood pressure Among the subjects enrolled in the American Cancer Society Cancer Prevention Study II , a large nation-wide prospect i ve study , 282 died from multiple myeloma ( MM ) during the first 4 years of follow-up . These were divided into incident cases who were initially free from disease and prevalent cases who reported MM or related symptoms at the time of enrollment . For each case , 4 controls matched for age , sex , ethnic group and residence were r and omly selected . Previous history of diabetes [ odds ratio ( OR ) = 2.0 ] and employment as farmer ( OR = 2.7 ) were the risk factors consistently suggested by the results of the analysis . The risk associated with farming showed a linear trend with duration of exposure . Pesticide or herbicide exposure was not a risk factor per se but , when combined with farming , it increased the OR to 4.3 . Low education , occupational exposure to dyes , and employment in a bank , on the railroad or as a maid were also suggested risk factors , but either they were not statistically significant or they were based on small numbers of exposed subjects . No association between MM and asbestos exposure was observed OBJECTIVE To compare the efficacy of non-nutritive sweetened beverages ( NNS ) or water for weight loss during a 12-week behavioral weight loss treatment program . METHODS An equivalence trial design with water or NNS beverages as the main factor in a prospect i ve r and omized trial among 303 men and women was employed . All participants participated in a behavioral weight loss treatment program . The results of the weight loss phase ( 12 weeks ) of an ongoing trial ( 1 year ) that is also evaluating the effects of these two treatments on weight loss maintenance were reported . RESULTS The two treatments were not equivalent with the NNS beverage treatment group losing significantly more weight compared to the water group ( 5.95 kg versus 4.09 kg ; P < 0.0001 ) after 12 weeks . Participants in the NNS beverage group reported significantly greater reductions in subjective feelings of hunger than those in the water group during 12 weeks . CONCLUSION These results show that water is not superior to NNS beverages for weight loss during a comprehensive behavioral weight loss program Consumers often turn to non-caloric sweeteners ( NCS ) as a means of promoting a healthy body weight . However , several studies have now linked their long-term use to increased weight gain , raising the question of whether these products produce unintended psychological , physiological , or behavioral changes that have implication s for weight management goals . In the following , we present the results of three experiments bearing on this issue , testing whether NCS-consumption influences how  individuals think about and respond to food .  Participants in each of our three experiments were r and omly assigned to consume a sugar-sweetened beverage , an unsweetened beverage , or a beverage sweetened with NCS . We then measured their cognition ( Experiment 1 ) , product choice ( Experiment 2 ) , and subjective responses to a sugar-sweetened food ( Experiment 3 ) . Results revealed that consuming NCS-sweetened beverages influences psychological processes in ways that - over time - may increase calorie intake To determine the effect of chewing sugar-free gum on caries incidence , the authors conducted a r and omized clinical study . A total of 1,402 children in Puerto Rico , in grade s 5 through 7 at baseline , completed the study . They were r and omized by classroom into a control group or chewing gum group ; those in the gum group were instructed to chew sugar-free gum for 20 minutes after each of three meals a day . Clinical and radiographic evaluations were performed at baseline and after two and three years . The results show that all subjects and high-risk subjects , respectively , in the gum group developed 7.9 percent and 11.0 percent fewer decayed , missing or filled surfaces than subjects in the control group . Based on these findings , the authors concluded that chewing sorbitol-based sugar-free gum after eating significantly reduces the incidence of dental caries Objective The present study evaluated weight loss and compliance outcomes for overweight adolescents assigned to one of two dietary interventions differing in the type of snacks allowed . Methods The study was a 12-week , controlled clinical trial , among otherwise healthy but overweight ( body mass index ≥95th percentile ) 11-year-old to 15-year-old girls who were r and omly assigned to either a 1,500 kcal/day free-snack program or a 1,500 kcal/day restricted-snack program . All subjects were counseled to consume three servings of dairy products per day , and were provided with a 500 mg calcium supplement as well . Subjects in the free-snack group could choose any 150-calorie item as one of their two daily snacks , including regular soda if desired ; however , subjects in the restricted-snack group were limited to diet soda . Results Thirty-two adolescent girls completed the 12-week intervention . Both diets were equally effective in achieving a modest amount of weight loss , and were equally acceptable to the subjects . Significant decreases in weight , body mass index , anthropometric measures , total cholesterol and triglycerides were observed . Conclusions A 1,500 kcal/day diet allowing for a free snack of 150 calories was equally as effective as a more restricted snack policy in achieving a modest amount of weight loss among overweight 11-year-old to 15-year-old girls . In addition , results suggest that some soda may be included in a teen weight control diet , as long as caloric intake is maintained at recommended levels , and care is taken to achieve adequate intake of essential nutrients . Calcium intake among subjects was low at baseline , and , although it increased during the study ( due to supplementation ) , further efforts to increase consumption of naturally calcium-rich and calcium-fortified foods and beverages are needed BACKGROUND A population of over 12,000 mature subjects participated in a longitudinal study ( 8 years ) of nutrition and health ( the Su . Vi . Max Study ) . In this context , a specific cross-sectional study was carried out in a r and omly selected sub population . AIM To identify anthropometric , nutritional and biochemical correlates of spontaneous use of ' light ' foods and drinks in a free-living population . DESIGN Men ( n = 2299 ) and women ( n = 1979 ) , 45 - 60 years , reported their food intakes over six non-consecutive days . Consumers of low-fat and low-sugar foods and drinks , and artificial sweeteners , were compared with non-consumers . RESULTS Users of low-sugar products were heavier than non-users ; female consumers of low-fat products , but not males , had higher body weight and BMI than non-consumers . Users of low-sugar products had higher triacylglycerols and glycaemia than non-users while biochemical parameters were not different in users and non-users of low-fat products . Use of low-sugar products led to increased diet density of a few micronutrients , including cholesterol . Low-fat product selection was associated with increased intake of most micronutrients , both in absolute value and in density . CONCLUSIONS In mature adults , selection of fat-reduced products was associated with improved quality of the diet , while anthropometric and biological parameters appeared less favourable in consumers of low-sugar products vs. non-consumers . The longitudinal follow-up of the cohort in future years will help determine cause- and -effect relationships among these parameters AIMS Stevioside is a natural plant glycoside isolated from the plant Stevia rebaudiana which has been commercialized as a sweetener in Japan for more than 20 years . Previous animal studies have shown that stevioside has an antihypertensive effect . This study was to design ed to evaluate the effect of stevioside in human hypertension . METHODS A multicentre , r and omized , double-blind , placebo-controlled study was undertaken . This study group consisted of 106 Chinese hypertensive subjects with diastolic blood pressure between 95 and 110 mmHg and ages ranging from 28 to 75 years with 60 subjects ( men 34 , women 26 ; mean + /- s.d . , 54.1+/-3.8 years ) allocated to active treatment and 46 ( men 19 , women 27 ; mean + /- s.d . , 53.7+/-4.1 years ) to placebo treatment . Each subject was given capsules containing stevioside ( 250 mg ) or placebo thrice daily and followed-up at monthly intervals for 1 year . RESULTS After 3 months , the systolic and diastolic blood pressure of the stevioside group decreased significantly ( systolic : 166.0+/-9.4 - 152.6+/-6.8 mmHg ; diastolic : 104.7 + /- 5.2 - 90.3+/-3.6 mmHg , P<0.05 ) , and the effect persisted during the whole year . Blood biochemistry parameters including lipid and glucose showed no significant changes . No significant adverse effect was observed and quality of life assessment showed no deterioration . CONCLUSIONS This study shows that oral stevioside is a well tolerated and effective modality that may be considered as an alternative or supplementary therapy for patients with hypertension Brain cancer incidence rates in the United States have been increasing in both adults ( 1 ) and children ( 2 ) . The possibility that aspartame , a widely ingested artificial sweetener , may be a cause of brain cancer in humans was suggested in a recent report by Olney et al. ( 3 ) . From a descriptive analysis of national cancer data , they noted increased brain cancer incidence rates in the United States that coincided with the introduction of aspartame into food stuffs in the early 1980s . As part of a population -based case– control study of environmental and nutritional risk factors for pediatric brain tumor occurrence , we collected data on aspartame consumption before the date of diagnosis for case patients ( or a comparable reference date for control subjects ) from the biologic mothers of study children by in-person interview . The methodology for the study has been published previously ( 4 ) . Briefly , case patients were 19 years of age or older and were diagnosed with a primary brain tumor between 1984 and 1991 in 19 West Coast counties of the United States . Control subjects were recruited using r and om-digit dialing and were frequency-matched by age at diagnosis , year of birth , sex , and study site . We present data on aspartame consumption among the subset of participants from the Los Angeles and San Francisco