Tea-induced calmness: Sugar-sweetened tea calms consumers exposed to acute stressor Sugar-Sweetened Beverage Health Warnings and Purchases: A Randomized Controlled Trial. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake Effect of sugar-sweetened beverages on body weight in children: design and baseline characteristics of the Double-blind, Randomized INtervention study in Kids. The relative reinforcing value of sweet versus savory snack foods after consumption of sugar- or non-nutritive sweetened beverages Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. The impact of ‘on-pack’ pictorial health warning labels and calorie information labels on drink choice: A laboratory experiment Consumption of caloric and non-caloric versions of a soft drink differentially affects brain activation during tasting Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Effect of drinking compared with eating sugars or whey protein on short-term appetite and food intake The Smart Choices front-of-package nutrition label. Influence on perceptions and intake of cereal Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol The Association between Carbohydrate-Rich Foods and Risk of Cardiovascular Disease Is Not Modified by Genetic Susceptibility to Dyslipidemia as Determined by 80 Validated Variants The effect of non-caloric sweeteners on cognition, choice, and post-consumption satisfaction Adolescent beverage habits and changes in weight over time: findings from Project EAT. What do review papers conclude about food and dietary patterns? Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. A trial of sugar-free or sugar-sweetened beverages and body weight in children. The problem of accuracy in dietary surveys. Analysis of the over 65 UK National Diet and Nutrition Survey Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program: A Randomized Clinical Trial. Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women. Food advertising, children’s food choices and obesity: interplay of cognitive defences and product evaluation: an experimental study
The food and beverage industry has been increasingly replacing sugar with non-nutritive sweeteners in their sweetened products to control or reduce total calories . Research comparing the effect of nutritive and non-nutritive sweeteners on emotional state of participants exposed to acute stressors is still limited . This study aim ed to determine the effect of drinking tea sweetened with either a nutritive sweetener ( sugar ) or a non-nutritive sweetener ( sucralose or stevia ) on emotional state , in terms of calmness and pleasantness , of participants exposed to an acute stressor . Effects of acute stress on sweetness intensity and overall liking of tea beverages were also determined . Results showed that the possibility of tea-induced calmness , calculated as the difference between calmness ratings after and before drinking a tea sample , was established on stress session in the sugar-sweetened tea .  Overall liking , but not the sweetness intensity , of the sugar-sweetened tea was affected by acute stress . In conclusion , this study provides empirical evidence that the consumption of tea sweetened with nutritive sweetener , but not with non-nutritive sweetener , has calming effect on consumers with acute stress , suggesting that this effect may not be due to the sweet taste of sugar , but due to the caloric nature of the sweetener INTRODUCTION Five U.S. states have proposed policies to require health warnings on sugar-sweetened beverages , but warnings ' effects on actual purchase behavior remain uncertain . This study evaluated the impact of sugar-sweetened beverage health warnings on sugar-sweetened beverage purchases . STUDY DESIGN Participants completed one study visit to a life-sized replica of a convenience store in North Carolina . Participants chose six items ( two beverages , two foods , and two household products ) . One item was r and omly selected for them to purchase and take home . Participants also completed a question naire . Research ers collected data in 2018 and conducted analyses in 2019 . SETTING / PARTICIPANTS Participants were a demographically diverse convenience sample of 400 adult sugar-sweetened beverage consumers ( usual consumption ≥12 ounces/week ) . INTERVENTION Research staff r and omly assigned participants to a health warning arm ( sugar-sweetened beverages in the store displayed a front-of-package health warning ) or a control arm ( sugar-sweetened beverages displayed a control label ) . MAIN OUTCOME MEASURES The primary trial outcome was sugar-sweetened beverage calories purchased . Secondary outcomes included reactions to trial labels ( e.g. , negative emotions ) and sugar-sweetened beverage perceptions and attitudes ( e.g. , healthfulness ) . RESULTS All 400 participants completed the trial and were included in analyses . Health warning arm participants were less likely to be Hispanic and to have overweight/obesity than control arm participants . In intent-to-treat analyses adjusting for Hispanic ethnicity and overweight/obesity , health warnings led to lower sugar-sweetened beverage purchases ( adjusted difference , -31.4 calories ; 95 % CI= -57.9 , -5.0 ) . Unadjusted analyses yielded similar results ( difference , -32.9 calories ; 95 % CI= -58.9 , -7.0 ) . Compared with the control label , sugar-sweetened beverage health warnings also led to higher intentions to limit sugar-sweetened beverage consumption and elicited more attention , negative emotions , thinking about the harms of sugar-sweetened beverage consumption , and anticipated social interactions . Trial arms did not differ on perceptions of sugar-sweetened beverages ' added sugar content , healthfulness , appeal/coolness , or disease risk . CONCLUSIONS Brief exposure to health warnings reduced sugar-sweetened beverage purchases in this naturalistic RCT . Sugar-sweetened beverage health warning policies could discourage sugar-sweetened beverage consumption . