Randomized controlled trials that evaluated nonnutritive sweetener interventions and long-term cardiometabolic health
| Study,* country | No. of participants randomly assigned (%completed) | Sex | Population | Age, mean ± SD; yr | BMI, mean ± SD; kg/m2 | Duration, mo | Type and source of NNS | Daily dose of NNS | Comparator(s) | Outcomes | Risk of bias† | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BMI | Weight | Waist | Body fat | HOMA-IR | |||||||||||
| Blackburn et al. 1997, (38) USA | 163 (53) | F | Obese, on weight-loss program | 44 ± 10 | 37 ± 5 | 16 | Aspartame ASB, packets, foodstuffs | Participants’ discretion | Aspartame avoidance | • | High | ||||
| Hsieh et al. 2003, (36) China | 174 (97) | M, F | Mild hypertension | 52 ± 7 | 23 ± 3 | 24 | Stevioside capsules | 1500 mg | Placebo | • | Low | ||||
| Ferri et al. 2006, (37) Brazil | 14 (86) | M, F | Mild hypertension | 45 ± 7 | 27 ± 3 | 6 | Stevioside capsules | 3 phases: 3.8, 7.5, 15.0 mg/kg | Placebo | • | • | Unclear | |||
| Tate et al. 2012, (34) USA | 213 (86) | M, F | Overweight, on weight-loss program | 42 ± 11 | 36 ± 6 | 6 | Unspecified ASB | Recommended ≥ 2 servings | Water, attention control‡ | • | • | High | |||
| Maersk et al. 2012, (35) Denmark | 33 (76) | M, F | Overweight | 39 ± 8 | 33 ± 4 | 6 | Aspartame ASB | 1 L of diet cola | Water | • | • | • | High | ||
| Peters et al. 2016, (19) USA | 308 (72) | M, F | Overweight, on weight-loss program | 48 ± 11 | 34 ± 4 | 12 | Unspecified ASB | At least 710 mL | Water with ASB avoidance | • | • | High | |||
| Madjd et al. 2015, (20) Iran | 71 (87) | F | Overweight, on weight-loss program | 32 ± 7 | 34 ± 3 | 6 | Unspecified ASB | 250 mL | Water | • | • | • | • | High | |
Note: ASB = artificially sweetened beverage, BMI = body mass index, F = female, HOMA-IR = homeostatic model assessment for insulin resistance, M = male, NNS = nonnutritive sweetener, SD = standard deviation.
↵* Sorted by year of publication.
↵† Risk of bias was assessed using the Cochrane Risk of Bias tool. (30) See Appendix 1, Table S3 for detailed risk of bias results for quality assessment.
↵‡ Data from multiple comparator groups were combined.