sites where questions on aspartame consumption were added to the original question naire midway through the interviews . Our analysis of the child ’s exposure was conducted on 56 case patients and 94 control subjects who were born in 1981 or later ( to correspond with the U.S. Food and Drug Administration [ FDA ] approval of aspartame ) . We also evaluated brain tumor risk in relation to mother ’s consumption of aspartame during pregnancy and breast-feeding for 49 case patients and 90 control subjects who were in utero in 1981 or later . We calculated odds ratios ( ORs ) and 95 % confidence intervals and adjusted for the frequency-matched variables with the use of unconditional logistic regression . Additional adjustment for known or suspected risk factors ( maternal vitamin use , cured meat consumption , passive smoke exposure , x-ray exposure , head injury , and family history of brain cancer ) did not change our results . Case children were no more likely than control children to consume foods containing aspartame , either from all sources of aspartame combined ( OR 4 1.1 ) or from diet drinks ( OR 4 0.9 ) ( Table 1 ) . There was no suggestion of a dose – response relation based on age at first consumption , number of years of consumption , or frequency of consumption . We observed no elevated brain tumor risk to the child from maternal consumption of aspartame  during pregnancy nor did we find elevated risks during any trimester of pregnancy or during breast-feeding ( Table 2 ) . Additionally , we found no evidence for an aspartame – brain tumor association when the analysis was stratified by histologic subgroups ( astroglial , primitive neuroectodermal , or all others ) . These findings are not consistent with an aspartame – brain cancer relation , although our study sample was small and the confidence intervals of our risk estimates are relatively wide . Recall bias is unlikely to have affected these results , or we would expect to see elevations in risk ; however , it is conceivable that exposure misclassification that was r and omly distributed between case patients and control subjects could have masked a true effect , if the true effect was weak . We are aware of no other epidemiologic studies that have evaluated brain cancer risk from aspartame consumption . There have been numerous studies ( 5 - 8 ) related to the potential neurotoxic effects of aspartame . However , few experimental or biochemical reports related to the carcinogenicity of aspartame are in the scientific literature . Before approval of aspartame for human consumption , the FDA and an FDA appointed public board of inquiry review ed several studies to determine if aspartame can induce brain neoplasms in mice or rats . The mice studies were negative , but interpretation of two of the three rat studies differed initially between the FDA and its board of inquiry . These differences were resolved , and the FDA commissioner concluded that aspartame did not contribute to brain tumor formation in rats ( 7 - 10 ) . A subsequent rat study also found no association between aspartame and brain tumor occurrence ( 11 ) . Because some dietary constituents can be nitrosated in the stomach to form potentially carcinogenic N-nitroso compounds ( 12 ) , Shephard et al. ( 13 ) evaluated the mutagenic activity of aspartame after nitrosation . They observed only a weak mutagenic effect of nitrosated aspartame at concentrations considerably higher than normal human intake levels . On the basis of the kinetics of nitrosation of mutagenic intermediates , Shephard et al. concluded that the terminal amino group of aspartame , not the amide function , was primarily nitrosated . It would be nitrosation of the amide function , not the terminal amino group , that could produce a potential brain carcinogen , based on the ability of the related nitrosoureas to induce brain tumors in laboratory animals ( 14 ) . Thus , our review revealed little biologic or experimental evidence that aspartame is likely to act as a human brain carcinogen OBJECTIVE The increase in consumption of sugar-added beverages over recent decades may be partly responsible for the obesity epidemic among U.S. adolescents . Our aim was to evaluate the relationship between BMI changes and intakes of sugar-added beverages , milk , fruit juices , and diet soda . RESEARCH METHODS AND PROCEDURES Our prospect i ve cohort study included > 10,000 boys and girls participating in the U.S. Growing Up Today Study . The participants were 9 to 14 years old in 1996 and completed question naires in 1996 , 1997 , and 1998 . We analyzed change in BMI ( kilograms per meter squared ) over two 1-year periods among children who completed annual food frequency question naires assessing typical past year intakes . We studied beverage intakes during the year corresponding to each BMI change , and in separate models , we studied 1-year changes in beverage intakes , adjusting for prior year intakes . Models included all beverages simultaneously ; further models adjusted for total energy intake . RESULTS Consumption of sugar-added beverages was associated with small BMI gains during the corresponding year ( boys : + 0.03 kg/m2 per daily serving , p = 0.04 ; girls : + 0.02 kg/m2 , p = 0.096 ) . In models not assuming a linear dose-response trend , girls who drank 1 serving/d of sugar-added beverages  gained more weight ( + 0.068 , p = 0.02 ) than girls drinking none , as did girls drinking 2 servings/d ( + 0.09 , p = 0.06 ) or 3 + servings/d ( + 0.08 , p = 0.06 ) . Analyses of year-to-year change in beverage intakes provided generally similar findings ; boys who increased consumption of sugar-added beverages from the prior year experienced weight gain ( + 0.04 kg/m2 per additional daily serving , p = 0.01 ) . Children who increased intakes by 2 or more servings/d from the prior year gained weight ( boys : + 0.14 , p = 0.01 ; girls + 0.10 , p = 0.046 ) . Further adjusting our models for total energy intake substantially reduced the estimated effects , which were no longer significant . DISCUSSION Consumption of sugar-added beverages may contribute to weight gain among adolescents , probably due to their contribution to total energy intake , because adjustment for calories greatly attenuated the estimated associations Given the potential use of a low-calorie sweetener during weight reduction , a toxicity study of chronic aspartame ingestion was conducted . Particular attention was given to possible long-term effects of aspartame on the fuel hormonal alterations characteristically caused by weight reduction . As a group mean age was 19.3 yr , body weight was 164.6 lb , and mean height was 65.4 in . Subjects were an average of 33 % in excess of ideal body weight . The aspartame dose was 2.7 g/day and was compared on a double-blind r and omized basis with a lactose placebo . Both material s were given in gelatin capsules . An average of 6.9 + /- 1.5 lb was lost by the aspartame group during the 13-wk study on a calculated 1,000-calorie diet . The placebo group lost 4.5 + /- 1.2 lb ( no significant difference between the two groups ) . After an overnight fast , reductions in glucose and immunoreactive insulin were seen in both groups , while rising trends in immunoreactive glucagon were observed . These changes are all characteristic of calorie restriction . In no instance was there a detectable effect of the ingested aspartame . No meaningful effect of weight reduction or aspartame was seen on plasma triglyceride and cholesterol , nor on any other parameter of hematologic , hepatic , or renal function that was measured . Similarly , side effects were equally distributed between asparatame and placebo OBJECTIVE . The obesity epidemic in the United States continues to increase . Because obesity tends to track over time , the increase in overweight among young children is of significant concern . A number of eating patterns have been associated with overweight among preschool-aged children . Recently , 100 % fruit juice and sweetened fruit drinks have received considerable attention as potential sources of high-energy beverages that could be related to the prevalence of obesity among young children . Our aim was to evaluate the beverage intake among preschool children who participated in the National Health and Nutrition Examination Survey 1999–2002 and investigate associations between types and amounts of beverages consumed and weight status in preschool-aged children . METHODS . We performed a secondary analysis of the data from the National Health and Nutrition Examination Survey 1999–2002 , which is a continuous , cross-sectional survey of a nationally representative sample of the noninstitutionalized population of the United State . It included the collection of parent reported demographic descriptors , a  24-hour dietary recall  , a  measure of physical activity  , and a st and ardized physical examination .  The 24-hour dietary recall was obtained in person by a trained interviewer and reflected the foods and beverages that were consumed by the participant the previous day . The National Health and Nutrition Examination Survey food groups were classified on the basis of the US Department of Agriculture 's Food and Nutrient Data base for Dietary Studies . We review ed the main food descriptors used and classified all beverages listed . One hundred percent fruit juice was classified as only beverages that contained 100 % fruit juice , without sweetener . Fruit drinks included any sweetened fruit juice , fruit-flavored drink ( natural or artificial ) , or drink that contained fruit juice in part . Milk included any type of cow milk and then was subcategorized by percentage of milk fat . Any sweetened soft drink , caffeinated or uncaffeinated , was categorized as soda . Diet drinks included any fruit drink , tea , or soda that was sweetened by low-calorie sweetener . Several beverages were removed from the analysis because of low frequency of consumption among the sample . Water was not included in the analysis because it is not part of the US Department of Agriculture 's Food and Nutrient Data base categories . For the purpose s of this analysis , the beverages were converted and reported as ounces , rather than grams , as reported by the National Health and Nutrition Examination Survey , to make it more clinical ly relevant . The child 's BMI percentile for age and gender were calculated on the basis of Centers for Disease Control and Prevention criteria and used to identify children 's weight status as underweight ( < 5 % ) , normal weight ( 5 % to < 85 % ) , at risk for overweight ( 85 % to < 95 % ) , or overweight ( ≥95 % ) . Because of the small number of children in the underweight category , they were included in the normal-weight category for this analysis . Data were analyzed using SUDAAN 9.0.1 statistical software programs . SUDAAN allows for improved accuracy and validity of results by calculating test statistics for the stratified , multistage probability design of the National Health and Nutrition Examination Survey . Sample weights were applied to all analyses to account for unequal probability of selection from oversampling low-income children and black and Mexican American children . Descriptive and χ2 analyses and analysis of covariance , adjusting for age , gender , ethnicity , household income , energy intake , and physical activity , were conducted . RESULTS . All children who were aged 2 to 5 years were identified ( N = 1572 ) . Those with missing data were removed from additional analysis , result ing in a final sample of 1160 preschool children . Of the 1160 children analyzed , 579 ( 49.9 % ) were male . White children represented 35 % , black children represented 28.3 % , and Hispanic children represented 36.7 % of the sample . Twenty-four percent of the children were overweight or at risk for overweight ( BMI ≥85 % ) , and 10.7 % were overweight ( BMI ≥95 % ) . There were no statistically significant differences in BMI between boys and girls or among the ethnicities . Overweight children tended to be older ( mean age : 3.83 years ) compared with the normal-weight children ( mean age : 3.48 years ) . Eighty-three percent of children drank milk , 48 % drank 100 % fruit juice , 44 % drank fruit drink , and 39 % drank soda .  Whole milk was consumed by 46.5 % of the children , and 3.1 % and 5.5 % of the children consumed skim milk and 1 % milk , respectively . Preschool children consumed a mean total beverage volume of 26.93 oz/day , which included 12.32 oz of milk , 4.70 oz of 100 % fruit juice , 4.98 oz of fruit drinks , and 3.25 oz of soda . Weight status of the child had no association with the amount of total beverages , milk , 100 % fruit juice , fruit drink , or soda consumed . There was no clinical ly significant association between the types of milk ( percentage of fat ) consumed and weight status . In analysis of covariance , daily total energy intake increased with increased consumption of milk , 100 % fruit juice , fruit drinks , and soda . However , there was not a statistically significant increase in BMI on the basis of quantity of milk , 100 % fruit juice , fruit drink , or soda consumed . CONCLUSIONS . On average , preschool children drank less milk than the 2005 Dietary Guidelines for Americans recommendation of 16 oz/day . Only 8.6 % drank low-fat or skim milk , as recommended for children who are older than 2 years . On average , preschool children drank < 6 oz/day 100 % fruit juice . Increased beverage consumption was associated with an increase in the total energy intake of the children but not with their BMI . Prospect ively study ing preschool children beyond 2 to 5 years of age , through their adiposity rebound ( ∼5.5–6 years ) to determine whether there is a trajectory increase in their BMI , may help to clarify the role of beverage consumption in total energy intake and weight status The influence of dietary factors , in particular the intake of fat and beta‐carotene , on  breast‐cancer  risk was evaluated in a case‐control study including 1,486 breast cancer cases diagnosed over a 1 year period in Denmark . The control group was an age‐stratified r and om sample of 1,336 women from the general population . Data on usual diet prior to the breast cancer diagnosis were collected by self‐administered question naires of the semi‐quantitative food frequency type . A highly significant trend ( p < 0.001 ) of increasing risk was observed with increasing fat intake , the RR for the highest quartile being 1.45 ( 95 % Cl 1.17‐1.80 ) compared with the lowest . However , information was not available to allow adjustment for the possible confounding effect of energy intake . The risk of breast cancer was not associated with consumption of vegetables rich in beta‐carotene , multi‐vitamin tablets or other dietary supplements , coffee , tea , sugar or artificial sweeteners This study was design ed to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame . Although the protocol required the recruitment of 40 patients with unipolar depression and a similar number of individuals without a psychiatric history , the project was halted by the Institutional Review Board after a total of 13 individuals had completed the study because of the severity of reactions within the group of patients with a history of depression . In a crossover design , subjects received aspartame 30 mg/kg/day or placebo for 7 days . Despite the small n , there was a significant difference between aspartame and placebo in number and severity of symptoms for patients with a history of depression , whereas for individuals without such a history there was not . We conclude that individuals with mood disorders are particularly sensitive to this artificial sweetener and its use in this population