Los edulcorantes no calóricos y su intervención en la energía como en el peso corporal
25/febrero/22
PJ Rogers, PS Hogenkamp, C de Graaf, S Higgs, A Lluch, AR Ness, C Penfold, R Perry, P Putz, MR Yeomans y DJ Mela
Los edulcorantes no calóricos (ENC) se consumen en todo el mundo y su uso ha estado acompañado de debates y desacuerdos. En este análisis se reunió la totalidad de evidencia para probar si los ENC ad libitum o como reemplazo de los edulcorantes calóricos en alimentos o bebidas, tienen efecto sobre la ingesta de energía y el peso corporal.
Las conclusiones fueron las siguientes:
- Los ENC demuestran una reducción en la ingesta de energía y en el peso corporal al sustituir azúcares añadidos.
- Si se les da un buen uso en la práctica clínica, pueden ayudar en el logro de metas de salud pública, como la reducción de la ingesta de azúcares libres y energía.
ABSTRACT
“By reducing energy density, low-energy sweeteners (LES) might be expected to reduce energy intake (EI) and body weight (BW). To assess the totality of the evidence testing the null hypothesis that LES exposure (versus sugars or unsweetened alternatives) has no effect on EI or BW, we conducted a systematic review of relevant studies in animals and humans consuming LES with ad libitum access to food energy. In 62 of 90 animal studies exposure to LES did not affect or decreased BW. Of 28 reporting increased BW, 19 compared LES with glucose exposure using a specific ‘learning’ paradigm. Twelve prospective cohort studies in humans reported inconsistent associations between LES use and body mass index (−0.002 kg m−2 per year, 95% confidence interval (CI) −0.009 to 0.005). Meta-analysis of short-term randomized controlled trials (129 comparisons) showed reduced total EI for LES versus sugar-sweetened food or beverage consumption before an ad libitum meal (−94 kcal, 95% CI −122 to −66), with no difference versus water (−2 kcal, 95% CI −30 to 26). This was consistent with EI results from sustained intervention randomized controlled trials (10 comparisons). Meta-analysis of sustained intervention randomized controlled trials (4 weeks to 40 months) showed that consumption of LES versus sugar led to relatively reduced BW (nine comparisons; −1.35 kg, 95% CI –2.28 to −0.42), and a similar relative reduction in BW versus water (three comparisons; −1.24 kg, 95% CI –2.22 to −0.26). Most animal studies did not mimic LES consumption by humans, and reverse causation may influence the results of prospective cohort studies. The preponderance of evidence from all human randomized controlled trials indicates that LES do not increase EI or BW, whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water”.
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