Kalorifria sötningsmedel och kardiometabol hälsa

[King Grub]

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.

Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ July 17, 2017 vol. 189 no. 28.

http://www.cmaj.ca/content/189/28/E929

[ceejay]

Case of kausalitet och korrelation? Finns väl en hel del studier som har korrelerat lightläsk med övervikt.

[Luca Brasi]

Ursprungligen postat av ceejay

Case of kausalitet och korrelation? Finns väl en hel del studier som har korrelerat lightläsk med övervikt.

I de trettio kohort studierna som man har tittat på?

[upperkatt]

Ursprungligen postat av Luca Brasi

I de trettio kohort studierna som man har tittat på?

Three types of observational studies include cohort studies, case-control studies, and cross-sectional studies (Figure 1). Case-control and cohort studies offer specific advantages by measuring disease occurrence and its association with an exposure by offering a temporal dimension (i.e. prospective or retrospective study design). Cross-sectional studies, also known as prevalence studies, examine the data on disease and exposure at one particular time point (Figure 2).6 Because the temporal relationship between disease occurrence and exposure cannot be established, cross-sectional studies cannot assess the cause and effect relationship.

Song, J. W., & Chung, K. C. (2010). Observational studies: cohort and case-control studies. Plastic and reconstructive surgery, 126(6), 2234.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998589/

[3bz]

Ursprungligen postat av upperkatt

Song, J. W., & Chung, K. C. (2010). Observational studies: cohort and case-control studies. Plastic and reconstructive surgery, 126(6), 2234.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998589/

Du kanske borde läsa den citerade texten igen, det du fetade handlar om cross-sectional, inte prospective cohort studies som är det bästa epidemiologin har att erbjuda. Med det sagt så är det ju inte optimalt, men det går ju inte alltid att göra RCTs.

Sen är det ju inte heller alltid optimalt att göra en RCT iom tidsaspekten, ibland kan det vara bra att ha sämre data som sträcker sig över en längre tid, då inte allting ger en effekt inom en kort tid.

[upperkatt]

Ursprungligen postat av Luca Brasi

I de trettio kohort studierna som man har tittat på?

[QUOTE=upperkatt;7796076]Song, J. W., & Chung, K. C. (2010). Observational studies: cohort and case-control studies. Plastic and reconstructive surgery, 126(6), 2234.

Ursprungligen postat av 3bz

Du kanske borde läsa den citerade texten igen, det du fetade handlar om cross-sectional, inte prospective cohort studies som är det bästa epidemiologin har att erbjuda. Med det sagt så är det ju inte optimalt, men det går ju inte alltid att göra RCTs.

Sen är det ju inte heller alltid optimalt att göra en RCT iom tidsaspekten, ibland kan det vara bra att ha sämre data som sträcker sig över en längre tid, då inte allting ger en effekt inom en kort tid.

Oj, jag läste/tänkte helt fel, och var för snabb på tangenterna. Ber om ursäkt.