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT03511937 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 Intake of sugar-sweetened beverages is associated with overweight in observational studies . A possible explanation is that liquid sugars do not satiate and that their intake is not compensated by reduced caloric intake from other foods . However , evidence from intervention studies for this hypothesis is inconclusive because previous studies were not blinded . Hence results may have been influenced by expectations and behavioral cues rather than by physiological mechanisms . METHODS We design ed the Double-blind , R and omized INtervention study in Kids ( DRINK ) to examine the effect on body weight of covertly replacing sugar-sweetened by sugar-free beverages .  Children were only eligible if they habitually drank sugar-sweetened beverages . We recruited 642 healthy children ( mean age 8.2 , range 4.8 - 11.9 ) . We design ed , tested and produced custom-made beverages containing 10 % sugar and sugar-free beverages with the same sweet taste and look . Children receive one 250 mL can of study beverage daily for 18 months . We perform body measurements at 0 , 6 , 12 and 18 months . The primary outcome is the z-score of BMI for age . The maximum predicted difference in this score between groups is 0.72 , which corresponds with a difference in body weight of 2.3 kg . DISCUSSION The double-blind design eliminates behavioral factors that affect body weight . If children gain less body fat when drinking sugar-free than when drinking sugar-sweetened beverages that would show that liquid sugar indeed bypasses biological satiation mechanisms . It would also suggest that a reduction in liquid sugars could decrease body fat more effectively than reduction of other calorie sources The effects of sugar-sweetened ( SSB ) and non-nutritive sweetened ( NSB ) beverages on the regulation of appetite , energy intake and body weight regulation remain controversial . Using a behavioral choice paradigm , we sought to determine the effects of consuming a SSB or NSB on appetite and the reinforcing value of sweet relative to salty/savory snack foods . In a r and omized crossover study , 21 healthy weight adults consumed 360 ml of SSB ( sucrose ; 31 g ) or NSB ( sucralose ; 4 g ) with a st and ardized meal . Hedonic ratings for the sweet and salty/savory snack foods used for the reinforcement task were assessed prior to the start of the study . Satiety and the desire to eat foods with a specific taste profile were assessed before and every 30 min post-meal for 4 h. The relative reinforcing value of the snack foods was assessed using a computer-based choice task ( operant responding with concurrent schedules of reinforcement ) 4 h post-meal . Hedonic ratings did not differ between the most highly liked sweet and salty/savory snack foods . Beverage type did not influence measures of satiety or the desire to eat foods with a specific taste . However , sweet snacks were more ( p < 0.05 ) reinforcing relative to salty/savory snack foods after consuming a NSB than after a SSB . In conclusion , this is the first study to demonstrate that NSB can increase the motivation to gain access to sweet snacks relative to salty/savory snack foods later in the day BACKGROUND Consumption of low-calorie sweeteners ( LCSs ) has increased markedly during the past several decades , yet the prevalence of LCS consumption in recent years is currently unknown . OBJECTIVE The aim of this study was to describe LCS consumption in the United States and to characterize consumption by sociodemographic subgroups , source , frequency , eating occasion , and location . DESIGN Cross-sectional study using National Health and Nutrition Examination Survey data from 2009 to 2012 . The prevalence of LCS consumption was assessed using two 24-hour dietary recalls , while the frequency ( number of times per day ) , occasion ( meal vs snack vs alone ) , and location of LCS consumption ( at home vs away from home ) was assessed using data from the one , in-person , 24-hour dietary recall . PARTICIPANTS National Health and Nutrition Examination Survey participants ( 2 years old or older ) either in 2009 - 2010 ( n=9,047 ) or in 2011 - 2012 ( n=7,939 ) . After excluding participants with implausible energy intake ( n=44 ) , the final sample size was 16,942 . MAIN OUTCOME MEASURES The primary outcome was the proportion of individuals consuming one or more foods , beverages , or packets containing LCSs  during at least one of their two dietary recalls . STATISTICAL ANALYSES PERFORMED Data were weighted to provide national estimates and Stata frequency procedures for complex survey design were used for all analyses . RESULTS Our findings were that 25.1 % of children and 41.4 % adults reported