should be discouraged The objective of this study was to determine whether  sugarless chewing gums sweetened with different sweeteners differ in their ability to reduce an acidogenic response from a 10 percent sucrose-rinse challenge . Five commercially available chewing gums and two control regimens ( " no gum " or paraffin ) were tested using a plaque pH telemetry system . The gums were sweetened with sucrose , high-intensity sweeteners ( aspartame , saccharin , or acesulfame-K ) , or a polyol ( xylitol ) . Using a seven-period r and omized block design , eight adult panelists were challenged with a 10 percent sucrose solution and then r and omly used one of the test regimens during each of the seven test sessions . Each two-hour test session was divided into five periods : resting baseline ( five minutes ) ; sucrose rinse challenge ( two minutes ) ; postsucrose challenge ( ten minutes ) ; gum chewing ( ten minutes ) ; post gum chewing ( ninety-three minutes ) . The factors analyzed were : the area of the curve ( pH X Time ) below pH 5.5 , the minimum plaque pH attained , the changes in plaque pH over relevant intervals , and the length of time the plaque pH remained below pH 5.5 . The various response variables showed a similar pattern of statistically significant differences . All of the sugarless gums were effective in significantly increasing plaque pH and in reducing the area under the curve after the sucrose challenge compared with " no gum " treatment . No statistically significant differences were noted among the sugarless gums . The response to sucrose gum was intermediate between sugarless gums and " no gum " but was not statistically different from " no gum " or three of the sugarless gums . ( ABSTRACT TRUNCATED AT 250 WORDS The dietary intake of cyclamate was evaluated in the north-east of Spain in 1992 . In a r and om sample of the Catalan population consisting of 2450 people aged 6 - 75 years , two 24-h recalls at different seasons were collected ; the amount and type of all foods , drinks and drugs consumed were obtained and the total daily intake of cyclamate was expressed in mg/kg body weight ( bw ) , as the average of both 24-h recalls . Eighteen percent of the population consumed cyclamate , and the highest percentage was in men aged 35 - 44 years ( 33 % ) . Average daily intake of  cyclamate was 0.44 mg/kg bw in the whole population and 2.44 mg/kg bw among consumers . Subjects following a diet reported highest intakes , especially diabetics , and only 0.16 % of the sample studied had levels above the Acceptable Daily Intake ( ADI ) . Among consumers , the intake of cyclamate was negatively correlated with Body Mass Index ( BMI ) . The results show the pattern of cyclamate intake in the Spanish population A prospect i ve study of all patients with superficial bladder cancer diagnosed in Northern Alberta ( population 1.2 million ) from 1977 to 1983 was performed to establish patterns of recurrence . Of the 761 patients with all stages of bladder cancer at diagnosis , 642 were deemed to be free of disease after primary treatment consisting of transurethral resection , fulguration , or laser surgery .  Follow-up of these patients showed that approximately two-thirds of first recurrences occur within 18 months of diagnosis and that more of these patients have died of unrelated causes ( n = 73 ) than of bladder cancer ( n = 34 ) . Censored disease-free interval comparisons showed that initial recurrences occurred sooner in patients with multifocal rather than unifocal disease and also sooner in females than in males . Known risk factors ( occupational exposure to chemicals and cigarette smoking ) and suspected risk factors ( coffee consumption and artificial sweetener use ) had no effect on disease-free interval and are not related to tumor multiplicity This study explores whether the addition of aspartame-sweetened foods and beverages to a low fat , hypocaloric diet enhances compliance and result ing weight loss .  Fifty-nine obese ( 130 - 225 % of ideal body weight ) , free living men and women were r and omly assigned to either a Balanced Deficit Diet ( BDD ) or a BDD supplemented with aspartame . Over a 12-week weight loss period , volunteers attended weekly support group meetings including behavior modification training and exercise instruction . Males achieved a clinical ly significant weight loss ( greater than 23 lb ) in both study groups , while females lost an average of 12.8 lb in the control group vs. 16.5 lb in the experimental group . In both treatment groups , sleep , general energy level , level of physical activity , and feeling of well-being showed clinical ly meaningful improvement . This study suggests possible advantages to supplementing a BDD with aspartame-sweetened foods as part of a multidisciplinary weight loss program . The small sample size prohibits definitive conclusions but does provide the protocol for a larger , outpatient clinical trial BACKGROUND Bladder cancer is the second most incident malignancy among Lebanese men . The purpose of this study was to investigate potential risk factors associated with this observed high incidence . METHODS A case-control study ( 54 cases and 105 hospital-based controls ) was conducted in two major hospitals in Beirut . Cases were r and omly selected from patients diagnosed in the period of 2002 - 2008 . Controls were conveniently selected from the same setting s. Data were collected using interview question naire and blood analysis . Exposure data were collected using a structured face-to-face interview question naire . Blood sample s were collected to determine N-acetyltransferase1 ( NAT1 ) genotype by PCR-RFLP . Analyses revolved around univariate , bivariate and multivariate logistic regression , along with checks for effect modification . RESULTS The odds of having bladder cancer among  smokers  was 1.02 times significantly higher in cases vs. controls . The odds of exposure to occupational diesel or fuel combustion fumes were 4.1 times significantly higher in cases vs controls . The odds of prostate-related morbidity were 5.6 times significantly higher in cases vs controls . Cases and controls showed different clustering patterns of NAT1 alleles . No significant differences between cases and controls were found for consumption of alcohol , coffee , tea , or artificial sweeteners . CONCLUSIONS This is the first case-control study investigating bladder cancer risk factors in the Lebanese context . Results confirmed established risk factors in the literature , particularly smoking and occupational exposure to diesel . The herein observed associations should be used to develop appropriate prevention policies and intervention strategies , in order to control this alarming disease in Lebanon To examine the eating behavior of preschool children offered chocolate-flavored or plain milk at lunch , food consumption by 135 children , aged 18 - 66 months , was measured . Four different menus were served six times during a 12-week period , each menu being presented twice with each of three test beverages , plain milk ( 18.1 kcal/oz ) , sucrose-sweetened chocolate milk ( 29.4 kcal/oz ) , or aspartame-sweetened chocolate milk ( 18.6 kcal/oz ) . The type of milk beverage served had no significant effect on the consumption of other food items offered at that meal . Subjects did drink significantly more chocolate milk than plain milk during all meals and consequently consumed significantly more energy during those meals in which sucrose-sweetened chocolate milk was served . A macronutrient analysis of lunch-time food intake for each menu revealed significant differences in protein , fat , and carbohydrate content among the four menus . Older children consumed significantly more milk and more energy per lunch-time meal than did younger preschoolers , but no other consistent age-related differences were observed . No significant gender differences were detected in any of the statistical analyses conducted . These findings suggest that young children do not reduce the intake of other food items at a meal to compensate for the increased energy intake that results from excessive sucrose-sweetened milk consumption . Aspartame-sweetened milk increases milk intake in small children without providing them with the additional calories of sucrose-sweetened milk Chocolate milk increases milk consumption of children , but high sugar content raises health concerns . Interest in sugar reduction and parents ' preference for natural sweeteners necessitates further research on natural nonnutritive sweeteners . However , it is important to maintain consumer acceptability , especially for children , while reducing sugar in chocolate milk . The objectives of this study were to identify the sweetness intensity perception of stevia leaf ( STV ) and monk fruit ( MK ) extracts in skim chocolate milk ( SCM ) , to evaluate STV and MK as the sole or partial sweetener source for SCM for young adults ( 19 to 35 y ) and children ( 5 to 13 y ) , and to determine if information on natural nonnutritive sweeteners impacted parents ' acceptability of SCM . Power function and 2-alternative forced choice studies were used to determine the iso-sweetness of nonnutritive sweeteners to a sucrose control in SCM ( 51.4 g/L , SUC control ) . Young adults ( n = 131 ) evaluated 9 different SCM ( SUC control , STV , MK , STV : sucrose blends , or MK : sucrose blends ) in a completely r and omized 2-d test . Children ( n = 167 ) evaluated SUC control SCM and SCM with 39.7 g/L sucrose and 46 mg/L MK ( MK25 ) or 30 mg/L STV ( STV25 ) . Parents evaluated SUC control , MK25 , and STV25 in a balanced crossover design with a 40-d wait time between primed or unprimed ballots . Chocolate milks solely sweetened by nonnutritive sweeteners were less acceptable compared with SUC control by young adults . MK25 and STV25 were acceptable by young adults and children . The presentation of chocolate milk label information had different effects on parental acceptance . Traditional parents preferred sucrose sweetened SCM , and label conscious parents preferred SCM with natural nonnutritive sweeteners SYNOPSIS Recently , three pilot studies have proposed that the addition of products containing aspartame to thediets of migraine headache sufferers may produce a significant increase in the frequency of theirmigraines . The present study was a controlled thirteen-week , double-blind , r and omized cross-over study comparing the effect of aspartame to that of a matched placebo on the frequency and intensity of migraineheadache .  