Low-calorie Sweeteners: Disturbing the Energy Balance Equation in Adolescents?

OBJECTIVE: To investigate the relationship between LCS, energy intake, and weight in United States youth. METHODS: Data were collected from individuals aged 2 to 19 years, who participated in NHANES in 2009–2010 (n=3,296), 2011–2012 (n=3,139), and 2013–2014 (n=3,034). Logistic regression, unadjusted and adjusted for age, sex, race/ethnicity, income, energy intake, and physical activity, was used to estimate the odds of obesity in LCS consumers vs. non-consumers, overall, and across product categories (foods vs. beverages) and socio-demographic subgroups. RESULTS: Among adolescents, odds of obesity were 55% and 70% higher in LCS beverage consumers compared to non-consumers, in unadjusted and adjusted models, respectively. Energy intakes did not differ based on LCS consumption. In contrast, associations between LCS consumption and obesity risk were not statistically significant among children (2–11 years old), except in boys and those who self-identified as Hispanic. CONCLUSIONS: LCS consumption is associated with increased odds of obesity among adolescents. This relationship is strikingly independent of total energy intake. While findings should be interpreted cautiously due to limitations of self-report dietary intake and the cross-sectional nature of this analysis, our observational analysis supports the need to investigate mechanisms by which LCS may influence body weight, independently of changes in energy intake.