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European Journal of Clinical Nutrition (1999) 53, 757±763
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Review
Intense sweeteners and energy density of foods:
implications for weight control
A Drewnowski1*
1
Departments of Epidemiology and Medicine, and Nutritional Sciences Program, University of Washington, Seattle, WA, USA
Energy density of foods, as opposed to their sugar or fat content, is said to be a key determinant of energy
intakes. Recent laboratory studies have shown that, under ad lib conditions, subjects consume a constant weight
or volume of food, so that their energy intakes depend on the energy density of the diet. Because low energydensity foods provide fewer calories per eating bout, they should Ð in theory Ð lead to reduced energy intakes
and therefore weight loss. However, there is some question whether energy-dilute foods are as palatable as the
more energy-dense foods. Generally high energy density equals high palatability and vice versa. Intense
sweeteners represent an exception to the rule, since they maintain sweetness while reducing energy density.
While many studies have explored the effects of intense sweeteners on short-term regulation of food intake,
fewer studies have addressed the effectiveness of intense sweeteners in reducing energy density for weight
control. Issues of energy density, palatability, and satiety, as applied to intense sweeteners are the topic of this
review.
Descriptors: Energy density; palatibility; satiation; intense sweeteners
Introduction
Human obesity is the outcome of excess energy intake
and insuf®cient energy expenditure (West & York, 1998).
Studies of dietary factors in obesity have mostly focused
on intakes of sugar and fat and on the nutrient composition
of the diet (Lissner & Heitmann, 1995; Bray & Popkin,
1998). At one time or another, obesity was associated with
excessive consumption of fat (Lissner & Heitmann, 1995),
sugar (Harnack et al, 1999), starches (Stubbs et al, 1997),
or even protein (Parizkova & Rolland-Cachera, 1997).
However, the percentage of energy from a given nutrient,
as opposed to total calories, may not be the primary cause
of obesity. The contribution of dietary fat to obesity has
been sharply questioned (Willett, 1998) and it is unclear that
any single nutrient is to blame. Research attention is turning toward a new dietary variable: energy density, de®ned
as the amount of available energy per unit weight (Poppitt
& Prentice, 1996). An increasing number of studies now
address energy density of foods and the mean energy
density of the diet (Poppitt & Prentice, 1996; Prentice &
Poppitt, 1996; Rolls et al, 1999; Drewnowski, 1998).
Energy density, as opposed to the macronutrient content
of foods, is increasingly viewed as the key factor in the
regulation of food intake (Poppitt & Prentice, 1996; Prentice & Poppitt, 1996; Rolls et al, 1999; Drewnowski,
1998). Under ad libitum conditions, laboratory subjects
appear to consume a roughtly constant weight of food, as
opposed to a constant amount of energy (Poppitt &
Prentice, 1996; Prentice & Poppitt, 1996). In theory then,
selecting foods with low energy-density ought to lead to
*Correspondence: Dr Adam Drewnowski, 305 Raitt Hall Box 353410,
University of Washington, Seattle, WA 98195-3410, USA.
Received 19 November 1998; revised 12 March 1999; accepted 23 June
1999.
lower energy intakes and therefore weight loss. However,
not all researchers agree that the volume of food consumed
is, in fact constant, or that the regulation of food intake in
real life involves modulating energy density, as opposed to
the weight or volume of foods.
Nonetheless, lowering energy density of foods is viewed
as a viable option for obesity treatment (Rolls et al, 1999).
Obese women, thought to consume excessive amounts of
sweet high-fat foods, might be the chief bene®ciaries of this
approach. The volume of food can be expanded by the
addition of water, ®ber, or even air (Drewnowski, 1998).
However, unless palatability is kept constant, the resulting
food product may not be acceptable to the consumer
(Drewnowski, 1998). Intense sweeteners successfully
lower energy density of foods and beverages without
sacri®cing sweetness or good taste. Their in¯uence on
short-term regulation of food intake has been explored
previously (Rolls, 1991; Renwick, 1994; Drewnowski,
1995 for reviews). Their ef®cacy in aiding weight control,
as predicted by the energy density hypothesis, is addressed
in this review.
