<- Tutti gli studiDolcificantiNonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.
Azad MB, et al. · 2017
PubMed 28716847DOI: 10.1503/cmaj.161390CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne La lettura di LEORevisione sistematica e meta-analisi di 7 RCT (1.003 persone, mediana 6 mesi) E 30 coorti (405.907 persone, mediana 10 anni) — le due fonti danno risposte DIVERSE, ed e' questo il risultato
La domandaI dolcificanti aiutano davvero a perdere peso e a stare meglio?
Cosa hanno trovatoNegli studi randomizzati: nessun effetto significativo sul BMI (differenza media −0,37 kg/m², intervallo che attraversa lo zero). Negli studi di coorte: consumo abituale associato a un lieve AUMENTO del BMI e a piu' obesita', ipertensione, sindrome metabolica, diabete tipo 2 ed eventi cardiovascolari.
Cosa significa per teLa discordanza non e' un difetto dello studio, e' la risposta: quando li si assegna a caso non fanno dimagrire, e chi li usa spontaneamente sta peggio — ma quest'ultimo dato puo' semplicemente voler dire che li usa chi ha gia' un problema di peso. Chiunque prometta certezze in un senso o nell'altro sta guardando meta' dei dati.
Abstract (lingua originale)
BACKGROUND: Nonnutritive sweeteners, such as aspartame, sucralose and stevioside, are widely consumed, yet their long-term health impact is uncertain. We synthesized evidence from prospective studies to determine whether routine consumption of non-nutritive sweeteners was associated with long-term adverse cardiometabolic effects. METHODS: We searched MEDLINE, Embase and Cochrane Library (inception to January 2016) for randomized controlled trials (RCTs) that evaluated interventions for nonnutritive sweeteners and prospective cohort studies that reported on consumption of non-nutritive sweeteners among adults and adolescents. The primary outcome was body mass index (BMI). Secondary outcomes included weight, obesity and other cardiometabolic end points. RESULTS: From 11 774 citations, we included 7 trials (1003 participants; median follow-up 6 mo) and 30 cohort studies (405 907 participants; median follow-up 10 yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference -0.37 kg/m2; 95% confidence interval [CI] -1.10 to 0.36; I2 9%; 242 participants). In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I2 0%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome. INTERPRETATION: Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk. Further research is needed to fully characterize the long-term risks and benefits of nonnutritive sweeteners. Protocol registration: PROSPERO-CRD42015019749.
Come leggerlo: un singolo studio non è una prescrizione. Discuti cambiamenti di dieta o terapia con il tuo diabetologo.
