Effects of sugar intake on body weight: a review

Weight reduction programmes are mainly focused on reducing intake of fat and sugar. In this review we have evaluated whether the replacement of dietary (added) sugar by low‐energy sweeteners or complex carbohydrates contributes to weight reduction. In two experimental studies, no short‐term differences in weight loss were observed after use of aspartame as compared to sugar in obese subjects following a controlled energy‐restricted diet. However, consumption of aspartame was associated with improved weight maintenance after a year. In two short‐term studies in which energy intake was not restricted, substitution of sucrose by artificial sweeteners, investigated mostly in beverages, resulted in lower energy intake and lower body weight. Similarly, two short‐term studies, comparing the effect of sucrose and starch on weight loss in obese subjects did not find differences when the total energy intake was equal and reduced. An ad libitum diet with complex carbohydrates resulted in lower energy intake compared to high‐sugar diets. In two out of three studies, this was reflected in lower body weight in subjects consuming the complex carbohydrate diet. In conclusion, a limited number of relatively short‐term studies suggest that replacing (added) sugar by low‐energy sweeteners or by complex carbohydrates in an ad libitum diet might result in lower energy intake and reduced body weight. In the long term, this might be beneficial for weight maintenance. However, the number of studies is small and overall conclusions, in particular for the long term, cannot be drawn.