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Pooled review (meta-analysis)

Pooled review of 37 studies found mixed results on sweeteners and BMI

Azad and colleagues · CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017

Original title: Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.

Under review. A person has not yet checked this summary against the paper. It is written from the PubMed abstract. Until a person checks it, search engines are asked not to list this page.

What the study found

Mixed

In trials, sweeteners had no clear effect on BMI (mean difference -0.37 kg/m2; 95% CI -1.10 to 0.36). In cohort studies, sweetener use was linked to higher BMI (mean correlation 0.05, 95% CI 0.03 to 0.06).

The study at a glance

Type of study
Pooled review (meta-analysis)
Who or what was studied
37 studies · adults and teens in 7 trials (1003 people) and 30 long-term cohort studies (405 907 people)
What was tested
Sweetener use compared with no or less sweetener use; trials median 6 months, cohorts median 10 years
What it measured
The question itself: body weight and metabolic health
Who has a stake
No stake declared
One author had speaker fees from Medtronic, which does not make sweeteners. Otherwise no competing interests.
Journal
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2017
Source
PubMed record 28716847. This page is based on the abstract only.

How much this study counts

  • ✓Pools the results of 37 studies.
  • •A pooled review is only as strong as the studies it pools.
  • ✓Measured the question itself: body weight and metabolic health.
  • ✓No competing interests declared.
  • •Summarized from the PubMed abstract only. The full paper may hold details the abstract leaves out.

✓ Strength– Limit• Note

These points come from fixed rules about the type of study, its size and length, what it measured, and who has a stake. Every study on Digestery gets the same rules.

Where this study sits

This paper is not on the ladder. It is a pooled review (meta-analysis), and reviews and opinion pieces discuss studies that are already counted on the steps below.

↑ Stronger evidence

  1. Trials in people: body weight

    4

    1 benefit, 1 mixed, 2 no difference

  2. Trials in people: other measures

    0

    None among the papers we read.

  3. Trials in people: lab tests or safety

    7

    1 benefit, 1 mixed, 4 no difference, 1 harm

  4. Population studies

    5

    1 benefit, 4 harm

  5. Blood levels and genes

    1

    1 harm

↓ Weaker evidence

  • Points to benefit
  • Mixed
  • No difference
  • No direction
  • Points to harm

How it fits with the other research

The short answer to “Do artificial sweeteners cause weight gain?”

Trials say no; population studies disagree.

Confidence: low. Based on 32 on-topic papers.

Read the full answer
  • Quoted in “What we found”: Pooling 7 trials found no clear effect of sweeteners on BMI (mean difference -0.37 kg/m2), while 30 population studies linked sweetener use to a modest rise in BMI.
  • Part of the finding “Many population studies link sweeteners to more weight”.
  • Summed up in “What reviews found”: Pooled 7 trials (1003 people, median 6 months) and 30 cohorts (405 907 people, median 10 years). Trials: no clear BMI effect. Cohorts: sweetener use linked to higher BMI, weight, waist size, obesity and type 2 diabetes.
  • Marked as a key paper in the research timeline: Review shows trials and population studies disagree.

Other reviews on this question

See all 32 studies on this question

How this page was made

Label

First read of the abstract
Claude Sonnet
Independent second read
Claude Haiku
Differences settled
The two reads agreed on every checked field. Claude Opus 5.5.
Headline
Claude Sonnet, from the checked study record. A script checked its numbers and wording.
Numbers
Checked against the abstract by a script
“How much this study counts”
Fixed rules, the same for every study
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