consuming LCSs . Most LCS consumers reported use once daily ( 80 % of children , 56 % of adults ) and frequency of consumption increased with body weight in adults . LCS consumption was higher in females compared with males among adults , and in obese individuals , compared with overweight and normal-weight individuals . Individuals of non-Hispanic white race/ethnicity also had higher prevalence of consumption compared with non-Hispanic blacks and Hispanics and those in the highest tertile of income had higher LCS consumption compared with individuals of middle or low income across LCS product categories in adults , and for LCS beverages and LCS foods in children . Most LCS consumers reported consuming  LCS  with meals ( 64 % of adults , 62 % of children ) and the majority of LCS consumption occurred at home ( 71 % and 72 % among adults and children , respectively ) . CONCLUSIONS LCS consumption is highly prevalent in the United States , among both children and adults . Well-controlled , prospect i ve trials are required to underst and the health impact of this widespread LCS exposure Sugar-sweetened beverages ( SSBs ) are one of the largest added sugar sources to diets in the UK and USA . Health warning labels reduce hypothetical selection of SSBs in online studies but uncertainty surrounds their impact on selection of drinks for consumption . Calorie information labels are also promising but their impact on SSB selection is unclear . This laboratory study assessed the impact on SSB selection of ' on-pack ' labels placed directly on physical products : i.a pictorial health warning label depicting an adverse health consequence of excess sugar consumption ; and ii.calorie information labels . Potential moderation of any effects by socio-economic position ( SEP ) was also examined . Participants - 401 adults , resident in Engl and , approximately half of whom were of lower SEP and half of higher SEP , were asked to select a drink from a range of two non-SSBs and four SSBs ( subsequent to completing a separate study assessing the effects of food availability on snack selection ) . The drinks included ' on-pack ' labels according to r and omisation : Group 1:pictorial health warning label on SSBs ; Group 2:calorie information label on all drinks ; Group 3:no additional label . The primary outcome was the proportion of participants selecting an SSB . Compared to not having additional labels ( 39 % ) , neither the pictorial health warning label ( 40 % ) nor calorie information labels ( 43 % ) affected the proportion of participants selecting an SSB . Lower SEP participants ( 45 % ) were more likely to select an SSB compared to those of higher SEP ( 35 % ) , but SEP did not moderate the impact of labels on drink selection . In conclusion , pictorial health warning labels may be less effective in reducing SSB selection in lab-based compared with online setting s , or depending on label design and placement . Findings suggest that effects might be absent when choosing from real products with actual ' on-pack ' labels , positioned in a ' realistic ' manner . Field studies are needed to further assess the impact of ' on-pack ' SSB warning labels in real-world setting s to rule out the possible contribution of study design factors Sensory-specific satiety , which is defined as a relative decrease in pleasantness , is increased by greater oro-sensory stimulation . Both sensory-specific satiety and pleasantness affect taste activation in the orbitofrontal cortex . In contrast , metabolic satiety , which results from energy intake , is expected to modulate taste activation in reward areas . The aim of this study was to determine the effects of the amount of oro-sensory stimulation and energy content on consumption-induced changes in taste activation .  Ten men participated in a 2 × 2 r and omized crossover study . Subjects were scanned twice using functional magnetic resonance imaging : after fasting for at least 2h and after treatment , on four occasions . Treatment consisted of the ingestion of 450 mL of orangeade ( sweetened with 10 % sucrose or non-caloric sweeteners ) at 150 mL/min , with either small ( 5 mL ) or large ( 20 mL ) sips . During scanning , subjects alternately tasted orangeade , milk and tomato juice and rated its pleasantness . Before and after the scans , subjects rated pleasantness , prospect i ve consumption , desire to eat and sweetness for all tastants . Main findings were that , before treatment , the amygdala was activated more by non-caloric than by caloric orangeade . Caloric orangeade activated part of the striatum before , but not after treatment . We observed no main effects of sip size on taste activation and no interaction between sip size and caloric content . In conclusion , the brain responds differentially to caloric and non-caloric versions of a sweet drink and consumption of calories can modulate taste activation in the striatum . Further research is needed to confirm that the observed differences are due to caloric content and not to ( subliminal ) differences in the sensory profile . In addition , implication s for the effectiveness of non-caloric sweeteners in decreasing energy intake need to be established BACKGROUND Type 2 diabetes mellitus is an increasingly serious health problem among African American women . Consumption of sugar-sweetened drinks was associated with an increased