The results of this study indicated that the ingestion of aspartame by migraineurs caused asignificant increase in headache frequency for some subjects . The implication s of these findings and suggestions for further research are discussed The aim of this study was to analyze the relationship between current dietary habits  and  dental caries in schoolchildren from an area of Spain on which the prevalence of caries was low . The results of an epidemiological study conducted on a r and om sample of 893 children from the cities of Girona and Figueres are presented . The method of dietary interview consisted of a food-frequency question naire . This showed a positive relationship between dental caries and consumption of ice cream , pastries , cakes , sliced bread , on the one h and , and sugar-free chewing gum and sugar-free c and ies , on the other . A protective effect of skimmed milk and artificial sweeteners was also observed . Results reflect the role of certain foods in caries development , but also the outcome of selective dietary counseling to high-risk children The long-term effects of sucrose on appetite and mood remain unclear . Normal weight subjects compensate for sucrose added blind to the diet ( Reid et al. , 2007 ) . Overweight subjects , however , may differ . In a single-blind , between-subjects design , soft drinks ( 4x25cl per day ; 1800kJ sucrose sweetened versus 67kJ aspartame sweetened ) were added to the diet of overweight women ( n=53 , BMI 25 - 30 , age 20 - 55 ) for 4 weeks . A 7-day food diary gave measures of total energy , carbohydrate , protein , fat , and micronutrients . Mood and hunger were measured by ten single Likert scales rated daily at 11.00 , 14.00 , 16.00 , and 20.00 . Activity levels were measured by diary and pedometer . Baseline energy intake did not differ between groups . During the first week of the intervention energy intake increased slightly in the sucrose group , but not in the aspartame group , then decreased again , so by the final week intake again did not differ from the aspartame group . Compensation was not large enough to produce significant changes in the composition of the voluntary diet . There were no effects on hunger or mood . It is concluded that overweight women do not respond adversely to sucrose added blind to the diet , but compensate for it by reducing voluntary energy intake . Alternative explanations for the correlation between sugary soft drink intake and weight gain are discussed BACKGROUND Concern about the carcinogenic potential of aspartame was raised after an increase in lymphomas and leukemia was reported in an animal study at doses similar to human exposure . Two prospect i ve cohort studies published after the report found inconsistent results for estimated aspartame intake , artificially sweetened beverage consumption , and risk of lymphoid neoplasms . OBJECTIVE The objective of this study was to examine associations of artificially and sugar-sweetened carbonated beverage consumption ( for comparison ) and aspartame intake with risk of non-Hodgkin lymphoma ( NHL )  overall and by major histologic subtype in the Cancer Prevention Study -II Nutrition Cohort . METHODS Among 100,442 adult men and women who provided information on diet and lifestyle factors in 1999 , 1196 NHL cases were verified during a 10-y follow-up period . Cox proportional hazards regression was used to estimate multivariable-adjusted RRs and 95 % CIs . RESULTS In women and men combined , there were no associations of consumption of ≥1 ( 355 mL ) servings/d of artificially ( RR : 0.92 ; 95 % CI : 0.73 , 1.17 ; P-trend : 0.14 ) or sugar- ( RR : 1.10 ; 95 % CI : 0.77 , 1.58 ; P-trend : 0.62 ) sweetened carbonated beverages with NHL risk , compared to no consumption ( P-heterogeneity by gender : 0.11 - 1.00 ) . Similarly , aspartame intake was not associated with NHL risk ( RR : 1.02 ; 95 % CI : 0.84 , 1.24 ; P-trend : 0.69 , top vs. bottom quintile ) . Associations with NHL subtype ( multiple myeloma , diffuse large B-cell lymphoma , chronic lymphocytic leukemia/small lymphocytic lymphoma , and follicular and other B-cell lymphoma ) were generally null . CONCLUSION These findings do not support associations of daily consumption of artificially or sugar-sweetened carbonated beverages , or aspartame , with NHL risk
target: In healthy subjects , appetite and short term food intake , risk of cancer , risk of diabetes , risk of dental caries , weight gain and risk of obesity are the most investigated health outcomes .
  Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes .
  In subjects with diabetes and hypertension , the evidence regarding health outcomes of NNS use is also inconsistent .
background: Background Food products containing non-nutritive sweeteners ( NNSs ) instead of sugar have become increasingly popular in the last decades .
  Their appeal is obviously related to their calorie-free sweet taste .
  However , with the dramatic increase in their consumption , it is reasonable and timely to evaluate their potential health benefits and , more importantly , potential adverse effects .
  The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent , range , and nature of research activity in this area .