Artificial sweetener use and one-year weight change among women. Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in Men Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study Consumption of Artificially-Sweetened Soft Drinks in Pregnancy and Risk of Child Asthma and Allergic Rhinitis Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Sucrose compared with artificial sweeteners: a clinical intervention study of effects on energy intake, appetite, and energy expenditure after 10 wk of supplementation in overweight subjects. Artificial sweeteners and absence of bladder cancer risk in Copenhagen. Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women. Artificially and sugar-sweetened carbonated beverage consumption is not associated with risk of lymphoid neoplasms in older men and women. Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always normal weight individuals The Use of Low-Calorie Sweeteners by Children: Implications for Weight Management123 Sugar- and artificially sweetened beverages and intrahepatic fat: A randomized controlled trial. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study. Sweetened beverage consumption and risk of coronary heart disease in women. Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct Artificial sweeteners, caffeine, and alcohol intoxication in bar patrons. Artificial sweetener reduces nociceptive reaction in term newborn infants. Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study.
Weight change over a 1-year period was examined in a highly homogeneous group of 78,694 women ages 50 - 69 enrolled in a prospect i ve mortality study .  Artificial sweetener usage increased with relative weight and decreased with age . Users were significantly more likely than nonusers to gain weight , regardless of initial weight . Average weight gains or losses by artificial sweetener users differed by less than 2 pounds from gains or losses among nonusers . These results were not explicable by differences in food consumption patterns . The data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain Background — Sugar-sweetened beverage consumption is associated with weight gain and risk of type 2 diabetes mellitus .  Few studies have tested for a relationship with coronary heart disease ( CHD ) or intermediate biomarkers . The role of artificially sweetened beverages is also unclear . Methods and Results — We performed an analysis of the Health Professionals Follow-Up Study , a prospect i ve cohort study including 42 883 men . Associations of cumulatively averaged sugar-sweetened ( eg , sodas ) and artificially sweetened ( eg , diet sodas ) beverage intake with incident fatal and nonfatal CHD ( myocardial infa rct ion ) were examined with proportional hazard models . There were 3683 CHD cases over 22 years of follow-up . Participants in the top quartile of sugar-sweetened beverage intake had a 20 % higher relative risk of CHD than those in the bottom quartile ( relative risk=1.20 ; 95 % confidence interval , 1.09–1.33 ; P for trend < 0.01 ) after adjustment for age , smoking , physical activity , alcohol , multivitamins , family history , diet quality , energy intake , body mass index , pre-enrollment weight change , and dieting . Artificially sweetened beverage consumption was not significantly associated with CHD ( multivariate relative risk=1.02 ; 95 % confidence interval , 0.93–1.12 ; P for trend=0.28 ) . Adjustment for self-reported high cholesterol , high triglycerides , high blood pressure , and diagnosed type 2 diabetes mellitus slightly attenuated these associations . Intake of sugar-sweetened but not artificially sweetened beverages was significantly associated with increased plasma triglycerides , C-reactive protein , interleukin-6 , and tumor necrosis factor receptors 1 and 2 and decreased high-density lipoprotein , lipoprotein(a ) , and leptin ( P<0.02 ) . Conclusions — Consumption of sugar-sweetened beverages was associated with increased risk of CHD and some adverse changes in lipids , inflammatory factors , and leptin . Artificially sweetened beverage intake was not associated with CHD risk or biomarkers BACKGROUND Sugar-sweetened soft drinks have been linked to a number of adverse health outcomes such as high weight gain . Therefore , artificially sweetened soft drinks are often promoted as an alternative . However , the safety of artificial sweeteners has been disputed , and consequences of high intakes of artificial sweeteners for pregnant women have been minimally addressed . OBJECTIVE We examined the association between intakes of sugar-sweetened and artificially sweetened soft drinks and preterm delivery . DESIGN We conducted prospect i ve cohort analyses of 59,334 women from the Danish National Birth Cohort ( 1996 - 2002 ) . Soft drink intake was assessed in midpregnancy by using a food-frequency question naire . Preterm delivery ( lt 37 wk ) was the primary