Scoping review and evidence map of the relationship between exposure to dietary sweetness and body weight-related outcomes in adults.

Abstract

BACKGROUND: Numerous governmental and health organizations recommend reduced intake of added sugars due to the health risks associated with excess intake, including the risk of obesity. Some organizations further recommend avoiding dietary sweetness, regardless of the source. OBJECTIVE: A scoping review and evidence map were completed to characterize the research investigating dietary sweetness and body weight. The aim was to identify and map studies that investigate total dietary sweetness, sweet food/beverage, sugar, or sweetener intake and body weight-related outcomes and/or energy intake. DESIGN: Using pre-registered search terms (osf.io/my7pb), 36,779 publications (duplicates removed) from PubMed, Cochrane Library, and Scopus were identified and screened for inclusion. Eligible studies were clinical trials, longitudinal cohorts, case-control studies, cross-sectional studies, and systematic reviews conducted among adults (≥18 years) which investigated associations between dietary sweetness, sweet food/beverage, sugar, or sweetener (energetic or non-energetic) intake and body weight, body mass index, adiposity, and/or energy intake. RESULTS: A total of 833 eligible publications were identified, detailing 804 studies. Only 7 studies (0.9% of included studies) (2 clinical trials, 4 cross-sectional studies, 1 other design type) investigated associations between total dietary sweetness and a body weight-related outcome and/or energy intake. An additional 608 (75.6%) studies investigated sweet food/beverage, sugar, or sweetener intake and body weight-related outcomes and/or energy intake, including 225 clinical trials, 81 longitudinal cohorts, 4 case-control studies, and 280 cross-sectional studies. Most studies (90.6%) did not measure the sweetness of the diet or individual foods consumed. Ninety-two (11.4%) publications reported on dietary patterns that included sweet foods/beverages alongside other dietary components and 97 (12.1%) systematic reviews addressed different but related research questions. CONCLUSIONS: While there is a breadth of evidence from studies that investigate sweet food/beverage, sugar, and sweetener intake and body weight, there is limited evidence on the association between total dietary sweetness and body weight.