What is energy density?
Energy density is largely determined by the water and fat
content of foods. An analysis of approximately 100 foods
from a food frequency questionnaire (Drewnowski, 1998),
showed that the more energy-dense foods contained less
water per 100 g (see Figure 1). As shown in Figure 2,
energy-dense foods also contained more fat per unit weight
(Bray & Popkin, 1998). Together, water and fat content
accounted for 99% of the variance. As might be expected,
energy-dilute foods included beverages, soups, salads,
vegetables, and fruit. In contrast, energy-dense foods
Intense sweeteners and weight control
A Drewnowski
758
Figure 1 A scatterplot of water content (g=100 g) and energy density
(kcal=g) of approximately 100 foods from a food frequency questionnaire.
Figure 2 A scatterplot of fat content (g=100 g) and energy density
(kcal=g) of approximately 100 foods from a food frequency questionnaire.
included dry cereals, packaged snacks, sweets and desserts.
Typically, energy-dense foods were dry and contained fat,
added sugar, or both, whereas energy-dilute foods contained water, dietary ®ber, starch, or sometimes protein
(Drewnowski, 1998).
Obesity and energy density
Increasing rates of obesity worldwide have been linked to
overeating of sweet and high-fat foods (Drewnowski &
Popkin, 1997). Diets of developed nations are more energydense and tend to provide more calories per unit volume
than the traditional plant-based diets, with a higher proportion of complex carbohydrates and ®ber. This nutrition
transition has been accompanied by increasing urbanization, mechanized transport and lower levels of physical
activity. It is therefore unclear whether high rates of obesity
in af¯uent societies are a direct consequence of energy
density of the diet, as opposed to the basic imbalance
between energy intake and energy expenditure. In any
case, there are no data to link obesity with energy density
of the diet. Sensory studies suggest that obese women
prefer sweet and fat-rich foods (Drewnowski, 1986). Studies of food preferences showed that obese women gave
high ratings to sugar=fat mixtures such as doughnuts, cakes,
cookies, chocolate candy and other desserts. In contrast,
obese men tended to favor meat dishes and other combinations of fat and salt (Drewnowski, 1997). Arguably, the diet
of obese persons might be higher in energy-dense foods
that are high in fat, sugar and salt. However, no study has
compared mean energy density of the diet of obese as
opposed to lean individuals.
Using foods with low energy density is a common
strategy for weight control. By current estimates, 39% of
American women and 25% of men and trying to lose
weight, mostly by reducing their intakes of sugars and
fats (Levy & Heaton, 1993). Intense sweeteners play an
important role. Among the most frequent weight loss
practices were the use of diet soft drinks (by 52% of
women and 45% of the men) and of tabletop intense
sweeteners (43% of women and 33% of men). While
these practices precede current interest in energy density
of foods, the use of intense sweeteners to reduce energy
density ought to promote satiation, reduce energy intakes,
and thereby aid weight control.
This regulatory mechanism is based on a postulated
relationship between energy density and satiating power
of foods. Reported overeating of palatable sweet and highfat foods has been ascribed to their high energy density and
to their weak satiating power (Green et al, 1994). Assuming
that people consume a constant mass of food per day,
eating foods with lower energy-density, that is fewer
calories per unit weight, should reduce energy intakes
overall. And since energy-dilute foods are more bulky,
they ought to have higher satiating power (Holt et al,
1991). A high-volume energy-dilute diet should thus promote satiety and encourage weight loss. In principle then,
diet soft drinks with an energy density of zero ought to
promote satiety very effectively indeed.
Regulation of food intake
Energy density and palatability
The sweet taste of sugar is both pleasurable and rewarding
(Drewnowski, 1986). All children love sweets, correctly
associating sweetness with nutritive energy from sugar
(Drewnowski, 1986; 1997). Studies show that novel tastes
and ¯avors can become preferred provided they are associated with another high-density energy source, such as fat
(Johnson et al, 1991; Birch, 1992). This innate pleasure
response to sweet and high-fat foods may have a metabolic
basis (Drewnowski et al, 1995). Whereas selective fat
appetite is said to depend on galanin and neuropeptide Y
(Leibowitz & Kim, 1992), preferences for sweets may
involve the endogenous opiate peptide system (Drewnowski et al, 1995). Exposure to sweet taste is thought
to lead to the relese of endogenous opiates, explaining
perhaps why sweet snacks are sometimes consumed in
times of stress.