outcome measure . Covariate information was assessed by telephone interviews . RESULTS There was an association between intake of artificially sweetened carbonated and noncarbonated soft drinks and an increased risk of preterm delivery ( P for trend : le 0.001 , both variables ) . In comparison with women with no intake of artificially sweetened carbonated soft drinks , the adjusted odds ratio for women who consumed ge 1 serving of artificially sweetened carbonated soft drinks/d was 1.38 ( 95 % CI : 1.15 , 1.65 ) . The corresponding odds ratio for women who consumed ge 4 servings of artificially sweetened carbonated soft drinks/d was 1.78 ( 95 % CI : 1.19 , 2.66 ) . The association was observed for normal-weight and overweight women . A stronger increase in risk was observed for early preterm and moderately preterm delivery than with late-preterm delivery . No association was observed for sugar-sweetened carbonated soft drinks ( P for trend : 0.29 ) or for sugar-sweetened noncarbonated soft drinks ( P for trend : 0.93 ) . CONCLUSIONS Daily intake of artificially sweetened soft drinks may increase the risk of preterm delivery . Further studies are needed to reject or confirm these findings Background : The influence of artificial sweeteners on metabolic diseases is controversial . Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes ( T2D ) but biases and reverse causation have been suspected to have influenced the observed association . In addition , it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary . Methods : We used data from 61,440 women in the prospect i ve E3N-European Prospect i ve Investigation into Cancer and Nutrition study , conducted between 1993 and 2011 . We estimated hazards ratios ( HRs ) and 95 % CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets . Results : Compared to “ never or rare ” consumers of artificial sweeteners , those using them “ always or almost always ” had an increased risk of T2D ( HR = 1.83 [ 95 % CI 1.66 - 2.02 ] in the multivariate model [ MM ] , HR = 1.33 [ 95 % CI 1.20 - 1.47 ] when further adjusted for body mass index , BMI ) . Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users ( HR = 2.10 [ 95 % CI 1.83 - 2.40 ] in the MM and HR = 1.15 [ 95 % CI 1.00 - 1.33 ] when adjusted for BMI , respectively ) . Conclusions : Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk , independently of major T2D risk factors , but partially mediated by adiposity . A pre caution ary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes Background Past evidence has suggested a role of artificial sweeteners in allergic disease ; yet , the evidence has been inconsistent and unclear . Objective To examine relation of intake of artificially-sweetened beverages during pregnancy with  child asthma and allergic rhinitis  at 18 months and 7 years . Methods We analyzed data from 60,466 women enrolled during pregnancy in the prospect i ve longitudinal Danish National Birth Cohort between 1996 and 2003 . At the 25th week of gestation we administered a vali date d Food Frequency Question naire which asked in detail about intake of artificially-sweetened soft drinks . At 18 months , we evaluated child asthma using interview data . We also assessed asthma and allergic rhinitis through a question naire at age 7 and by using national registries . Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months . We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95 % CI comparing daily vs. no intake . Results At 18 months , we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 ( 95 % CI : 1.13 , 1.33 ) times more likely to report a child asthma diagnosis compared to non-consumers . Similar results were found for child wheeze . Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient ( 1.30 , 95 % CI : 1.01 , 1.66 ) and medication ( 1.13 , 95 % CI : 0.98 , 1.29 ) registry , as well as self-reported allergic rhinitis ( 1.31 , 95 % CI : 0.98 , 1.74 ) during the first 7 years of follow-up . We found no associations for sugar-sweetened soft drinks . Conclusion Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis , while early childhood outcomes were related to non-carbonated soft drinks . These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development BACKGROUND Sugar-sweetened beverages are risk factors for type 2 diabetes ; however , the role of artificially sweetened beverages is unclear . OBJECTIVE The objective was to examine the associations of sugar- and artificially sweetened beverages with  incident type 2 diabetes .  DESIGN An analysis of healthy men ( n = 40,389 ) from the Health Professionals Follow-Up Study , a prospect i ve cohort study , was performed . Cumulatively averaged intakes of sugar-sweetened ( sodas , fruit punches , lemonades , fruit drinks ) and artificially sweetened ( diet sodas , diet drinks ) beverages from food-frequency question naires were tested for associations with type 2 diabetes by using Cox regression . RESULTS There were 2680 cases over 20 y of follow-up . After age adjustment , the hazard ratio ( HR ) for the comparison of the top with the bottom quartile of sugar-sweetened beverage intake was 1.25 ( 95 % CI : 1.11 , 1.39 ; P for trend < 0.01 ) . After adjustment for confounders , including multivitamins , family history , high triglycerides at baseline , high blood pressure , diuretics , pre-enrollment weight change , dieting , total energy , and body mass index , the HR was 1.24 ( 95 % CI : 1.09 , 1.40 ; P for trend < 0.01 ) . Intake of artificially sweetened beverages was significantly associated with type 2 diabetes in the age-adjusted analysis ( HR : 1.91 ; 95 % CI : 1.72 , 2.11 ; P for trend < 0.01 ) but not in the multivariate-adjusted analysis ( HR : 1.09 ; 95 % CI : 0.98 , 1.21 ; P for trend = 0.13 ) . The replacement of one serving of sugar-sweetened beverage with 1 cup ( ≈237 mL ) of coffee was associated with a risk reduction of 17 % . CONCLUSION Sugar-sweetened beverage consumption is associated with a significantly elevated risk of type 2 diabetes , whereas the association between artificially sweetened beverages and type 2 diabetes was largely explained by health status , pre-enrollment weight change , dieting , and body mass index BACKGROUND There is a lack of appetite studies in free-living subjects supplying the habitual diet with either sucrose or artificially sweetened beverages and foods . Furthermore , the focus of artificial sweeteners has only been on the energy intake ( EI ) side of the energy-balance equation . The data are from a subgroup from a 10-wk study , which was previously published . OBJECTIVE The objective was to investigate changes in EI and energy expenditure ( EE ) as possible reasons for the changes in body weight during 10 wk of supplementation of either sucrose or artificial sweeteners in overweight subjects . DESIGN Supplements of sucrose-sweetened beverages and foods ( 2 g/kg body weight ; n = 12 ) or similar amounts containing artificial sweeteners ( n = 10 ) were given single-blind in a 10-wk parallel design . Beverages accounted for 80 % and solid foods for 20 % by weight of the supplements . The rest of the diet was free choice . Indirect 24-h whole-body calorimetry was performed at weeks 0 and 10 . At week 0 the diet was a weight-maintaining st and ardized diet . At week 10 the diet consisted of the supplements and ad libitum choice of foods .  Visual analog scales were used to record appetite . RESULTS Body weight increased in the sucrose group and decreased in the sweetener group during the intervention . The sucrose group had a 3.3-MJ higher EI but felt less full and had higher ratings of prospect i ve food consumption than did the sweetener group at week 10 . Basal metabolic rate was increased in the sucrose group , whereas 24-h EE was increased in both groups at week 10 . Energy balance in the sucrose group was more positive than in the sweetener group at the stay at week 10 . CONCLUSION The changes in body weight in the 2 groups during the 10-wk intervention seem to be attributable to changes in EI rather than to changes in EE During the years 1979 to 1981 a population -based case-control study of bladder cancer including papillomas was performed in Greater Copenhagen . After exclusions some 388 patients ( 290 males ; 98 females ) and an age- and sex-matched group of 787 controls ( 592 males ; 195 females ) remained for analysis . Controls were selected at r and om from the general population of the study area . All persons were interviewed concerning use of artificial sweeteners in addition to their exposure to a number of other known or suspected risk factors for bladder cancer . Fifty-five male bladder cancer patients ( 19.4 % ) and 150 controls ( 25.7 % ) had at some time used artificial sweeteners regularly . Among females 27.1 % of cases and 25.9 % of controls regularly used sweeteners . In neither sex was the relative risk significantly increased in users compared with non-users of artificial sweeteners . The relative risk of 0.78 in the two sexes combined was not significantly different from 1.0 ( 95 % C.I. : 0.58 - 1.05 ) . There was no indication of a regular increase in risk with increasing daily consumption of table-top sweeteners nor was there any indication of an increase in risk with a duration of regular use of artificial sweeteners . Taking into account a possible latency period between first regular use and bladder cancer development did not change the finding of an absence of association between use of artificial sweeteners and the risk of bladder cancer . Neither saccharine nor cyclamate users had an increased risk of bladder cancer . This population -based case-control investigation provides further evidence that it is highly unlikely that the consumption of artificial sweeteners has contributed to current