They can also be considered a viable SSB alternative to water.
These findings were put forth in a systematic review and meta-analysis titled “Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-Analysis” published in the Jama Network Open journal.
Globally, major dietary guidelines recommend drinking water, not LNCSBs, to replace SSBs.
SSBs have also been associated with weight gain, the incidence of diabetes and hypertension and heart complications.
Hence, the scientists sought to assess whether LNCSB, as a substitute, can yield similar improvements in cardiometabolic risk factors compared to consuming only water.
“There are concerns that LNCSBs do not have established benefits, with major dietary guidelines recommending the use of water and not LNCSBs to replace sugar-sweetened beverages (SSBs). Whether LNCSB as a substitute can yield similar improvements in cardiometabolic risk factors versus water in their intended substitution for SSBs is unclear.
“Hence, the investigation assessed the association of LNCSBs using three prespecified substitutions of LNCSBs for SSBs, water for SSBs, and LNCSBs for water, with body weight and cardiometabolic risk factors in adults with and without diabetes,” said the researchers.
They identified 10,329 reports in Medline, Embase and the Cochrane Central Register of Controlled Trials from inception through to 26 December 2021.
After that, the scope was narrowed to 17 RCTs, with 24 trial comparisons involving 1,733 adults with a mean age of 33.1 years and containing at least two weeks’ worth of interventions comparing different beverages in question. There were 1,341 women, or 77.4% of the subjects who were tested, and they were overweight or obese and at risk for or already have diabetes.
Go low
The consumption of LNCSBs as substitutes for SSBs was found to be associated with reduced body weight, BMI, percentage of body fat, and IHCL.
For example, the subjects in those tests had recorded improvements in their BMI within the range of 0.07 to 0.58.
This measurement was also associated with a small reduction in body weight in the range of 0.41kg to 1.71kg. The percentage of their body fat also decreased between 0.18% and 1.03%.
For trials involving the water as a substitute for SSBs, they studies showed no significant improvements. However, the direction of association favoured water in all cases.
The use of LNCSBs as a substitute for water did not lead to significant difference in outcomes, except for a greater decrease in haemoglobin A1c (HbA1c) used to test for diabetes (seen with water) and in body weight and systolic BP (seen with LNCSBs).
The directions of the association favoured LNCSBs or water in nearly all cases.
The researchers concluded: “This systematic review and meta-analysis found that using LNCSBs as an intended substitute for SSBs was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution. The evidence supports the use of LNCSBs as an alternative replacement strategy for SSBs over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.”
Source: Jama Network Open
DOI: 10.1001/jamanetworkopen.2022.2092
“Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-Analysis.”
Authors: Néma D. McGlynn, et al