risk of diabetes in 2 studies but not in a third ; however , to our knowledge , no data are available on African Americans regarding this issue . Our objective was to examine the association between consumption of sugar-sweetened beverages , weight gain , and incidence of type 2 diabetes mellitus in African American women . METHODS A prospect i ve follow-up study of 59,000 African American women has been in progress since 1995 . Participants reported on food and beverage consumption in 1995 and 2001 . Biennial follow-up question naires ascertained new diagnoses of type 2 diabetes . The present analyses included 43,960 women who gave complete dietary and weight information and were free from diabetes at baseline . We identified 2713 incident cases of type 2 diabetes mellitus during 338,884 person-years of follow-up . The main outcome measure was the incidence of type 2 diabetes mellitus . RESULTS The incidence of type 2 diabetes mellitus was higher with higher intake of both sugar-sweetened soft drinks and fruit drinks . After adjustment for confounding variables including other dietary factors , the incidence rate ratio for 2 or more soft drinks per day was 1.24 ( 95 % confidence interval , 1.06 - 1.45 ) . For fruit drinks , the comparable incidence rate ratio was 1.31 ( 95 % confidence interval , 1.13 - 1.52 ) . The association of diabetes with soft drink consumption was almost entirely mediated by body mass index , whereas the association with fruit drink consumption was independent of body mass index . CONCLUSIONS Regular consumption of sugar-sweetened soft drinks and fruit drinks is associated with an increased risk of type 2 diabetes mellitus in African American women . While there has been increasing public awareness of the adverse health effects of soft drinks , little attention has been given to fruit drinks , which are often marketed as a healthier alternative to soft drinks Background : It is hypothesized that a solid form of food or food components suppresses subjective appetite and short-term food intake ( FI ) more than a liquid form . Objective : To compare the effect of eating solid vs drinking liquid forms of gelatin , sucrose and its component mixtures , and whey protein , on  subjective appetite and FI in young men . Design and subjects : A r and omized crossover design was used in three experiments in which the subjects were healthy males of normal weight .  Solid and liquid forms of gelatin ( 6 g ) ( experiment 1 , n=14 ) , sucrose ( 75 g ) and a mixture of 50 % glucose/50 % fructose ( G50:F50 ) ( experiment 2 , n=15 ) , and acid and sweet whey protein ( 50 g ) ( experiment 3 , n=14 ) were compared . The controls were water ( experiments 1 and 3 ) and calorie-free sweetened water with gelatin ( sweet gelatin , experiment 1 ) or calorie-free sweetened water ( sweet control , experiment 2 ) . Subjective average appetite was measured by visual analog scales over 1 h and ad libitum FI was measured 1 h after treatment consumption . Results : Average appetite area under the curve was not different between solid and liquid forms of sugars , but was larger , indicating greater satiety for solid compared with liquid forms of gelatin and sweet , but not acid whey protein . The FI was not different from that of control because of solid or liquid sugars or gelatin treatments . However , both solid and liquid forms of whey protein , with no difference among them , suppressed FI compared with control ( P<0.05 ) . Conclusion : Macronutrient composition is more important than physical state of foods in determining subjective appetite and FI Numerous front-of-package ( FOP ) nutrition labeling systems exist , but it is unclear if such labels influence behavior . A single- summary label called Smart Choices ( SC ) appeared briefly on products in the United States in 2009 . The current study aim ed to evaluate ( 1 ) the influence the SC symbol has on the serving and consumption of cereal ; and ( 2 ) the impact of providing calorie and serving size information on a FOP label . Two hundred and sixteen adults were r and omized to a high-sugar breakfast cereal  that had either ( 1 ) no label ; ( 2 ) the SC symbol ; or ( 3 ) a modified SC symbol with serving size information . Participants rated perceptions of healthfulness , taste , and purchase intent , estimated calories per serving and poured and ate the cereal for breakfast . Participants in the SC label conditions were better able to estimate calories per serving , but there were no differences across groups on perceptions of healthfulness , taste , purchase intent , and levels of vitamins , and sugar or amount of cereal poured or consumed . These results suggest that calories per serving information on FOP labels can increase knowledge , but the SC symbol had little impact on behavior . Studies examining FOP label influence on purchasing , consumption , and product reformulation are greatly needed to determine label utility CONTEXT Sugar-sweetened beverages like soft drinks and fruit punches contain large amounts of readily absorbable sugars and may contribute to weight gain and an increased risk of type 2 diabetes , but these relationships have been minimally addressed in adults . OBJECTIVE To examine the association between consumption of sugar-sweetened beverages and weight change and  risk of type 2 diabetes in women . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort analyses conducted from 1991 to 1999 among women in the Nurses ' Health Study II . The diabetes analysis included 91,249 women free of diabetes and other major chronic diseases at baseline in 1991 . The weight change analysis included 51,603 women for whom complete dietary information and body weight were ascertained in 1991 , 1995 , and 1999 . We identified 741 incident cases of confirmed type 2 diabetes during 716,300 person-years of follow-up . MAIN OUTCOME MEASURES Weight gain and incidence of type 2 diabetes . RESULTS Those with stable consumption patterns had no difference in weight gain , but weight gain over a 4-year period was highest among women who increased their sugar-sweetened soft drink consumption from 1 or fewer drinks per week to 1 or more drinks per day ( multivariate-adjusted means , 4.69 kg for 1991 to 1995 and 4.20 kg for 1995 to 1999 ) and was smallest among women who decreased their intake ( 1.34 and 0.15 kg for the 2 periods , respectively ) after adjusting for lifestyle and dietary confounders . Increased consumption of fruit punch was also associated with greater weight gain compared with decreased consumption . After adjustment for potential confounders , women consuming 1 or more sugar-sweetened soft drinks per day had a relative risk [ RR ] of type 2 diabetes of 1.83 ( 95 % confidence interval [ CI ] , 1.42 - 2.36 ; P<.001 for trend ) compared with those who consumed less than 1 of these beverages per month . Similarly , consumption of fruit punch was associated with increased diabetes risk ( RR for > or = 1 drink per day compared with < 1 drink per month , 2.00 ; 95 % CI , 1.33 - 3.03 ; P = .001 ) . CONCLUSION Higher consumption of sugar-sweetened beverages is associated with a greater magnitude of weight gain and an increased risk for development of  type 2 diabetes in women , possibly by providing excessive calories and large amounts of rapidly absorbable sugars Background Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide . Most chronic diseases are associated with underlying preventable risk factors , such as elevated blood pressure , high blood glucose or glucose intolerance , high lipid levels , physical inactivity , excessive sedentary behaviours , and overweight/obesity . The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood . Sugar-sweetened beverages are known to be significant sources of additional caloric intake , and given recent attention to their contribution in the development of chronic diseases , a systematic review is warranted . We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are . Methods / Design Of interest are studies addressing sugar-sweetened beverage consumption , taking a broad perspective . Both direct consumption studies as well as those evaluating interventions that influence consumption ( e.g. school policy , educational ) will be relevant . Non-specific or multi-faceted behavioural , educational , or policy interventions may also be included subject to the level of evidence that exists for the other interventions /exposures . Comparisons of interest and endpoints of interest are pre-specified . We will include r and omized controlled trials , controlled clinical trials , interrupted time series studies , controlled before-after studies , prospect i ve and retrospective comparative cohort studies , case – control studies , and nested case – control design s. The MEDLINE ® , Embase , The Cochrane Library , CINAHL , ERIC , and PsycINFO ® data bases and grey literature sources will be search ed . The processes for selecting studies , abstract ing data , and resolving conflicts are described . We will assess risk of bias using design -specific tools . To determine sets of confounding variables that should be adjusted for , we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessment s. Meta- analysis will be conducted where appropriate ; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified . The Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach will be used to determine the quality of evidence for outcomes . Systematic review registration PROSPERO CRD42014009641 Background It is still unclear whether carbohydrate consumption is associated with cardiovascular disease ( CVD ) risk . Genetic susceptibility might modify the associations between dietary intakes and disease risk . Objectives The aim was to examine the association between the consumption of carbohydrate-rich foods ( vegetables , fruits and berries , juice , potatoes , whole grains , refined grains , cookies and cakes , sugar and sweets , and sugar-sweetened beverages ) and the risk of incident ischemic CVD ( iCVD ; coronary events and ischemic stroke ) , and whether these associations differ depending on genetic susceptibility to dyslipidemia . Methods Among 26,445 individuals ( 44–74 years ; 62 % females ) from the Malmö Diet and Cancer Study cohort , 2,921 experienced an iCVD event during a mean follow-up time of 14 years . At baseline , dietary data were collected using a modified diet history method , and clinical risk factors were measured in 4,535 subjects . We combined 80 vali date d genetic variants associated with triglycerides and HDL-C or LDL-C , into genetic risk scores and examined the interactions between dietary intakes and genetic risk scores on the incidence of iCVD . Results Subjects in the highest intake quintile for whole grains