bladder cancer rates in man Background The importance of exchanging sucrose for artificial sweeteners on risk factors for developing diabetes and cardiovascular diseases is not yet clear . Objective To investigate the effects of a diet high in sucrose versus a diet high in artificial sweeteners on fasting and postpr and ial metabolic profiles after 10 weeks . Design Healthy overweight subjects were r and omised to consume drinks and foods sweetened with either sucrose ( ∼2 g/kg body weight ) ( n = 12 ) or artificial sweeteners ( n = 11 ) as supplements to their usual diet . Supplements were similar on the two diets and consisted of beverages ( ∼80 weight% ) and solid foods ( yoghurts , marmalade , ice cream , stewed fruits ) . The rest of the diet was free of choice and ad libitum . Before ( week 0 ) and after the intervention ( week 10 ) fasting blood sample s were drawn and in week 10 , postpr and ial blood was sample d during an 8-hour meal test ( breakfast and lunch ) . Results After 10 weeks postpr and ial glucose , insulin , lactate , triglyceride , leptin , glucagon , and GLP-1 were all significantly higher in the sucrose compared with the sweetener group . After adjusting for differences in body weight changes and fasting values ( week 10 ) , postpr and ial glucose , lactate , insulin , GIP , and GLP-1 were significantly higher and after further adjusting for differences in energy and sucrose intake , postpr and ial lactate , insulin , GIP , and GLP-1 levels were still significantly higher on the sucrose-rich diet . Conclusion A sucrose-rich diet consumed for 10 weeks result ed in significant elevations of postpr and ial glycaemia , insulinemia , and lipidemia compared to a diet rich in artificial sweeteners in slightly overweight healthy subjects Nonnutritive sweeteners have been used to lower the energy density of foods with the intention of affecting weight loss or weight maintenance . However , some epidemiological and animal evidence indicates an association between weight gain or insulin resistance and artificial sweetener consumption . In the present study , we hypothesized that the nonnutritive sweetener sucralose , a trichlorinated sucrose molecule , would elicit responses similar to water but different from sucrose and sucrose combined with sucralose on subjective and hormonal indications of hunger and short-term glucose homeostasis . Eight female volunteers ( body mass index , 22.16 ± 1.71 kg/m(2 ) ; age , 21.75 ± 2.25 years )  consumed sucrose and /or sucralose in water in a factorial design . Blood sample s were taken at fasting and 30 and 60 minutes after treatment followed by a st and ardized breakfast across treatments , and blood sample s were taken 30 , 60 , 90 , and 120 minutes after breakfast . Plasma was analyzed for glucose , insulin , glucagon , triacylglycerols ( TAG ) , and acylated ghrelin . Perceptions of hunger and other subjective measurements were assessed before each blood sample . No differences were detected in subjective responses , circulating triacylglycerol , or glucagon concentrations among treatments over time . Significant differences were observed in insulin , glucose , and acylated ghrelin concentrations over time only between sucrose-containing treatments and non-sucrose-containing treatments regardless of sucralose consumption . Therefore , sucralose may be a relatively inert nonnutritive sweetener with regard to hunger signaling and short-term glucose homeostasis BACKGROUND Concern about the carcinogenic potential of aspartame was raised after an increase in lymphomas and leukemia was reported in an animal study at doses similar to human exposure . Two prospect i ve cohort studies published after the report found inconsistent results for estimated aspartame intake , artificially sweetened beverage consumption , and risk of lymphoid neoplasms . OBJECTIVE The objective of this study was to examine associations of artificially and sugar-sweetened carbonated beverage consumption ( for comparison ) and aspartame intake with risk of non-Hodgkin lymphoma ( NHL )  overall and by major histologic subtype in the Cancer Prevention Study -II Nutrition Cohort . METHODS Among 100,442 adult men and women who provided information on diet and lifestyle factors in 1999 , 1196 NHL cases were verified during a 10-y follow-up period . Cox proportional hazards regression was used to estimate multivariable-adjusted RRs and 95 % CIs . RESULTS In women and men combined , there were no associations of consumption of ≥1 ( 355 mL ) servings/d of artificially ( RR : 0.92 ; 95 % CI : 0.73 , 1.17 ; P-trend : 0.14 ) or sugar- ( RR : 1.10 ; 95 % CI : 0.77 , 1.58 ; P-trend : 0.62 ) sweetened carbonated beverages with NHL risk , compared to no consumption ( P-heterogeneity by gender : 0.11 - 1.00 ) . Similarly , aspartame intake was not associated with NHL risk ( RR : 1.02 ; 95 % CI : 0.84 , 1.24 ; P-trend : 0.69 , top vs. bottom quintile ) . Associations with NHL subtype ( multiple myeloma , diffuse large B-cell lymphoma , chronic lymphocytic leukemia/small lymphocytic lymphoma , and follicular and other B-cell lymphoma ) were generally null . CONCLUSION These findings do not support associations of daily consumption of artificially or sugar-sweetened carbonated beverages , or aspartame , with NHL risk Objective : The purpose of this study was to compare the dietary strategies , and use of fat- and sugar-modified foods and beverages in a  weight loss maintainer group ( WLM ) and an always-normal weight group (NW).Subjects : WLM ( N=172 ) had maintained ⩾10 % weight loss for 11.5 years , and had a body mass index ( BMI ) of 22.0 kg m−2 . NW ( N=131 ) had a BMI of 21.3 kg m−2 and no history of being overweight . Three , 24-h recalls on r and om , non-consecutive days were used to assess dietary intake . Results : WLM reported consuming a diet that was lower in fat ( 28.7 vs 32.6 % , P<0.0001 ) and used more fat-modification strategies than NW . WLM also consumed a significantly greater percentage of modified dairy ( 60 vs 49 % ; P=0.002 ) and  modified dressings and sauces  ( 55 vs 44 % ; P=0.006 ) than NW . WLM reported consuming three times more daily servings of artificially sweetened soft drinks ( 0.91 vs 0.37 ; P=0.003 ) , significantly fewer daily servings of sugar-sweetened soft drinks ( 0.07 vs 0.16 ; P=0.03 ) and more daily servings of water ( 4.72 vs 3.48 ; P=0.002 ) than NW . Conclusions : These findings suggest that WLM use more dietary strategies to accomplish their weight loss maintenance , including greater restriction on fat intake , use of fat- and sugar-modified foods , reduced consumption of sugar-sweetened beverages and increased consumption of artificially sweetened beverages . Ways to promote the use of fat-modified foods and artificial sweeteners merits further research in both prevention- and treatment-controlled trials The rise in pediatric obesity since the 1970s has been well established in the United States and is becoming a major concern worldwide . As a potential means to help slow the obesity epidemic , low-calorie sweeteners ( LCS ) have gained attention as dietary tools to assist in adherence to weight loss plans or prevention of excess weight gain . Observational studies tend to show positive correlations between LCS consumption and weight gain in children and adolescents . Although the data are intriguing , these epidemiologic studies do not establish that LCS cause weight gain , because there are likely many lifestyle and genetic differences between children and families who choose to consume LCS and those who do not . Short-term r and omized controlled trials have shown LCS use to be BMI neutral or to have modest weight-reducing effects in overweight and obese adolescents . The long-term effects of LCS in children and adolescents are unknown . Some compelling research is currently underway and may provide needed insight into the potential role of LCS in weight management . The paucity of data regarding the effects of LCS use in children and adolescents creates challenges in decision-making for health care providers and parents OBJECTIVE To test the hypothesis that substituting artificially sweetened beverages ( ASB ) for sugar-sweetened beverages ( SSB ) decreases intrahepatocellular lipid concentrations ( IHCL ) in overweight subjects with high SSB consumption . METHODS About 31 healthy subjects with BMI greater than 25 kg/m(2 ) and a daily consumption of at least 660 ml SSB were r and omized to a 12-week intervention in which they replaced SSBs with ASBs . Their IHCL ( magnetic resonance spectroscopy ) , visceral adipose tissue volume ( VAT ; magnetic resonance imaging ) , food intake ( 2-day food records ) , and fasting blood concentrations of metabolic markers were measured after a 4-week run-in period and after a 12-week period with ASB or control ( CTRL ) . RESULTS About 27 subjects completed the study .  IHCL was reduced to 74 % of the initial values with ASB ( N = 14 ; P < 0.05 ) but did not change with CTRL . The decrease in IHCL attained with ASB was more important in subjects with IHCL greater than 60 mmol/l than in subjects with low IHCL . ALT decreased significantly with SSB only in subjects with IHCL greater than 60 mmol/l . There was otherwise no significant effect of ASB on body weight , VAT , or metabolic markers . CONCLUSIONS In subjects with overweight or obesity and a high SSB intake , replacing SSB with ASB decreased intrahepatic fat over a 12-week period Background : Substituting sweeteners with non-nutritive sweeteners ( NNS ) may aid in glycaemic control and body weight management . Limited studies have investigated energy compensation , glycaemic and insulinaemic responses to artificial and natural NNS . Objectives : This study compared the effects of consuming NNS ( artificial versus natural ) and sucrose ( 65 g ) on energy intake , blood glucose and insulin responses . Methods : Thirty healthy male subjects took part in this r and omised , crossover study with four treatments : aspartame- , monk fruit- , stevia- and sucrose-sweetened beverages . On each test day , participants were asked to consume a st and ardised breakfast in the morning , and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption . Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day . Results : Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose ( P=0.010 ) . The energy ' saved ' from replacing sucrose with NNS was fully compensated for at subsequent meals ; hence , no difference in total daily energy intake was found between the treatments ( P=0.831 ) . The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour , whereas these responses were higher for all three NNS beverages following the test lunch . Thus , there were no differences in total area under the curve ( AUC ) for glucose ( P=0.960 ) and insulin ( P=0.216 ) over 3 h between the four test beverages . Conclusions : The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake , postpr and ial glucose and insulin compared with a sucrose-sweetened beverage BACKGROUND Artificially sweetened ( AS ) and sugar-sweetened ( SS ) beverages are commonly consumed during pregnancy . A recent Danish study reported that the daily intake of an AS beverage was associated with an increased risk of preterm delivery .  OBJECTIVE We examined the intake of AS and SS beverages in pregnant women to replicate the Danish study and observe whether AS intake is indeed associated with preterm delivery . DESIGN This was a prospect i ve study of 60,761 pregnant women in the Norwegian Mother and Child Cohort Study . Intakes of carbonated and noncarbonated AS and SS beverages and use of artificial sweeteners in hot drinks were assessed by a self-reported food-frequency question naire in midpregnancy . Preterm delivery was the primary outcome , and data were obtained from the Norwegian Medical Birth Registry . RESULTS Intakes of both AS and SS beverages  increased with increasing BMI and energy intake and were higher in women with less education , in daily smokers , and in single women . A high intake of AS beverages was associated with preterm delivery ; the adjusted OR for those drinking > 1 serving/d was 1.11 ( 95 % CI : 1.00 , 1.24 ) . Drinking > 1 serving of SS beverages per day was also associated with an increased risk of preterm delivery ( adjusted OR : 1.25 ; 95 % CI : 1.08 , 1.45 ) . The trend tests were positive for both beverage types . CONCLUSION This study suggests that a high intake of both AS and SS beverages is associated with an increased risk of preterm delivery BACKGROUND Previous studies have linked full-calorie sugar-sweetened beverages ( SSBs ) with greater weight gain and an increased risk of type 2 diabetes . OBJECTIVE We prospect ively examined the association between consumption of SSBs and the risk of coronary heart disease ( CHD ) in women . DESIGN Women ( n = 88,520 ) from the Nurses ' Health Study aged 34 - 59 y , without previously diagnosed coronary heart disease ( CHD ) , stroke , or diabetes in 1980 , were followed from 1980 to 2004 . Consumption of SSBs was derived from 7 repeated food-frequency question naires administered between 1980 and 2002 . Relative risks ( RRs ) for CHD were calculated by using Cox proportional hazards models and adjusted for known cardiovascular disease risk factors . RESULTS During 24 y of follow-up , we ascertained 3105 incident cases of CHD  ( nonfatal myocardial infa rct ion and fatal CHD ) . After st and ard and dietary risk factors were adjusted for , the RRs ( and 95 % CIs ) of CHD according to categories of cumulative average of SSB consumption ( < 1/mo , 1 - 4/mo , 2 - 6/wk , 1/d , and > or = 2 servings/d ) were 1.0 , 0.96 ( 0.87 , 1.06 ) , 1.04 ( 0.95 , 1.14 ) , 1.23 ( 1.06 , 1.43 ) , and 1.35 ( 1.07 , 1.69 ) ( P for trend < 0.001 ) . Additional adjustment for body mass index , energy intake , and incident diabetes attenuated the associations , but they remained significant . Artificially sweetened beverages were not associated with CHD . CONCLUSION Regular consumption of SSBs is associated with a higher  risk of CHD in women , even after other unhealthful lifestyle or dietary factors are accounted for To examine whether artificial sweeteners aid in the control of long-term food intake and body weight , we gave free-living , normal-weight subjects 1150 g soda sweetened with aspartame ( APM ) or high-fructose corn syrup ( HFCS ) per day . Relative to when no soda was given , drinking APM-sweetened soda for 3 wk significantly reduced calorie intake of both females ( n = 9 ) and males ( n = 21 ) and decreased the body weight of males but not of females . However , drinking HFCS-sweetened soda for 3 wk significantly increased the