title: Metabolic effects of aspartame in adulthood: A systematic review and meta-analysis of randomized clinical trials.
abstract: Data about harms or benefits associated with the consumption of aspartame, a nonnutritive sweetener worldwide consumed, are still controversial. This systematic review and meta-analysis of randomized controlled clinical trials aimed to assess the effect of aspartame consumption on metabolic parameters related to diabetes and obesity. The search was performed on Cochrane, LILACS, PubMed, SCOPUS, Web of Science databases, and on a gray literature using Open Grey, Google Scholar, and ProQuest Dissertations & Theses Global. Searches across all databases were conducted from the earliest available date up to April 13, 2016, without date and language restrictions. Pooled mean differences were calculated using a random or fixed-effects model for heterogeneous and homogenous studies, respectively. Twenty-nine articles were included in qualitative synthesis and twelve, presenting numeric results, were used in meta-analysis. Fasting blood glucose (mmol/L), insulin levels (μU/mL), total cholesterol (mmol/L), triglycerides concentrations (mmol/L), high-density lipoprotein cholesterol (mmol/L), body weight (kg), and energy intake (MJ) were considered as the main outcomes in subjects that consumed aspartame, and results were presented as mean difference; % confidence interval, range. Aspartame consumption was not associated with alterations on blood glucose levels compared to control (-0.03 mmol/L; 95% CI, -0.21 to 0.14) or to sucrose (0.31 mmol/L; 95% CI, -0.05 to 0.67) and on insulin levels compared to control (0.13 μU/mL; 95% CI, -0.69 to 0.95) or to sucrose (2.54 μU/mL; 95% CI, -6.29 to 11.37). Total cholesterol was not affected by aspartame consumption compared to control (-0.02 mmol/L; 95% CI, -0.31 to 0.27) or to sucrose (-0.24 mmol/L; 95% CI, -0.89 to 0.42). Triglycerides concentrations were not affected by aspartame consumption compared to control (0.00 mmol/L; 95% CI, -0.04 to 0.05) or to sucrose (0.00 mmol/L; 95% CI, -0.09 to 0.09). High-density lipoprotein cholesterol serum levels were higher on aspartame compared to control (-0.03 mmol/L; 95% CI, -0.06 to -0.01) and lower on aspartame compared to sucrose (0.05 mmol/L; 95% CI, 0.02 to 0.09). Body weight did not change after aspartame consumption compared to control (5.00 kg; 95% CI, -1.56 to 11.56) or to sucrose (3.78 kg; 95% CI, -2.18 to 9.74). Energy intake was not altered by aspartame consumption compared to control (-0.49 MJ; 95% CI, -1.21 to 0.22) or to sucrose (-0.17 MJ; 95% CI, -2.03 to 1.69). Data concerning effects of aspartame on main metabolic variables associated to diabetes and obesity do not support a beneficial related to its consumption.
authors.affiliation: a Department of Pharmacy, Health Sciences Faculty , University of Brasilia , Brasilia , Brazil.
authors.forename: Natalia Cardoso
authors.initials: NC
authors.lastname: Santos
authors.affiliation: a Department of Pharmacy, Health Sciences Faculty , University of Brasilia , Brasilia , Brazil.
authors.forename: Laiza Magalhaes
authors.initials: LM
authors.lastname: de Araujo
authors.affiliation: b Department of Dentistry, Brazilian Centre for Evidence-Based Research , Federal University of Santa Catarina , Florianopolis , SC , Brazil / School of Dentistry, Faculty of Medicine and Dentistry , University of Alberta , Canada.
authors.forename: Graziela
authors.initials: G
authors.lastname: De Luca Canto
authors.affiliation: c Laboratory of Oral Histopathology, Health Sciences Faculty , University of Brasilia , Brasilia , Brazil.
authors.forename: Eliete Neves Silva
authors.identifier: http://orcid.org/0000-0002-7622-1550
authors.initials: ENS
authors.lastname: Guerra
authors.affiliation: a Department of Pharmacy, Health Sciences Faculty , University of Brasilia , Brasilia , Brazil.
authors.forename: Michella Soares
authors.initials: MS
authors.lastname: Coelho
authors.affiliation: a Department of Pharmacy, Health Sciences Faculty , University of Brasilia , Brasilia , Brazil.
authors.forename: Maria de Fatima
authors.initials: MF
authors.lastname: Borin
mesh_terms: D000328:Adult; D006801:Humans; D001218:Aspartame / Q000494:pharmacology; D001835:Body Weight / Q000187:drug effects; D004435:Eating / Q000187:drug effects; D013549:Sweetening Agents / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic
chemical_list: D001218:Aspartame; D013549:Sweetening Agents
keywords: Aspartame; blood glucose; energy intake; insulin; lipid profile; meta-analyze; systematic review