had a 13 % ( 95 % CI : 3–23 % ; p-trend : 0.002 ) lower risk for iCVD compared to the lowest quintile . A higher consumption of foods rich in added sugar ( sugar and sweets , and sugar-sweetened beverages ) had a significant cross-sectional association with higher triglyceride concentrations and lower HDL-C concentrations . A stronger positive association between a high consumption of sugar and sweets on iCVD risk was observed among those with low genetic risk score for triglycerides ( p-interaction=0.05 ) . Conclusion In this prospect i ve cohort study that examined food sources of carbohydrates , individuals with a high consumption of whole grains had a decreased risk of iCVD . No convincing evidence of an interaction between genetic susceptibility for dyslipidemia , measured as genetic risk scores of dyslipidemia-associated variants , and the consumption of carbohydrate-rich foods on iCVD risk was observed Consumers often turn to non-caloric sweeteners ( NCS ) as a means of promoting a healthy body weight . However , several studies have now linked their long-term use to increased weight gain , raising the question of whether these products produce unintended psychological , physiological , or behavioral changes that have implication s for weight management goals . In the following , we present the results of three experiments bearing on this issue , testing whether NCS-consumption influences how  individuals think about and respond to food .  Participants in each of our three experiments were r and omly assigned to consume a sugar-sweetened beverage , an unsweetened beverage , or a beverage sweetened with NCS . We then measured their cognition ( Experiment 1 ) , product choice ( Experiment 2 ) , and subjective responses to a sugar-sweetened food ( Experiment 3 ) . Results revealed that consuming NCS-sweetened beverages influences psychological processes in ways that - over time - may increase calorie intake BACKGROUND Obesity in adolescence has been increasing in the past several decades . Beverage habits among adolescents include increased consumption of sugar-sweetened beverages and decreased consumption of milk . OBJECTIVE This study aim ed to examine the association between beverage consumption and 5-y body weight change  in 2294 adolescents . DESIGN Project EAT ( Eating Among Teens ) is a 5-y longitudinal study of eating patterns among adolescents . Surveys were completed in 1998 - 1999 ( time 1 ) and in 2003 - 2004 ( time 2 ) . Multivariable linear regression was used to examine the association between beverage consumption at time 2 and change in body mass index from time 1 to time 2 , with adjustments for age , socioeconomic status , race , cohort , physical activity , sedentary behavior , coffee , tea , time 1 body mass index , and beverage variables . RESULTS In prospect i ve analyses , consumption of beverages was not associated with weight gain , except for consumption of low-calorie soft drinks ( positive association , P = 0.002 ) and white milk ( inverse association , P = 0.03 ) , but these associations did not appear to be a monotonic linear dose-response relation . The positive association with low-calorie soft drinks was no longer present after adjustment for dieting and parental weight-related concerns , which suggests that the use of low-calorie soft drinks is a marker for more general dietary behaviors and weight concerns . CONCLUSIONS We showed no association between sugar-sweetened beverage consumption , juice consumption , and adolescent weight gain over a 5-y period . A direct association between diet beverages and weight gain appeared to be explained by dieting practice s. Adolescents who consumed little or no white milk gained significantly more weight than their peers who consumed white milk . Future research that examines beverage habits and weight among adolescents should address portion sizes , adolescent maturation , and dieting behaviors Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways . Therefore , associations between single nutrients and chronic disease may be difficult to identify and interpret , but when dietary patterns ( DPs ) are examined the combination of many food factors will be considered . An explorative literature search of published review articles was conducted to obtain a fuller underst and ing of current DPs in epidemiological research , to discuss pros and cons of DPs in nutrition research , and to identify results of studies linking DPs to chronic disease risk in adults . R and omized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits . Systematic review s of feeding trials and prospect i ve population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs . However , to date only a few review articles of DP studies have followed a systematic process using independent review ers with strict inclusion , exclusion , and study quality criteria . Diets with plenty of plants foods , fish , and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases . In contrast , Western-type DPs with food products low in essential nutrients and high in energy , like sugar-sweetened beverages , sweets , refined cereals and solid fats ( e.g. butter ) , and high in red and processed meats , are associated with adverse health effects . An emphasis on high- quality original research , and systematic review s following a structured process to objective ly select and