Abstract:
A two-year randomized controlled trial conducted by a research team at the University of Liverpool in the United Kingdom found that among people participating in a weight loss program, drinking a sugar-free beverage every day compared with drinking plain water every day had no significant difference in maintaining weight loss results. The findings suggest that concerns about artificial sweeteners disrupting appetite and causing weight regain were not borne out in this rigorous, long-term trial.
There has long been controversy over whether sugar-free drinks help with weight management. Compared with sugary drinks, sugar-free drinks retain the sweetness but contain almost no sugar and calories. However, many researchers are concerned that the artificial sweeteners used may affect the appetite regulation mechanism, thereby increasing the risk of weight regain.
To test this issue, researchers from the University of Liverpool organized 493 overweight or obese adults to participate in the trial. All subjects participated in a structured behavioral weight loss management program and were randomly assigned to two groups, one of which drank plain water every day and the other group drank commercially available sugar-free drinks every day. The entire study lasted 104 weeks, or two years.
The sugar-free drinks used in the study contained low- or no-calorie sweeteners, including aspartame, acesulfame potassium and sucralose. Participants' intakes were always within the safe limits set by the European Food Safety Authority.
The results of the study showed that the sugar-free beverage group lost an average of 4.8 kilograms, while the water drinking group lost an average of 3.7 kilograms. Although the sugar-free drink group lost slightly more weight, the difference between the two groups did not reach a statistically significant level.
More importantly, both groups of participants successfully maintained their weight loss. Even after professional weight loss support was stopped late in the study, they maintained their weight loss over the next year without significant rebound.
In addition to weight changes, participants in both groups experienced decreases in waist and hip circumference, as well as improvements in body composition measures and multiple metabolic health markers. The study also found no clinically significant differences in changes in blood pressure and cholesterol between the two groups.
In terms of diet, the sugar intake of participants in both groups decreased, with the decrease in the sugar-free beverage group being slightly greater than that in the drinking water group. This suggests that replacing sugary drinks with sugar-free drinks can help reduce sugar intake.
The research team noted that these results do not support concerns that artificial sweeteners disrupt appetite control or impair metabolic health. However, they also emphasized that the participants' weight loss results were achieved within the framework of a complete behavioral management program, so the effects cannot simply be attributed solely to the drink itself.
The research was co-led by Professor Joanne Harrold, Dean of the School of Psychology at the University of Liverpool, and Professor Jason Halford, currently a professor at the University of Leeds and formerly working at the University of Liverpool. The findings have been published in the British Journal of Nutrition.
Harrold said that the University of Liverpool has long been committed to public health research. The latest results show that in well-designed and long-lasting randomized trials, artificial sweeteners were not found to cause appetite disorders or weight gain. She hopes that this evidence can provide reference for the future formulation of public health policies by the World Health Organization and various countries.
One of the backgrounds of the research is that the World Health Organization has previously recommended against using non-sugar sweeteners as the main tool for weight control due to uncertainty in the evidence from previous observational studies. This study provides more direct and reliable clinical evidence for this controversy through randomization and continuous follow-up for two years.
Halford said that the international community has previously lacked long-term clinical data to evaluate the true effect of sugar-free drinks. According to the results of this study, for people who want to control their weight, sugar-free drinks are an effective alternative to sugary drinks, and their long-term weight loss maintenance effect is equivalent to drinking plain water.
Researchers believe that although choosing what drinks to drink is only one part of weight management, this two-year study shows that replacing sugary drinks with artificial sweetener drinks in scientific weight loss plans will not hinder the long-term maintenance of weight loss results.
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