1793-PUB: Effects of Nonnutritive Sweeteners on Glycemic Indices in Healthy Persons, with Overweight or Obesity, or Diabetes—A Systematic Review and Meta-analysis of Randomized Controlled Trials
Bibliographic record
Abstract
Evidence on nonnutritive sweeteners (NNS) and glycemia is controversial due to possible mechanisms promoting glucose intolerance. No study had systematically assessed variations in glycemic outcomes based on NNS type and dose, length of exposure, and nature of the comparator in trials evaluating subjects undergoing different clinical conditions. We conducted a systematic review and meta-analysis summarizing trials contrasting NNS consumers vs. non-consumers to assess the effect on eight glycemic indices. In participants without any major disease at baseline, NNS intake significantly increased fasting blood glucose (FBG). FBG and fasting insulin (FI) were higher among NNS consumers with hyperglycemia, those who followed for > 8wk, consumers of ≤ 350 mg/d, and participants receiving sucralose. Sucralose also increased 2h-glucose and 2h-insulin but reduced HbA1c. Aspartame increased HbA1c. Participants with obesity consuming NNS displayed significantly less FBG, FI, and HOMA. Results were consistent when clustering those with controlled baseline glycemia, subjects followed for ≤ 8wk, consumers of > 350 mg/d, and those replacing sugar with NNS. NNS consumers with baseline hyperglycemia exhibited less FI and HOMA. Participants consuming ≤ 350 mg/d displayed reductions in FBG and HOMA. Trials evaluating stevia consumers reported less FBG and FI levels. We found no overall effect on persons with diabetes. Subgroup assessments revealed that persons with diabetes with uncontrolled glycemia at baseline or who were followed for > 10wk displayed higher FI. In summary, the effect of NNS in glycemia varies across indices and between persons with inequivalent clinical conditions. Higher doses of NNS or longer interventions do not necessarily improve glycemic indices. Better-designed trials evaluating glycemic metabolism are needed to elucidate if NNS can be used as an alternative to sugar. Disclosure S.Golzan: None. A.Espinosa: None. M.Abbasi: None. M.Movahedian: None. M.Fathi: None. A.Hekmatdoost: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.020 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.028 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.019 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".