Abstract
BackgroundSubjects with morbid obesity commonly use Non-Nutritive Sweeteners (NNS), but the health-related effects of NNS have been questioned. The objectives of this study were to explore the associations between theuse of NNS and the health and lifestyle in subjects with morbid obesity.MethodsThis cross-sectional study included subjects with morbid obesity (BMI ≥ 40 kg/m2 or ≥35 kg/m2 with obesity-related comorbidity). Information about demographics, physical and mental health, and dietary habits was collected, and a blood screen was taken. One unit of NNS was defined as 100 ml beverages with NNS or 2 tablets/units of NNS for coffee or tea. The associations between the intake of NNS and the health-related variables were analyzed with ordinal regression analyses adjusted for age, gender and BMI.ResultsOne hundred subjects (women/men 83/17; mean age 44.3 years (SD 8.5)) were included. Median intake of NNS was 3.3 units (range 0 – 43). Intake of NNS was not associated with BMI (p = 0.64). The intake of NNS was associated with reduced heavy physical activity (p = 0.011), fatigue (p < 0.001), diarrhea (p = 0.009) and reduced well-being (p = 0.046); with increased intake of total energy (p = 0.003), fat (p = 0.013), carbohydrates (p = 0.002), sugar (p = 0.003) and salt (p = 0.001); and with reduced intake of the vitamins A (p = 0.001), C (p = 0.002) and D (p = 0.016).ConclusionsThe use of NNS-containing beverages was associated with an unhealthy lifestyle, reduced physical and mental health and unfavourable dietary habits with increased energy intake including sugar, and reduced intake of some vitamins.
Highlights
Subjects with morbid obesity commonly use Non-Nutritive Sweeteners (NNS), but the health-related effects of nutritive sweeteners (NNS) have been questioned
High intake of NNS was associated with diabetes, reduced physical activity, fatigue, reduced well-being, and diarrhea (Table 3)
The results indicate that the intake of NNS-containing beverages was approximately 100 ml higher in subjects with diabetes than in those without, and the same difference was seen between those with strong physical activity less than 1 hour/week compared to those with more than 2 h, and in subjects with low mood
Summary
Subjects with morbid obesity commonly use Non-Nutritive Sweeteners (NNS), but the health-related effects of NNS have been questioned. The objectives of this study were to explore the associations between theuse of NNS and the health and lifestyle in subjects with morbid obesity. The global prevalence rates of overweight and obesity, defined as Body Mass Index (BMI) above 25 and 30 kg/m2, were in 2014 39% and 13% respectively [1]. To maintain the pleasure of the sweet taste and at the same time reduce the energy intake, subjects with obesity commonly replace sugar by non-nutritive sweeteners (NNS). Observational studies indicate weight gain and interventional studies the opposite [12] Most studies have focused on the effect on body weight, whereas associations with lifestyle and general health have been less studied
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