Given the neural mechanisms of food reward, it is not
surprising that food palatability and energy density should
be linked. Foods that deliver concentrated energy per unit
volume are generally preferred over those that do not.
Though some investigators believe that energy density
and palatability are independent variables, diluting energy
density of foods through the addition of water, ®ber, or
Intense sweeteners and weight control
A Drewnowski
protein usually leads to a reduction in palatability. The
range across which energy density can be reduced without
affecting palatability is quite limited. While a 2% yogurt
and a fat-free yogurt can be matched for palatability, boiled
spinach (0.1 kcal=g) will never be as palatable as chocolate
(6 kcal=g). Those studies that manipulated energy density
while keeping palatability constant used foods whose
energy density was already low (Drewnowski, 1998).
Generally, the difference between `high' and `low' energy
density foods was between 1.6 and 1.1 kcal=g (Rolls et al,
1999; Drewnowski, 1998).
Intense sweeteners are mostly used in diet beverages and
`light' semi-solid foods, such as yogurts, puddings and
frozen desserts. The reduction in energy density is in the
order of 0.4 kcal=g. As shown in Table 1 the use of intense
sweeteners in diet soft drinks and beverage mixes reduced
energy density from 0.40 kcal=g to zero, while the energy
density of yogurts, puddings and frozen dessers, generally
in the 0.8 ± 1.0 kcal=g range, was reduced by half. For
comparison purposes, the nonabsorbable fat replacement
product Olestra reduces energy density of potato chips from
approximately 4.5 to 2.5 kcal=g.
Palatability and satiety
Palatability and satiety have opposite effects on food
consumption. While food palatability increases appetite
and thereby energy intakes, satiety limits intakes by reducing meal size or by delaying the time of the next meal
(Blundell et al, 1996; Rolls et al, 1994; Rolls, 1995).
Among chief measures of palatability are perceived pleasantness of a given food, intent to eat, or the amount of
food consumed (Birch, 1992).
Satiety, de®ned as internal state of energy repletion after
a meal, has been measured in terms of fullness, reduced
hunger, or reduced intent to consume a meal or a snack
(DeGraaf et al, 1993; Green & Blundell, 1996; Rolls et al,
1990). Satiety has also been measured in terms of reduced
palatability. Sensory speci®c satiety was speci®cally
de®ned as reduced palatability of the just-consumed food
relative to other foods (Rolls, 1986). With satiety measured
in terms of palatability and vice versa, the relationship
between the two is, by de®nition, reciprocal (see Table 2).
Whereas palatable foods Ð such as sugar and fat Ð are
reported to be less satiating, the more satiating foods are,
as a rule, less palatable (Holt et al, 1991). As might be
expected, the best tasting, but least satiating, foods are
those that are energy-dense, sweet, or rich in fat (Drewnowski, 1986; 1987; 1995; Drewnowski & Greenwood,
1983).
Energy density, palatability and satiety
The satiating power of different foods may depend on their
energy density or nutrient composition (Poppitt & Prentice,
1996; Prentice & Poppitt, 1996; Burley et al, 1993; Rolls et
al, 1988). Protein and carbohydrate are thought to be more
satiating than fat. In one study (Holt et al, 1991), subjects
rated satiety every 15 min for 2 h after consuming equicaloric (240 kcal) portions of 38 common foods. Satiety
index (SI) was calculated by dividing the area under the
satiety response curve for each food by mean satiety curve
for white bread and multiplying by 100. Satiety was most
highly correlated with the volume of food consumed, which
ranged from a low of 38 g for peanuts to a high of 625 g for
oranges. Chocolate was the least satiating food, while
vegetables and fruit were more satiating. Boiled potatoes,
porridge and ®sh were more satiating than cookies or cakes.
