The use of artificial sweeteners: does it really contribute to weight loss?

Abstract

The changes in lifestyle associated to sedentarism and bad food habits have contributed to the growth of obesity around the world. Therefore, the use of non-nutritive sweeteners has increased due to the rise of concerns about obesity. However, although some studies have shown the benefits of artificial sweeteners in weight control, others have indicated the opposite effects. According to several large scale studies as the San Antonio Heart Study and the National Health and Nutrition Examination Survey (NHANES), there is a positive association between artificial sweetener consumption and weight and/or BMI gain. Possible involved mechanisms by which NNS can aid in weight management must be considered, although in most of studies some data are inconsistent. One of the hypotheses is that a lack of activation in cephalic phase stimulation may increase the risk of obesity, while another is that activation through eating in general or exposure to sweet items could stimulate appetite and intake. There is also a view which relates NNS in insulin secretion and glucose metabolism. In relation to nutritive and osmotic effects, NNS may promote weaker satiety compared to NS, as the nature of the sweetener is also a factor. NNS can cause failure to release of gut peptides resulting in lower satiety and increased energy consumption. About palatability, NNS are often added to foods or beverages to improve the acceptability of low energy or energy reduced foods or diets, increasing their intake over more energy dense versions. Some studies assume that palatability promotes hunger and/or reduces satiety and stimulate intake.