calorie intake and body weight of both sexes . Ingesting either type of soda reduced intake of sugar from the diet without affecting intake of other nutrients . Drinking large volumes of APM-sweetened soda , in contrast to drinking HFCS-sweetened soda , reduces sugar intake and thus may facilitate the control of calorie intake and body weight BACKGROUND It has been extensively shown , mainly in US population s , that sugar-sweetened beverages ( SSBs ) are associated with increased risk of type 2 diabetes ( T2D ) , but less is known about the effects of artificially sweetened beverages ( ASBs ) . OBJECTIVE We evaluated the association between self-reported SSB , ASB , and 100 % fruit juice consumption and T2D risk over 14 y of follow-up in the French prospect i ve Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospect i ve Investigation into Cancer and Nutrition cohort . DESIGN A total of 66,118 women were followed from 1993 , and 1369 incident cases of T2D were diagnosed during the follow-up . Cox regression models were used to estimate HRs and 95 % CIs for T2D risk . RESULTS The average consumption of sweetened beverages in consumers was 328 and 568 mL/wk for SSBs and ASBs , respectively . Compared with nonconsumers , women in the highest quartiles of SSB and ASB consumers were at increased risk of T2D with HRs ( 95 % CIs ) of 1.34 ( 1.05 , 1.71 ) and 2.21 ( 1.56 , 3.14 ) for women who consumed > 359 and > 603 mL/wk of SSBs and ASBs , respectively . Strong positive trends in T2D risk were also observed across quartiles of consumption for both types of beverage ( P = 0.0088 and P < 0.0001 , respectively ) . In sensitivity analyses , associations were partly mediated by BMI , although there was still a strong significant independent effect . No association was observed for 100 % fruit juice consumption . CONCLUSIONS Both SSB consumption and ASB consumption were associated with increased T2D risk . We can not rule out that factors other than ASB consumption that we did not control for are responsible for the association with diabetes , and r and omized trials are required to prove a causal link between ASB consumption and T2D Consumption of sugar-sweetened beverages has been shown , largely in American population s , to increase type 2 diabetes incidence . We aim ed to evaluate the association of consumption of sweet beverages ( juices and nectars , sugar-sweetened soft drinks and artificially sweetened soft drinks ) with  type 2 diabetes incidence in European adults . We established a case – cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study . After exclusions , the final sample size included 11,684 incident cases and a subcohort of 15,374 participants . Cox proportional hazards regression models ( modified for the case – cohort design ) and r and om-effects meta-analyses were used to estimate the association between sweet beverage consumption ( obtained from vali date d dietary question naires ) and type 2 diabetes incidence . In adjusted models , one 336 g ( 12 oz ) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 ( 95 % CI 1.09 , 1.38 ) and 1.52 ( 95 % CI 1.26 , 1.83 ) , respectively . After further adjustment for energy intake and BMI , the association of sugar-sweetened soft drinks with type 2 diabetes persisted ( HR 1.18 , 95 % CI 1.06 , 1.32 ) , but the association of artificially sweetened soft drinks became statistically not significant ( HR 1.11 , 95 % CI 0.95 , 1.31 ) . Juice and nectar consumption was not associated with type 2 diabetes incidence . This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults BACKGROUND Previous laboratory research on alcohol absorption has found that substitution of artificially sweetened alcohol mixers for sucrose-based mixers has a marked effect on the rate of gastric emptying , result ing in elevated blood alcohol concentrations . Studies conducted in natural drinking setting s , such as bars , have indicated that caffeine ingestion while drinking is associated with higher levels of intoxication . To our knowledge , research has not examined the effects of alcohol mixers that contain both an artificial sweetener and caffeine , that is , diet cola . Therefore , we assessed the event-specific association between diet cola consumption and alcohol intoxication in bar patrons . We sought to determine whether putative increases in blood alcohol , produced by accelerated gastric emptying following diet cola consumption , as identified in the laboratory , also appear in a natural setting associated with impaired driving . METHODS We conducted a secondary analysis of data from 2 nighttime field studies that collected anonymous information from 413 r and omly selected bar patrons in 2008 and 2010 . Data sets were merged and recoded to distinguish between energy drink , regular cola , diet cola , and noncaffeinated alcohol mixers . RESULTS Caffeinated alcohol mixers were consumed