judge studies , is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease To test the hypothesis that endogenous opiate peptides selectively influence hedonic response to sweet and high-fat foods , the opiate antagonist naloxone , opiate agonist butorphanol , and a saline placebo were administered by intravenous infusion to 16 obese and 25 normal-weight women . Twenty of the women ( 10 obese , 10 lean ) fulfilled DSM-III-R diagnostic criteria for bulimia nervosa , as determined by psychiatric interview . During drug infusion the women tasted and rated 20 sweetened dairy products and were presented with eight snack foods of varying sugar and fat content . Naloxone suppressed hedonic responses in all subject groups and suppressed the consumption of sweet and high-fat foods in binge eaters , but not in nonbingers . Food intakes of obese women were not affected by naloxone . Butorphanol had no effect on either hedonic response or on food consumption in any group . Although opiate blockade is not a viable strategy for weight reduction in the treatment of obesity , it may be useful in the clinical management of the binge-eating disorder BACKGROUND The consumption of beverages that contain sugar is associated with overweight , possibly because liquid sugars do not lead to a sense of satiety , so the consumption of other foods is not reduced . However , data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain . METHODS We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age . Participants were r and omly assigned to receive 250 ml ( 8 oz ) per day of a sugar-free , artificially sweetened beverage ( sugar-free group ) or a similar sugar-containing beverage that provided 104 kcal ( sugar group ) . Beverages were distributed through schools . At 18 months , 26 % of the children had stopped consuming the beverages ; the data from children who did not complete the study were imputed . RESULTS The z score for the body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group ; the 95 % confidence interval ( CI ) of the difference was -0.21 to -0.05 . Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group ( 95 % CI for the difference , -1.54 to -0.48 ) . The skinfold-thickness measurements , waist-to-height ratio , and fat mass also increased significantly less in the sugar-free group . Adverse events were minor . When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study , the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group ( P=0.06 ) . CONCLUSIONS Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children . ( Funded by the Netherl and s Organization for Health Research and Development and others ; DRINK Clinical Trials.gov number , NCT00893529 . ) STUDY OBJECTIVE To investigate the prevalence and nature of low energy reporting in a dietary survey of British adults over 65 years of age . DESIGN R and omly selected cross sectional sample of 2060 British adults over 65 years . Four day weighed food diaries and question naires on health , lifestyle and socioeconomic characteristics . SETTING Great Britain . PARTICIPANTS 539 women and 558 men over 65 years who were free living and completed four day food diaries .  MAIN RESULTS A high proportion of men and women were classified as low energy reporters ( LERs ) . Reported consumption of full fat dairy products , sugar and sweet foods , and alcoholic drinks differed most between LERs and non-LERs . Among LERs , reported protein and starch intakes were higher , fat , sugar and alcohol intakes were lower . LERs of either sex were more likely to be obese , male LERs were also more likely to belong to the manual social classes . CONCLUSIONS The high level of low energy reporting probably result ed from a coalescence of factors such as the weighed diary methodology and a reluctance to report consumption of unhealthy foods . The use of validatory biomarkers such as doubly labelled water needs to be more widespread Importance Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program ( SNAP ) are of interest to policymakers . Objective To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants ' diets . Design , Setting , and Participants Lower income participants ( n = 279 ) not currently enrolled in SNAP were r and omized to 1 of 4 experimental financial food benefit conditions : ( 1 ) incentive ( 30 % financial incentive for fruits and vegetables purchased using food benefits ) ; ( 2 ) restriction ( not allowed to buy sugar sweetened beverages , sweet baked goods , or c and ies with food benefits ) ; ( 3 ) incentive plus restriction ( 30 % financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages , sweet baked goods , or c and y with food benefits ) ; or ( 4 ) control ( no incentive or restrictions on foods purchased with food benefits ) . Participants in all conditions were given a study -specific debit card where funds were added every 4 weeks for a 12-week period . Outcome measures were collected at baseline and in the final 4 weeks of the experimental period . Main Outcomes and Measures Primary outcomes ( from 24-hour dietary recalls ) included intake of energy , discretionary calories , and overall diet quality . Results A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition . These included ( 1 ) reduced intake of energy ( -96 kcal/d , st and ard error [ SE ] , 59.9 ) ; ( 2 ) reduced intake of discretionary calories ( -64 kcal/d , SE 26.3 ) ; ( 3 ) reduced intake of sugar sweetened beverages , sweet baked goods , and c and ies ( -0.6 servings/d , SE 0.2 ) ; ( 4 ) increased intake of solid fruit ( 0.2 servings/d , SE 0.1 ) ; and ( 5 ) improved Healthy Eating Index score ( 4.1 points , SE 1.4 ) . Fewer improvements were observed in the incentive only and restriction only arms . Conclusions and Relevance A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions . Clinical Trial Registration clinical trials.gov Identifier : NCT02643576 BACKGROUND Despite safety reports of the artificial sweetener aspartame , health-related concerns remain . OBJECTIVE We prospect ively evaluated whether the consumption of aspartame- and sugar-containing soda is associated with  risk of hematopoetic cancers .  