The effects of artificial- and stevia-based sweeteners on lipid profile in adults: a GRADE-assessed systematic review, meta-analysis, and meta-regression of randomized clinical trials

Mina Movahedian, S. Amirhossein Golzan, Damoon Ashtary-Larky, Cain C.T. Clark, Omid Asbaghi, Azita Hekmatdoost

    Research output: Contribution to journalReview articlepeer-review

    6 Citations (Scopus)

    Abstract

    It has been posited that Non-nutritive sweeteners (NNS) intake may affect lipid profile. However, its proven effects on lipid profile are unclear, as clinical studies on this topic have produced inconsistent results. To fill this gap in knowledge, this systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of artificial- and stevia-based sweeteners consumption on lipid profile markers. To identify eligible RCTs, a systematic search up to April 2021 was completed in PubMed/Medline, Scopus, and EMBASE, using relevant keywords. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI) for TG, TC, and LDL. On the other hand, a fixed-effect model was used to estimate the WMD and 95% CI for HDL. Fourteen RCTs were included in the present meta-analysis. The pooled analysis revealed that NNS did not affect TG (WMD:-1.31, 95% CI:-5.89, 3.27 mg/dl), TC (WMD:-2.27,95% CI:-7.61,3.07 mg/dl), LDL (WMD:1,95% CI: −2.72, 4.71 mg/dl), and HDL (WMD:0.06, 95% CI:-0.62,0.73 mg/dl). Subgroup analysis showed that NNS may be related to a small, but statistically significant, increase in LDL (WMD:4.23, 95% CI:0.50,7.96 mg/dl) in subjects with normal levels of LDL (<100 mg/dl). We found that consumption of artificial- and stevia-based sweeteners is not associated with lipid profile changes in adults. This study has been registered at PROSPERO (registration number: CRD42021250025).

    Original languageEnglish
    Pages (from-to)5063-5079
    Number of pages17
    JournalCritical Reviews in Food Science and Nutrition
    Volume63
    Issue number21
    Early online date9 Dec 2021
    DOIs
    Publication statusPublished - 18 Aug 2023

    Bibliographical note

    Publisher Copyright:
    © 2021 Taylor & Francis Group, LLC.

    Keywords

    • HDL
    • LDL
    • lipid profile
    • Non-nutritive-sweeteners
    • stevia-based sweetener
    • total cholestrol
    • trigliceride

    ASJC Scopus subject areas

    • Food Science
    • Industrial and Manufacturing Engineering

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