title: The effects of water and non‐nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial Effects on obese women of the sugar sucrose added to the diet over 28 d: a quasi-randomised, single-blind, controlled trial 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. The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight. Effects of replacing diet beverages with water on weight loss and weight maintenance: 18-month follow-up, randomized clinical trial Aspartame Consumption for 12 Weeks Does Not Affect Glycemia, Appetite, or Body Weight of Healthy, Lean Adults in a Randomized Controlled Trial. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Sugar- and artificially sweetened beverages and intrahepatic fat: A randomized controlled trial. 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 Use of aspartame by apparently healthy children and adolescents. The Consolidated Standards of Reporting Trials (CONSORT): Guidelines for Reporting Randomized Trials The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure. Effects of aspartame in young persons during weight reduction. An evaluation of the effect of aspartame on weight loss A randomized controlled trial contrasting the effects of 4 low-calorie sweeteners and sucrose on body weight in adults with overweight or obesity. Effects of sucrose drinks on macronutrient intake, body weight, and mood state in overweight women over 4 weeks
abstract: Objective To evaluate the effects of water versus beverages sweetened with non‐nutritive sweeteners ( NNS ) on body weight in subjects enrolled in a year‐long behavioral weight loss treatment program . Methods The study used a r and omized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight‐stable people with overweight and obesity . All participants participated in a weight loss program plus assignment to consume 24 ounces ( 710 ml ) of water or NNS beverages daily for 1 year . Results NNS and water treatments were non‐equivalent , with NNS treatment  showing greater weight loss at the end of 1 year . At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg ( P < 0.001 for difference ) . Conclusions Water and NNS beverages were not equivalent for weight loss and maintenance during a 1‐year behavioral treatment program . NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users  of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program . These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program To investigate whether obese women can compensate for sucrose added to the diet when it is given blind , rather than gaining weight or exhibiting dysfunctional regulation of intake , in the present study , forty-one healthy obese ( BMI 30–35 kg/m2 ) women ( age 20–50 years ) , not currently dieting , were r and omly assigned to consume sucrose ( n 20 ) or aspartame ( n 21 ) drinks over 4 weeks in a parallel single-blind design . Over the 4 weeks , one group consumed 4 × 250 ml sucrose drinks ( total 1800 kJ/d ) and the other group consumed 4 × 250 ml aspartame drinks . During the baseline week and experimental weeks , body weight and other biometric data were measured and steps per day , food intake using 7 d unweighed food diaries , and mood using ten- or seven-point Likert scales four times a day were recorded . At the end of the experiment , the participants weighed 1·72 ( se 0·47 ) kg less than the value predicted by the National Institute of Diabetes and Digestive and Kidney Diseases ( NIDDK ) model ; the predicted body weight accounted for 94·3 % of the variance in the observed body weight and experimental group accounted for a further 1·1 % of the variance in the observed body weight , showing that women consuming sucrose drinks gained significantly less weight than predicted . The reported daily energy intake did not increase significantly , and sucrose supplements significantly reduced the reported voluntary sugar , starch and fat intake  compared with aspartame . There were no effects on appetite or mood . Over 4 weeks , as part of everyday eating , sucrose given blind in soft drinks was partially compensated for by obese women , as in previous experiments with healthy and overweight participants 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 . ) 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 Background : Beneficial effects of replacing diet beverages ( DBs ) with water on weight loss , during a 24-week hypoenergetic diet were previously observed . However , it is not known whether this difference is sustained during a subsequent 12-month weight maintenance period . Objective : To evaluate effects of replacing DBs with water on body weight maintenance over a 12-month period in participants who undertook a 6-month weight loss plan . Design : Seventy-one obese and overweight adult women ( body mass index ( BMI ): 27–40 kg m–2 ; age : 18–50 years ) who usually consumed DBs in their diet were r and omly assigned to either substitute water for DBs ( water group : 35 ) or continue drinking DBs five times per week ( DBs group : 36 ) after their lunch for the 6-month weight loss intervention and subsequent 12-month weight maintenance program . Results : A total of 71 participants who were r and omly assigned were included in the study by using an intention-to-treat analysis . Greater additional weight loss ( mean±s.d . ) in the water group was observed compared with the DBs group after the 12-month follow-up period ( −1.7±2.8 vs −0.1±2.7 kg , P=0.001 ) . BMI decreased more in the water group than in the DBs group ( −0.7±1 vs −0.05±1.1 kg m–2 , P=0.003 ) . There was also a greater reduction in fasting insulin levels ( −0.5±1.4 vs −0.02±1.5 mmol l–1 , P=0.023 ) , better improvement in homeostasis model assessment of insulin resistance ( −0.2±0.4 vs −0.1±0.3 , P=0.013 ) and a greater decrease in 2-h postpr and ial plasma glucose ( −0.2±0.3 vs −0.1±0.3 mmol l–1 , P<0.001 ) in the water group compared with the DBs over the 12-month weight maintenance period . Conclusions : Replacement of DBs with water after the main meal in women who were regular users of DBs may cause further weight reduction during a 12-month weight maintenance program . It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period Background Low-calorie sweeteners are often used to moderate energy intake and postpr and ial glycemia , but some evidence indicates that they may exacerbate these aims . Objective The trial 's primary aim was to assess the effect of daily aspartame ingestion for 12 wk on glycemia . Effects on appetite and body weight were secondary aims . Methods One hundred lean [ body mass index ( kg/m2 ) : 18 - 25 ] adults aged 18 - 60 y were r and omly assigned to consume 0 , 350 , or 1050 mg aspartame/d ( ASP groups ) in a beverage for 12 wk in a parallel-arm design . At baseline , body weight and composition were determined , a 240-min oral-glucose-tolerance test ( OGTT ) was administered , and measurements were made of appetite and selected hormones . Participants also collected a 24-h urine sample . During the intervention , the 0-mg/d ASP group consumed capsules containing 680 mg dextrose and 80 mg para-amino benzoic acid . For the 350-mg/d ASP group , the beverage contained 350 mg aspartame and the 1050-mg/d ASP group consumed the same beverage plus capsules containing 680 mg dextrose and 700 mg aspartame .  Body weight , blood pressure , heart rate , and waist circumference were measured weekly . At weeks 4 , 8 , and 12 , participants collected 24-h urine sample s and kept appetite logs . Baseline measurements were repeated at week 12 . Results With the exception of the baseline OGTT glucose concentration at 60 min ( and result ing area under the curve value ) , there were no group differences for glucose , insulin , resting leptin , glucagon-like peptide 1 , or gastric inhibitory peptide at baseline or week 12 . There also were no effects of aspartame ingestion on appetite , body weight , or body composition . Compliance with the beverage intervention was ∼95 % . Conclusions Aspartame ingested at 2 doses for 12 wk had no effect on glycemia , appetite , or body weight among healthy , lean adults . These data do not support the view that aspartame is problematic for the management of glycemia , appetite , or body weight . This trial was registered at www . clinical trials.gov as NCT02999321 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 OBJECTIVE To test the hypothesis that substituting artificially sweetened beverages ( ASB ) for sugar-sweetened beverages ( SSB ) decreases intrahepatocellular lipid concentrations ( IHCL ) in overweight subjects with high SSB consumption . METHODS About 31 healthy subjects with BMI greater than 25 kg/m(2 ) and a daily consumption of at least 660 ml SSB were r and omized to a 12-week intervention in which they replaced SSBs with ASBs . Their IHCL ( magnetic resonance spectroscopy ) , visceral adipose tissue volume ( VAT ; magnetic resonance imaging ) , food intake ( 2-day food records ) , and fasting blood concentrations of metabolic markers were measured after a 4-week run-in period and after a 12-week period with ASB or control ( CTRL ) . RESULTS About 27 subjects completed the study .  IHCL was reduced to 74 % of the initial values with ASB ( N = 14 ; P < 0.05 ) but did not change with CTRL . The decrease in IHCL attained with ASB was more important in subjects with IHCL greater than 60 mmol/l than in subjects with low IHCL . ALT decreased significantly with SSB only in subjects with IHCL greater than 60 mmol/l . There was otherwise no significant effect of ASB on body weight , VAT , or metabolic markers . CONCLUSIONS In subjects with overweight or obesity and a high SSB intake , replacing SSB with ASB decreased intrahepatic fat over a 12-week period 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 This study was conducted to determine the effects and the differences , if any , result ing from the ingestion of aspartame ( sweetener ) versus sucrose . A 13-wk , double-blind study was conducted using 126 apparently healthy children and adolescents as panelists . Individuals were r and omly assigned in a double-blind design to aspartame or sucrose in each of five age groups ; dosage levels were assigned according to age and weight groups . Physical examinations and special eye examinations were performed at the beginning and end of the study . Other parameters determined including laboratory tests of liver and renal function , hematologic status , and plasma levels of phenylalanine and tyrosine . Clinical ly significant differences in laboratory parameters measured could not be demonstrated ; all mean values