by 33.9 % of the patrons . Cola-caffeinated mixed drinks were much more popular than those mixed with energy drinks . A large majority of regular cola-caffeinated mixed drink consumers were men ( 75 % ) , whereas diet cola-caffeinated mixed drink consumers were more likely to be women ( 57 % ) . After adjusting for the number of drinks consumed and other potential confounders , number of diet cola mixed drinks had a significant association with patron intoxication ( β = 0.233 , p < 0.0001 ) . Number of drinks mixed with regular ( sucrose-sweetened ) cola and energy drinks did not have significant associations with intoxication ( p > 0.05 ) . CONCLUSIONS Caffeine 's effect on intoxication may be most pronounced when mixers are artificially sweetened , that is , lack sucrose which slows the rate of gastric emptying of alcohol . Risks associated with on-premise drinking may be reduced by greater attention given to types of mixers , particularly diet colas BACKGROUND Sucrose has been shown to have an analgesic effect in preterm and term neonates .  Sucrose , however , has a high osmolarity and may have deleterious effects in infants with fructose intolerance . Furthermore , it may favour caries . We therefore investigated the effects of a commercially available artificial sweetener ( 10 parts cyclamate and 1 part saccharin ) , glycine ( sweet amino acid ) or breast milk in reducing reaction to pain as compared with a placebo . SUBJECTS Eighty healthy term infants , four days old , with normal birth weight . INTERVENTIONS The infants were r and omly assigned to one of four groups : 2 ml sweetener , glycine , expressed breast milk or water were given 2 min before a heel prick for the Guthrie test . The procedure was filmed with a video camera and analysed by two observers who did not know which medication the infant had received . RESULTS Using a multivariate regression analysis , the following variables had significant correlation with relative crying time and recovery time : behavioural state before the intervention , the pricking nurse , and the type of medication . Relative crying time and recovery time were significantly less in the sweetener group but not in the glycine and the breast milk group . CONCLUSIONS The artificial sweetener used in our study reduces pain reaction to a heel prick in term neonates , and thus provides an alternative to sucrose . In contrast , glycine tends to increase pain reaction whereas breast milk has no effect OBJECTIVE To examine the effects of non-alcoholic beverage and caffeine consumption on  all-cause mortality in older adults . METHODS The Leisure World Cohort Study is a prospect i ve study of residents of a California retirement community . A baseline postal health survey included details on coffee , tea , milk , soft drink , and chocolate consumption .  Participants were followed for 23 years ( 1981 - 2004 ) . Risk ratios ( RRs ) of death were calculated using Cox regression for 8644 women and 4980 men ( median age at entry , 74 years ) and adjusted for age , gender , and multiple potential confounders . RESULTS Caffeine consumption exhibited a U-shaped mortality curve . Moderate caffeine consumers had a significantly reduced risk of death ( multivariable-adjusted RR=0.94 , 95 % CI : 0.89 , 0.99 for 100 - 199 mg/day and RR=0.90 , 95 % CI : 0.85 , 0.94 for 200 - 399 mg/day compared with those consuming < 50 mg/day ) . Individuals who drank more than 1 can/week of artificially sweetened ( but not sugar-sweetened ) soft drink ( cola and other ) had an 8 % increased risk ( 95 % CI : 1.01 - 1.16 ) . Neither milk nor tea had a significant effect on mortality after multivariable adjustment . CONCLUSIONS Moderate caffeine consumption appeared beneficial in reducing risk of death . Attenuation in the observed associations between mortality and intake of tea and milk with adjustment for potential confounders suggests that such consumption identifies those with other mortality-associated lifestyle and health risks . The increased death risk with consumption of artificially sweetened , but not sugar-sweetened , soft drinks suggests an effect of the sweetener rather than other components of the soft drinks , although residual confounding remains a possibility
Data from large , epidemiologic studies support the existence of an association between  artificially-sweetened beverage  consumption and weight gain in children .
Epidemiological data have demonstrated an association between artificial sweetener use and  weight gain .
Evidence of a causal relationship linking artificial sweetener use to weight gain and other metabolic health effects is limited .
However , recent animal studies provide intriguing information that supports an active metabolic role of artificial sweeteners .
This systematic review examines the current literature on  artificial sweetener consumption in children and its health effects .