Low-calorie sweeteners and human health: a rapid review of systematic reviews
Lesley Andrade, Kirsten M. Lee,
Allison C. Sylvetsky, Sharon I. Kirkpatrick
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Introduction: Low-calorie sweeteners are increasingly prevalent in the food supply and their consumption has increased in recent decades. Although low-calorie sweeteners approved for use are considered safe from a toxicological perspective, their short- and long-term impacts on chronic disease risk remain uncertain. The aim of this review was to summarize the evidence from systematic reviews on low-calorie sweetener use and chronic conditions and risk factors in children and adults. Methods: MEDLINE and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews of randomized and nonrandomized studies that considered low-calorie sweeteners in relation to type 2 diabetes, cardiovascular disease, cancer, anthropometric measures, hypertension, hyperglycemia, hyperlipidemia, insulin resistance, and dental caries. Data were extracted from 9 reviews deemed of moderate or high quality on the basis of AMSTAR-2. Results: Narrative synthesis suggested inconsistent evidence on low-calorie sweetener use in relation to chronic conditions and associated risk factors, with nonrandomized studies suggesting positive associations and randomized studies suggesting negative or no associations. Conclusion: Continued research on the long-term health impacts of low-calorie sweeteners across all life stages is warranted.
Research interests: healthy eating and nutrition policy, chronic disease prevention, dietary assessment, non-nutritive sweeteners, healthy weights promotions and eating disorder/disordered eating prevention, population and public health, health equity, public health systems
PhD Candidate, Public Health and Health Systems, Faculty of Health, University of Waterloo (2017- )
MHSc, Public Health Science, Community Nutrition stream, University of Toronto (2003-2005)
BSc, Honours Nutrition & Nutraceutical Sciences, University of Guelph (1998-2002)
Select professional activities and networks:
- Andrade L, Lee KM, Sylvetsky AC, Kirkpatrick SI. Low-calorie sweeteners and human health: a rapid review of systematic reviews. Nutrition Reviews. 2020, 28(11)2078-2082.
- Andrade L, Moran K, Snelling S, Malaviarachchi D, Beyers J, Near K, and Randall Simpson J. Beyond BMI: A feasibility study implementing NutriSTEP in primary care practices using electronic medical records (EMR). Health Promotion and Chronic Disease Prevention. 2020, 40(1):1-10.
- Maynard M, Andrade L, Packull-McCormick S, Perlman C, Leos-Toro C, Kirkpatrick SI. Food insecurity and mental health among females in high-income countries. International Journal of Environmental Research and Public Health. 2018, 15:1424..
- Kirkpatrick SI, Andrade L. State of the evidence on non-nutritive sweeteners. Submitted to Health Canada, 2018.
- Beyond BMI Research Team. Beyond BMI: Building an EMR-based childhood healthy weights surveillance system to include nutritional risk and protective factors through the collection and EMR-integration of NutriSTEP®. Submitted to Public Health Ontario. 2017.
- Andrade L, Yantzi N, Urajnik D, Graham C; Craig C; Despatie L, Barber K. Healthy Kids Community Challenge City of Greater Sudbury: Community needs assessment. Submitted to City of Greater Sudbury Healthy Kids Community Challenge Planning and Advisory Committee, 2016.
- Snelling S, Andrade L, Beyers J, Malaviarachchi D, Biro S. Fera L. Beyond BMI: Risk and protective factors for child healthy weights assessed using NutriSTEP® in primary care. Submitted to Public Health Ontario, 2015.
- Andrade L, Lee KM, Stapleton J, Kirkpatrick SI. Is increasing use of low-calorie sweeteners a cause for concern? A rapid review of systematic reviews. Canadian Nutrition Society Annual Meeting, 2019.
- Andrade L, Raffoul A, Hammond D, Kirkpatrick SI. Indicators of disordered eating are common among urban Canadian young adults. Dietitians of Canada Annual Conference, 2019.
- Andrade L, Raffoul A, Acton R, Lee K, Burns K, Godin K, Hanning R. Tackling weight-based stigma in the classroom: Developing capacity for weight-sensitive instruction among university students and instructors. Canadian Obesity Summit, 2019.
- Andrade L, Kirkpatrick SI. Examining the impact of food insecurity on eating disorder pathologies. Canadian Institutes of Health Research Student Health Research Forum. 2018.
- Andrade L, McDonough T. Beyond BMI: NutriSTEP® for the prevention, and care and management of childhood obesity. Canadian Obesity Summit, 2017.
- Andrade L, McDonough T, Randall Simpson J. Beyond BMI: The collection and integration of risk and protective factor information in electronic medical records (EMRs) for childhood healthy weights surveillance in Ontario. Nutrition Resource Centre Forum and Nutrition Exchange, 2016.
- Andrade L, Moran K. Beyond BMI: Investigating the feasibility of using electronic medical records and NutriSTEP® for childhood healthy weights surveillance. Grand Rounds, Public Health Ontario. 2015.
- 2018-2021: Ontario Graduate Scholarship, Government of Ontario
- 2018-2021: President's Graduate Scholarship, University of Waterloo
- 2018-2019: Graduate Student Experience Award, University of Waterloo
- 2018: Canadian Institutes of Health Research Travel Award
Select professional activities and networks:
- Chair, Community and Public Health Nutrition Network, Dietitians of Canada (2018 - Present)
- Member in Good Standing, College of Dietitians of Ontario (2005 – Present)
- Member and Evaluation Representative, City of Greater Sudbury Healthy Kids Community Challenge Planning and Advisory Committee (2015 – 2017)
- Foundational Standards Specialist, Public Health Sudbury & Districts (2015-2017)
- Interim Manager, Health Promotion Division, Public Health Sudbury & Districts (2013-2014)
- Public Health Nutritionist, Public Health Sudbury & Districts (2005-2015)
- Coordinator, Northern Healthy Eating Project (NHEP) (2007 – 2012)