were within normal limits . No unusual findings were observed in phenylalanine or tyrosine levels . All phenylpyruvic acid and methanol determinations were negative . No important physical changes occurred , and no product-related side effects were reported Background The rules for reporting the results of r and omized controlled trials ( RCTs ) in published manuscripts have been elusive , and many nurse scientists have learned to write research reports by trial and error . ApproachNew comprehensive guidelines for reporting RCTs are now available to authors , editors , and readers , a development that is likely to improve the quality of published reports . The Consoli date d St and ards of Reporting Trials ( CONSORT ) guidelines consist of two parts , a 22-item checklist and a flowchart template , that track the flow of all participants through the RCT . Currently , some journals , including Nursing Research , have adopted CONSORT and suggest or require its use in su bmi tted manuscripts , but other journals do not . Results The CONSORT has potential to be useful beyond writing manuscripts . Because CONSORT is a comprehensive guide to essential elements of an RCT report , it also provides a useful guide for design ing RCTs and writing funding proposals that include all the essential elements of a trial . It also could be a useful synopsis of important concepts when teaching research design to doctoral students . Discussion Reports of RCTs that use CONSORT are easier to read , interpret , and evaluate for relevancy to clinical practice . In addition , excellent reports of research increase the visibility of nursing research beyond our discipline . The CONSORT adds value to nursing research because research ers and readers alike will benefit if it is used more often 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 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 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 Low-calorie sweeteners ( LCSs ) provide sweetness with little or no energy . However , each LCS 's unique chemical structure has potential to elicit different sensory , physiological , and behavioral responses that affect body weight . OBJECTIVE The purpose of this trial was to compare the effects of consumption of 4 LCSs and sucrose on body weight , ingestive behaviors , and glucose tolerance over a 12-wk intervention in adults ( 18 - 60 y old ) with overweight or obesity ( body mass index 25 - 40 kg/m2 ) . METHODS In a parallel-arm design , 154 participants were r and omly assigned to consume 1.25 - 1.75 L of beverage sweetened with sucrose ( n = 39 ) , aspartame ( n = 30 ) , saccharin ( n = 29 ) , sucralose ( n = 28 ) , or rebaudioside A ( rebA ) ( n = 28 ) daily for 12 wk . The beverages contained 400 - 560 kcal/d ( sucrose treatments ) or < 5 kcal/d ( LCS treatments ) . Anthropometric indexes , energy intake , energy expenditure , appetite , and glucose tolerance were measured at baseline . Body weight was measured every 2 wk with energy intake , expenditure , and appetite assessed every 4 wk . Twenty-four-hour urine collection s were completed every 4 wk to determine study compliance via para-aminobenzoic acid excretion . RESULTS Of the participants enrolled in the trial , 123 completed the 12-wk intervention . Sucrose and saccharin consumption led to increased body weight across the 12-wk intervention ( Δweight = + 1.85 ± 0.36 kg and + 1.18 ± 0.36 kg , respectively ; P ≤ 0.02 ) and did not differ from each other . There was no significant change in body weight with consumption of the other LCS treatments compared with baseline , but change in body weight for sucralose was negative and significantly lower compared with all other LCSs at week 12 ( weight difference ≥ 1.37 ± 0.52 kg , P ≤ 0.008 ) . Energy intake decreased with sucralose consumption ( P = 0.02 ) and ingestive frequency was lower for sucralose than for saccharin ( P = 0.045 ) . Glucose tolerance was not significantly affected by any of the sweetener treatments . CONCLUSIONS Sucrose and saccharin consumption significantly increase body weight compared with aspartame , rebA , and sucralose , whereas weight change was directionally negative and lower for sucralose compared with saccharin , aspartame , and rebA consumption . LCSs should be categorized as distinct entities because of their differing effects on body weight . This trial was registered at clinical trials.gov as NCT02928653 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
target: When comparing NNS vs sucrose , significant weight/ BMI differences appeared favouring NNS .
  Consumption of NNS led to significantly negative weight/ BMI differences in unrestricted energy diets , but not in weight-reduction diets .
  Participants with overweight/obesity and adults showed significant favourable weight/ BMI differences with NNS .
  Data suggest that replacing sugar with NNS leads to weight reduction , particularly in participants with overweight/obesity under an unrestricted diet , information that could be utilized for evidence -based public policy decisions
background: There is an ongoing debate about the possible influences of nonnutritive sweeteners ( NNS ) on body weight .
  We conducted a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) with NNS to assess their impact on body weight .