EAL

NNNS: Appetite (2006)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

To review the literature and to clarify the state of knowledge concerning the effects of intense sweeteners on appetite and food consumption.

Inclusion Criteria:

Not described.

Exclusion Criteria:

Not described.

Description of Study Protocol:

Review of articles.

Data Collection Summary:

Description of Actual Data Sample:

Summary of Results:

Sweeteners, Hunger and Food Intake: Short-Term Effects of Aspartame on Hunger Ratings and Food Intake in a Test Meal

Study	Subjects*	Dose	Vehicle	Hunger Ratings	Type of Test Meal	Food Intake
Anderson et al, 1989	Exp. One: Nine- to 10-year-olds (N=20)	119mg	300ml flavored drink with polycose	No effect compared with cyclamate	Lunch, 90-minute delay	No effect compared with cyclamate
Anderson et al, 1989	Exp. Two: Nine- to 10-year-olds (N=20)	295mg	300ml flavored drink	No effect compared with sucrose	Lunch, 90-minute delay	No effect compared with sucrose
Black et al, 1990	Males only (N=20)	160mg or 320mg	280ml or 560ml diet soda	No effect or decreased	Lunch, 60-minute delay	No effect compared with water
Birch et al, 1989	Exp. One: Four- to five-year-olds (N=24)	140mg	205ml favored drink	Not collected	Snacks, zero- to 30- and 60-minute delay	No effect or decreased at 30-minutes compared with water
Birch et al, 1989	Exp. Two: Two- to four-year-olds (N=20)	102mg	150ml flavored drink	Not collected	Snacks, zero- to 30- and 60-minute delay	No effect or decreased at 30-minutes compared with water
Blundell, Hill, 1986	Body weight not collected (N=95)	162mg	200ml plain water	Increased compared with water	Not collected	Not collected
Mattes, 1990	N=24	112mg	70g cornflakes	No effect or decreased	Next meal and total daily	No effect compared with unsweetened cereal or sucrose
Rodin, 1990	Overweight and normal (N=24)	250mg	500ml lemon-flavored water	Not collected	Lunch, 38-minute delay	No effect compared with water
Rogers et al, 1988	N=12	162mg	200ml plain water	Increased compared with water	Lunch, 60-minute delay	No effect compared with water
Rogers et al, 1990	Exp. One: N=12	234mg	Capsules	Not collected	Lunch, 60-minute delay	Decreased compared with water
Rogers et al, 1990	Exp. Two: N=15	235mg and 470mg	Capsules	Decreased compared with water	Lunch, 60-minute delay	Decreased compared with water
Rolls et al, 1988	Females only N=12	77mg	Gelatin (ad libitum)	Decreased	Cheese on crackers, 60-minute delay	No effect compared with sucrose
Rolls et al, 1989	N=32	211mg to 391mg	Gelatin and pudding (ad libitum)	Decreased	Lunch, 120-minute delay	No effect compared with sucrose
Rolls et al, 1990	Exp. One: Males only (N=14)	110mg and 220mg	237ml and 473ml lemonade	Decreased	With lunch	No effect compared with water or no drink
	Exp. Two: Males only (N=14)	110mg and 220mg	237ml and 473ml lemonade	Decreased	Lunch, 30-minute delay	No effect compared with water or no drink
	Exp. Three: Males only (N=14)	110mg and 220mg	237ml and 473ml lemonade	Decreased	Lunch, 60-minute delay	No effect compared with water or no drink
Ryan-Harshman et al, 1987	Males only (N=13)	5.04g and 10.08g	Capsules	No effect	Lunch, 60- to 105-minute delay	No effect
Tordoff, Alleva, 1990	Dieters and non-dieters (N=120)	0.05%, 0.30%, 0.50%, 1.0%	Chewing gum	Increased	Not collected	Not reported

*Normal weight, non-dieting male and female adults, unless otherwise specified in experiment.

Sweeteners and Weight

Kanders et al, 1988: 12-week program involving 59 obese men. Study explored whether the addition of aspartame-sweetened foods and beverages to a low-fat hypocaloric diet affected weight loss. No significant differences in weight loss in the groups with and without aspartame supplementation. The males lost slightly more weight without aspartame (10.4kg vs. 12.2kg) and the females showed the opposite trend (7.4kg vs. 5.8kg).
Stellman, Garfinkel: The statistically significant, but clinically irrelevant weight change of 0.45kg is likely the result of the very large sample size.

Author Conclusion:

Several investigators have reported increases in ratings of hunger associated with aspartame consumption. Most have found that aspartame is associated with decreased or unchanged ratings of hunger. Even if aspartame increases ratings of hunger in some situations, there is no evidence that aspartame has any impact on the controls of food intake and body weight.

Limitations

Data from long-term studies are limited.

Funding Source:

Government:	NIDDK
University/Hospital:	Johns Hopkins University School of Medicine

Reviewer Comments:

Quality Criteria Checklist: Review Articles
Relevance Questions
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes

Validity Questions
	1.	Was the question for the review clearly focused and appropriate?	Yes
	1.	Was the question for the review clearly focused and appropriate?	Yes
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	Yes
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	Yes
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	Yes
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	Yes
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	No
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	No
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	Yes
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes