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Pooled review (meta-analysis)

Pooled review of 12 studies in young people found mixed results on diet drinks

Espinosa and colleagues · Advances in nutrition (Bethesda, Md.) · 2024

Original title: Effects of Nonnutritive Sweeteners on the BMI of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies.

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What the study found

Mixed

In trials, diet drinks led to less BMI gain than sugary drinks (mean difference = -0.114 kg/m2; 95% CI -0.207, -0.021). In cohorts, the link to BMI gain was not clear (0.05 kg/m2; 95% CI -0.03, 0.13).

The study at a glance

Type of study
Pooled review (meta-analysis)
Who or what was studied
12 studies · children and teens in 4 trials (1372 people) and 8 cohort studies (35,340 people)
What was tested
Diet drinks compared with sugar-sweetened drinks in trials; diet drink intake over time in cohorts
What it measured
The question itself: body weight and metabolic health
Who has a stake
No disclosure in PubMed
No disclosure in PubMed. Some included trials had company ties; removing them weakened results.
Journal
Advances in nutrition (Bethesda, Md.), 2024
Source
PubMed record 39299839. This page is based on the abstract only.

How much this study counts

  • ✓Pools the results of 12 studies.
  • •A pooled review is only as strong as the studies it pools.
  • ✓Measured the question itself: body weight and metabolic health.
  • •The PubMed record has no conflict-of-interest statement.
  • •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
  • Part of the finding “Against sugar, sweeteners mostly meant less gain”.
  • Part of the finding “A 28-year cohort points the other way”.
  • Summed up in “What reviews found”: Pooled 4 trials (1372 children and teens) and 8 cohort studies (35,340). Trials: less BMI gain with diet drinks than sugary drinks (-0.114 kg/m2). Cohorts: no clear link. No study compared diet drinks with water.
  • Open item for a person: Espinosa 2024: removing studies with conflicts of interest weakened estimates; abstract does not name which pooled trials had company ties.

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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