SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2017
Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.
2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
In one paragraph
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 182 papers, 21 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
182citing papers in PubMed, 21 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial of the Effect of Replacing Sugar-sweetened Beverages With Non-nutritive Sweetened Beverages or Water on Gut Microbiome and Metabolic Outcomes: STOP Sugars NOW Trial
Changing or Substituting Low-calorie Sweetened Beverages for Sugar-Sweetened Beverages or Water and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Prospective Cohort Studies
Who cites it
182 citing papers in PubMed, 21 syntheses or guidelines pooled it.
- The longitudinal association between artificial sweetener intake and the risk of type 2 diabetes among adults aged 18 years and older: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- The effects of non-nutritive sweeteners on lipid profile in adults: a systematic review and meta-analysis of randomized controlled clinical trials.Scientific reports · 2025Pooled it
- Non-Sugar-Sweetened Beverages and Risk of Chronic Diseases: An Umbrella Review of Meta-analyses of Prospective Cohort Studies.Nutrition reviews · 2025Pooled it
- Evaluating agreement between individual nutrition randomised controlled trials and cohort studies - a meta-epidemiological study.BMC medicine · 2025Pooled it
- Association between low-calorie sweetener consumption during pregnancy and child health: A systematic review and meta-analysis.Maternal & child nutrition · 2025Pooled it
- Artificially sweetened beverages do not influence metabolic risk factors: a systematic review and meta-analysis.Frontiers in nutrition · 2025Pooled it
- Effects of Nonnutritive Sweeteners on the BMI of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies.Advances in nutrition (Bethesda, Md.) · 2024Pooled it
- 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association.Diabetes & metabolism journal · 2024Guideline
- The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies.Advances in nutrition (Bethesda, Md.) · 2024Pooled it
- Effect of Non- and Low-Caloric Sweeteners on Substrate Oxidation, Energy Expenditure, and Catecholamines in Humans-A Systematic Review.Nutrients · 2023Pooled it
- The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-Analysis.Nutrients · 2023Pooled it
- Consumption of Non-Nutritive Sweetener during Pregnancy and Weight Gain in Offspring: Evidence from Human Studies.Nutrients · 2022Pooled it
- Relation of Change or Substitution of Low- and No-Calorie Sweetened Beverages With Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Prospective Cohort Studies.Diabetes care · 2022Pooled it
- 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.JAMA network open · 2022Pooled it
- Effects of prenatal artificial sweeteners consumption on birth outcomes: a systematic review and meta-analysis.Public health nutrition · 2021Pooled it
- Dose-response association between sugar- and artificially sweetened beverage consumption and the risk of metabolic syndrome: a meta-analysis of population-based epidemiological studies.Public health nutrition · 2021Pooled it
- Effects of Unsweetened Preloads and Preloads Sweetened with Caloric or Low-/No-Calorie Sweeteners on Subsequent Energy Intakes: A Systematic Review and Meta-Analysis of Controlled Human Intervention Studies.Advances in nutrition (Bethesda, Md.) · 2021Pooled it
- The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies.International journal of obesity (2005) · 2021Pooled it
- Non-nutritive sweeteners for diabetes mellitus.The Cochrane database of systematic reviews · 2020Pooled it
- Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies.BMJ (Clinical research ed.) · 2019Pooled it
122 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors.
Meghan B AzadGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man. meghan.azad@umanitoba.ca.
Ahmed M Abou-SettaGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Bhupendrasinh F ChauhanGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Rasheda RabbaniGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Justin LysGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Leslie CopsteinGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Amrinder MannGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Maya M JeyaramanGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Ashleigh E ReidGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Michelle FianderGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Dylan S MacKayGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Jon McGavockGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Brandy WicklowGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Ryan ZarychanskiGeorge & Fay Yee Centre for Healthcare Innovation (Azad, Abou-Setta, Chauhan, Rabbani, Lys, Copstein, Mann, Jeyaraman, Fiander, Zarychanski); Children's Hospital Research Institute of Manitoba (Azad, Chauhan, McGavock, Wicklow); Department of Pediatrics and Child Health (Azad, McGavock, Wicklow); Department of Community Health Sciences (Abou-Setta); College of Pharmacy (Chauhan); Max Rady College of Medicine (Reid); Department of Human Nutritional Sciences (Azad, MacKay); Department of Internal Medicine (Zarychanski), University of Manitoba; Department of Hematology and Medical Oncology, CancerCare Manitoba (Zarychan-ski), Winnipeg, Man.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonnutritive 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.
methodsWe 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.
resultsFrom 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/m
interpretationEvidence 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.
Indexed as
Body Mass IndexWaist CircumferenceAdolescentAdultCardiovascular DiseasesHumansMetabolic SyndromeNon-Nutritive SweetenersObesityProspective StudiesPublication BiasRandomized Controlled Trials as TopicNon-Nutritive Sweeteners
Identifiers
What Socratic holds
Textmetadata
Read underepoch 390
Registered trials
NCT03543644ClinicalTrials.gov
NCT04245826ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.