A new paper — “Artificially Sweetened Beverages and the Response to the Global Obesity Crisis” — published in PLoS Medicine touches on important issues, including industry-funded studies.
Highlights:
- “Transnational beverage companies recognize that addressing growing health concerns about their products is needed to guarantee share of sales, volume growth, and overall financial results.”
- “In face of the growing threat of regulatory action on sugar-sweetened beverages (SSBs), transnational beverages companies are responding in multiple ways, including lobbying for voluntary self-regulation, influencing scientific research, promoting sports and physical activity events and research as part of their social responsibility strategy, and contributing to election campaigns.”
- “They are also targeting emerging markets (e.g., China, India, and Latin America), making substantial investments in global marketing and in the reformulation of products. Within this context, artificially sweetened beverages (ASBs), such as soft drinks, flavored water, juices, and ready-to-drink tea and coffee containing artificial sweeteners, have emerged as an important alternative to maintain industries’ sales and profits.”
- “ASBs are marketed as healthy alternatives to SSBs based on their characteristic of mimicking the sensory properties of SSBs while providing null (or low) energy content. However, there are long-standing concerns that ASBs may trigger compensatory mechanisms, which could offset a reduction in energy and sugar intake provided by their replacement of SSBs. The main proposed mechanisms are that ASBs stimulate sweet taste receptors—which could theoretically increase appetite, induce preference for sweet taste, and modulate gut hormone secretion—or result in overconsumption of solid foods due to awareness of the low calorie content of ASBs.”
- “The effect of ASBs on weight management has been tested in some randomized controlled trials (RCTs). These have produced mixed findings, with some studies indicating a null effect, while others have found modest reductions in weight.”
- “An important consideration when interpreting these findings is the potential for conflicts of interest, as industry-sponsored research is common.”
- “Recently, a systematic review found that ASB industry-sponsored reviews were more likely to report favorable results and conclusions regarding ASB effects on weight control than nonsponsored reviews. The opposite occurred with reviews sponsored by competitor food companies (e.g., the sugar industry), which were more likely to report negative results compared to nonsponsored reviews. Importantly, the authors estimated that “almost half of the reviews had authors that failed to disclose relevant conflicts of interest with the food industry.”
- “In summary, the available evidence does not directly support a role of ASBs in inducing weight gain or metabolic abnormalities but also does not consistently demonstrate that ASBs are effective for weight loss or preventing metabolic abnormalities.”
- “The promotion of ASBs must be discussed in a broader context of the additional potential impacts on health and the environment. In addition, a more robust evidence base, free of conflicts of interest, is needed.”
We find the authors’ policy takeaways important, particularly this one:
- “Caution should be exercised in engaging transnational beverage companies in future research. The US National Caries Program (NCP) was launched in 1971 with an aim of preventing tooth decay. There is evidence that the sugar industry acted to influence research priorities, and several strategies were adopted that focused on reducing the harms of sugar consumption rather than restricting intake.”
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