DESIGN We repeatedly assessed diet in the Nurses ' Health Study ( NHS ) and Health Professionals Follow-Up Study ( HPFS ) . Over 22 y , we identified 1324 non-Hodgkin lymphomas ( NHLs ) , 285 multiple myelomas , and 339 leukemias . We calculated incidence RRs and 95 % CIs by using Cox proportional hazards models . RESULTS When the 2 cohorts were combined , there was no significant association between soda intake and risks of NHL and multiple myeloma . However , in men , ≥1 daily serving of diet soda  increased risks of NHL ( RR : 1.31 ; 95 % CI : 1.01 , 1.72 ) and multiple myeloma ( RR : 2.02 ; 95 % CI : 1.20 , 3.40 ) in comparison with men who did not consume diet soda . We observed no increased risks of NHL and multiple myeloma in women . We also observed an unexpected elevated risk of NHL ( RR : 1.66 ; 95 % CI : 1.10 , 2.51 ) with a higher consumption of regular , sugar-sweetened soda in men but not in women . In contrast , when sexes were analyzed separately with limited power , neither regular nor diet soda  increased risk of leukemia but were associated with increased leukemia risk when data for men and women were combined ( RR for consumption of ≥1 serving of diet soda/d when the 2 cohorts were pooled : 1.42 ; 95 % CI : 1.00 , 2.02 ) . CONCLUSION Although our findings preserve the possibility of a detrimental effect of a constituent of diet soda , such as aspartame , on select cancers , the inconsistent sex effects and occurrence of an apparent cancer risk in individuals who consume regular soda do not permit the ruling out of chance as an explanation Objectives : To investigate the role of product evaluations , nutritional and persuasion knowledge on children ’s food choices conducted because of limited evidence about the role of product evaluations on consumer choices in conjunction with cognitive defences . Design : A r and omised controlled 2 × 2 factorial experiment with an exposure to a food and a control ( toy ) advertisement conducted in a non-laboratory setting at an annual event traditionally visited by families . Subjects : Children aged 7–13 years with biometric/weight data representative of the general Australian population . Measurements : Height and weight ( converted into body mass index z-scores ) measured in addition to children ’s nutritional and persuasion knowledge , product evaluations , age and gender . Results : The factors that undermine children ’s cognitive defences relate to taste , social appeal of foods and low nutritional and persuasion knowledge . An interplay between the above-mentioned factors was also observed , identifying four groups among young consumers , alluding to a complex and at times impulsive nature of children ’s decisions : ( 1 ) knowledgeable children with less positive product evaluations choosing a healthy snack ; ( 2 ) knowledgeable but hedonism-oriented children seeking peer conformity choosing an advertised product ; ( 3 ) knowledgeable children who chose a snack belonging to the same product category ; and ( 4 ) less knowledgeable children with positive product evaluations and low nutritional knowledge choosing snacks from the advertised product category . Obese children were more likely to belong to a cluster of less knowledgeable and hedonism-oriented children . Conclusions : The problem of consumption of less healthy foods is complex and multiple factors need to be considered by health practitioners , social marketers and parents to address the issue of childhood obesity . Nutritional knowledge alone is not sufficient to ensure children make healthier food choices and emphasis should also be placed on persuasion knowledge education , targeting of peer norms , self-efficacy and stricter regulation of advertising aim ed at children
In healthy subjects , appetite and short term food intake , risk of cancer , risk of diabetes , risk of dental caries , weight gain and risk of obesity are the most investigated health outcomes .
Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes .
In subjects with diabetes and hypertension , the evidence regarding health outcomes of NNS use is also inconsistent .
Background Food products containing non-nutritive sweeteners ( NNSs ) instead of sugar have become increasingly popular in the last decades .
Their appeal is obviously related to their calorie-free sweet taste .
However , with the dramatic increase in their consumption , it is reasonable and timely to evaluate their potential health benefits and , more importantly , potential adverse effects .
The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent , range , and nature of research activity in this area .