Effects of Prolonged Low-calorie Sweetener Consumption on Calorie and Macronutrient Intake in Female College Students

Background: Low-calorie sweeteners (LCS) provide individuals with alternatives to added sugars and provide the desired sweet taste without calories. LCS are found in foods and beverages labeled ‘sugar-free’, ‘no-sugar added’, and ‘light’. The consumption of LCS in the U.S. has increased in the last decade, with 25% of adolescents and 40% of adults consuming LCS daily. However, their effects on the human health and metabolism are not fully understood and it has been hypothesized that LCS may paradoxically promote sugar and calorie intake, leading to weight gain. The purpose of this study is to investigate how eight weeks of LCS consumption impacts caloric and macronutrient intake in female college students. Methods: Participants were eight healthy, non-smoking, non-pregnant females between 18-25 years of age, who did not report regular LCS consumption and who were classified as overweight or obese according to BMI (body mass index) (25 ≤ BMI \u3c35 kg/m2). Participants were screened over the phone to determine their eligibility. Participants who consumed foods or beverages containing LCS more than once per week were excluded. After the in-person screening and baseline visit, participants were instructed to drink the diet sodas, three times per day for eight weeks. Dietary recalls were conducted over the phone three times a week, based on the participants’ availability. Dietary recall data was compiled to study changes in calorie, macronutrient, and sugar intake over the course of the study. Results: Eight participants completed the study and provided plausible dietary intake data. One participant was excluded due to consistently reporting implausible energy intake (\u3c600 kcal per day). Overall, mean caloric intake among the seven remaining participants increased between the start of the study and their follow-up visit after drinking diet soda for eight weeks. Six of the seven participants reported an increase in carbohydrate consumption. Similarly, six participants reported increased sugar intake after the intervention period compared to baseline. Discussion: Our results suggest that consistent with data in rodent models, chronic LCS intake may promote rather than reduce calorie, carbohydrate, and sugar intake. This is in direct opposition to the intended benefits of using LCS as a replacement for added sugars. Given our small sample size, future studies with more participants are necessary to confirm these findings and assess potential differences in the relationship between LCS and dietary intake across sociodemographic and weight status subgroups