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To review the effectiveness of intense sweeteners in reducing energy density for weight control. 

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• To review issues of energy density, palatability and satiey, as applied to intense sweeteners.
• Descriptors: Energy density, palatability, satiation, intense sweeteners.

Reviewed what is energy density, diet beverages and satiety, energy compensation and control of body weight.

 

 

Diet Beverages and Study Quality

• Studies on diet beverages and satiety are extremely skewed in favor of very short-term studies.
• Typical study design tested hunger, satiety and energy intakes during a single meal or snack following ingestion of a sweet stimulus.
• The time interval between the beverage and the next meal was very short, most often between 30 and 60 minutes.

Beverages (Anderson et al, 1989, Birch et al, 1989, Black et al, 1991, Rolls et al, 1990), Pudding or Cereal (Mattes, 1990, Rolls et al, 1988 and 1989), With the Difference Between the High- and Low-Energy Versions Rarely Exceeding 200kcal (Burley et al, 1993, Drewnowski, 1986)

• Drewnowski et al, 1986, used a stronger energy manipulation (400kcal), a longer time interval (two to three hours) and three consecutive test meals: Lunch, snack and dinner, consumed for up to 10 hours postingestion. Since the volume of the test beverage was kept constant while energy content varied, energy density was the key manipulated variable.
• Short-term perception of hunger and satiey was influenced more strongly by preload volume than by any other variable. A 560ml portion of energy-free carbonated mineral water and an equal volume of aspartame-sweetened soft drink had comparable effects on satiety.
• Replacing sucrose with aspartame lowered energy density of soft drinks from 0.4kcal/ml to zero, but had no effect on immediate hunger ratings. Children aged nine to 10 years had similar hunger ratings after consuming sucrose (90kcal) or aspartame-sweetened (three kcal) soft drinks (Birch et al, 1989).
• Rolls et al, 1990, found adults who consumed sucrose or aspartame-sweetened lemonade (166kcal vs. five kcal) showed similar hunger ratings as measured 0, 30 and 60 minutes later. Similar results were obtained with solid and semi-solid foods (Rogers and Blundell, 1989).
• Levy and Heaton, 1993, and Green et al, 1994, used breakfasts of yogurt-like creamy white cheese that were either plain, sweetened with aspartame or sucrose or sweetened with aspatame and supplemented with maltodextrin. A difference in energy density of 0.6kcal/g vs. 1.4kcal/g had no initial impact on ratings of hunger or the intent to eat in 12 normal-weight women.

Energy Compensation

• Black et al, 1993, demonstrated that ingestion of saccharin-sweetned (131kcal), as opposed to glucose-sweetened yogurt (295kcal), led to complete energy compensation in a meal 60 minutes later.
• Birch et al, 1989, showed that two- to five-year-old children compensated perfectly for calories removed from soft drinks by the use of intense sweeteners.
• In Rolls et al, 1990, aspartame-sweetened lemonade led to energy compensation when lunch was presented 30 to 60 minutes later, but not when lunch and lemonade were consumed at the same time.
• Lavin et al, 1997, studied 14 restrained female subjects consuming four 330ml soft drinks during the day while being provided with lunch, evening meal and unlimited access to high-fat and high-carbohydrate snacks. The drinks were lemonade sweetened with 80g of sucrose (1.0 kcal/ml), lemonade sweetened with aspartame (zero kcal/ml) and carbbnated mineral water. No differences in hunger or fullness ratings were observed, suggesting that the subjects were insensitive to 320kcal vs. none. Energy compensation did occur and total daily intakes were the same across the three experimental conditions. The aspartame group was followed by elevated energy intakes on the next day. The data were atypical.   
• Mattes, 1996, showed energy from carbohydrates, when ingested in a beverage as opposed to a solid food, may fail to provoke a compensation response, at least in the short term.

Control of Body Weight

Only a few clinical and epidemiological studies have addressed long-term use of sweeteners.

• Porikos et al, 1982, showed that replacing sucrose with aspartame over a period of 11 days led to partial (40%) compensation for the missing sucrose calories.
• Tordoff and Alleva, 1990, demonstrated the consumption of 1,135ml of aspartame-sweetened as opposed to fructose-sweetened soda, daily for 21 days, was associated with lower energy intakes in both male and female subjects. Male subjects also lost weight during the three-week period. The calorie savings derived not from a reduction in food intake, but a decline in energy from soft drinks.
• Gatenby et al, 1997, found diet products may have little impact on total energy intakes or body weight status.
• Blackburn et al, 1997, a clinical study, recruited obese women for a multidisciplinary 17-month weight control program. A total of 163 women were randomly assigned to one of two groups, being asked to either abstain from or to freely consume aspartame-sweetened foods and beverages during the weight loss phase (16 weeks), a one-year maintenance program and a two-year follow-up period. The active phase was based on a 1,500kcal diet composed of 24% fat, 56% carbohydrates and 20% protein and an exercise prescription for 200 minutes of physical activity per week. Monthly group sessions and annual follow-ups were part of the program. At the end of the active weight loss period, the aspartame group consumed a mean of 0.29g of aspartame per day, about equivalent to 150g of sucrose in terms of sweetening power. While the initial weight loss (10% of initial body weight) was comparable for the two groups, the aspartame group showed better weight maintenance during the follow-up period. These data suggest that while aspartame does not directly promote rapid weight loss, the inclusion of aspartame-sweetened products in a multidisciplinary weight control program may promote the long-term maintenance of reduced body weight.

• Though naturally energy-dilute foods, such as raw vegetables and fruit, are widely distributed in the food supply, many consumers prefer to lower the energy density of their diet by using intense sweetners and fat-replacement products. Intense sweeteners offer a very effective method of reducing energy density of foods, while maintaining their palatability.
• According to current theories on energy density and satiety, palatable diet soft drinks provide volume and therefore affect satiety, even though the energy density is zero. Most studies on intense sweeteners and energy density have been short-term ones. Our understanding of energy density is limited. Whether or not the energy density approach to weight reduction will be effective in the long run still remains to be determined.

University/Hospital:

University of Washington

Do evidence-based analysis on studies mentioned in review.