How Sweet It Is: The Many Reasons for Low-calorie Sweetener Consumption by Young Adults

Background: Over 40% of adults and 25% of children report consuming low-calorie sweeteners (LCS) daily. Despite their widespread use and non-caloric nature, whether LCS are beneficial for weight management is unclear. Epidemiologic studies demonstrate that LCS promote weight gain, yet human intervention studies suggest that replacement of added sugars with LCS may be beneficial, particularly in the context of behavioral support. The purpose of this study was to elucidate reasons why individuals consume LCS to gain insight into the contextual factors associated with LCS consumption, which may dictate the extent to which they are ultimately helpful or harmful for metabolic health. Methods: Sixty-eight college students (18 to 35 years of age) reporting habitual LCS consumption participated in the study. Each participant identified their reasons for LCS use through a secure web link and responded to the focus prompt “I consume low-calorie sweeteners” and/or products labeled “diet”, “sugar-free” or ‘no sugar added because.’ Each participant was asked to report as many reasons for their LCS use as possible. Once saturation was reached in brainstorming, idea synthesis, a form of qualitative content analysis, was conducted by the research team to sort and group statements based on their collective meaning. Results: A list of 195 statements was generated during brainstorming. Idea synthesis resulted in 38 independent reasons that represented the full saturation of ideas from the original statement list. Reasons for LCS consumption included 13 discrete themes: taste (10), calorie/weight management (8), finances (3), performance (3), overall health (2), sugar reduction (2), access (2), dietary patterns (2), addiction (2), weather (1), habit (1), family influence (1), and social influence (1). Discussion: The current body of literature investigating LCS effects within the context of intensive weight loss interventions captures only one of many contexts in which LCS are consumed. Our findings demonstrate that LCS are consumed for numerous reasons, spanning palatability, cost, habit, peer and family influences, and craving, in addition to weight management. These results will aid in the design of subsequent studies to investigate LCS health effects in a manner that best reflects real-life consumption. Furthermore, these findings may explain seemingly discrepant conclusions of epidemiologic and rodent studies compared to human intervention trials. Future investigations should also aim to quantify the extent to which the 38 reasons identified for consumption are true of the broader population of individuals who regularly consume LCS