Satiating power was linked to low energy-density and high
levels of protein, ®ber, and water (Holt et al, 1991). As
might be expected, SI and hedonic preferences were inversely linked.
Table 2 A comparison of palatable vs satiating foods
Nutrient composition
Volume per portion
Energy density (kcal=g)
Sensory features
Palatability
Example foods
Palatable foods
Satiating foods
High sugar
High fat
Low
High
Sweet, fat
High
Chocolate
Potato chips
Cakes, pastries
High protein
High ®ber
High
Low
Watery
Low
Porridge
Spinach, potatoes
Fish
Table 1 Principal measures of hunger, appetite, and satiety in laboratory tests
Motivational states
Taste response
Desire to eat
Speci®c appetites
Food consumption
Principal measures
Reference
Hunger
Satiety
Fullness
Oversatiety (overfullness)
Nausea
Reduced pleasantness of sweet stimuli
Reduced pleasantness of food odors
Reduced appeal of just-consumed foods
Desire or intent to
consume
Appetite for a meal
Appetite for a snack
Appetite for something
sweet
Appetite for something savory
Pleasantness of something sweet
Pleasantness of something savory
Amount of food
consumed
Size of test meal
Delay till the next meal
Dietary intake assessment (24 h)
DeGraaf et al, 1993; Green & Blundell, 1996.
Holt et al, 1995; DeGraaf et al, 1993; Green & Blundell, 1996.
DeGraaf et al, 1993.
DeGraaf et al, 1993.
Rolls, 1986.
Rolls, 1986.
DeGraaf et al, 1993.
DeGraaf et al, 1993.
DeGraaf et al, 1993.
DeGraaf et al, 1993.
Blundell et al, 1996.
Blundell et al, 1996.
759
Intense sweeteners and weight control
A Drewnowski
760
Figure 3 A scatterplot of mean hedonic ratings and energy density of
foods. Data from Meiselman et al (1974).
Energy-dense foods containing sugar and fat were least
satiating, though most palatable. Studies of US military
personnel, conducted by Meiselman et al, (1974) also
showed a relationship between hedonic preferences and
energy density of foods. Subjects, predominantly young
males, preferred meat dishes and desserts over diet beverages, vegetables and fruit. Data for 115 out of more than
300 food questionnaire items used by Meiselman et al
(1974) are shown in Figure 3.
Diet beverages and satiety
Studies on diet beverages and satiety are extremely skewed
in favor of very short-term studies. Typical study design
tested hunger, satiety, and energy intakes during a single
meal or snack following ingestion of a sweet stimulus. The
time interval between the beverage and the next meal was
very short, most often between 30 and 60 min. Most studies
used beverages (Anderson et al, 1989; Birch et al, 1989;
Black et al, 1991; Rolls et al, 1990), occasionally pudding
or cereal (Mattes, 1990; Rolls et al, 1988; Rolls et al,
1989), with the difference between the high- and the lowenergy versions rarely exceeding 200 kcal (Burley et al,
1993; Drewnowski 1986). Some studies (Drewnowski et al,
1994a; 1994b) used a stronger energy manipulation (400
kcal), a longer time interval (2 ± 3 h), and three consecutive
test meals: lunch, snack, and dinner consumed for up to 10
h post ingestion. Since the volume of the test beverage was
kept constant while energy content varied, energy density
was the key manipulated variable.
Short-term perception of hunger and satiety ws in¯uenced more strongly by preload volume than by any other
variable. A 560 mL portion of energy-free carbonated
mineral water reduced desire to eat more effectively than
a 260 mL portion (Black et al, 1993). In turn, 560 mL of
mineral water and an equal volume of aspartame-sweetened
soft drink had comparable effects on satiety.
Replacing sucrose with aspartame lowered energy density of soft drinks from 0.4 kcal=ml to zero, but had no
effect on immediate hunger ratings. Children, aged 9 ± 10 y,
had similar hunger ratings after consuming sucrose (90
kcal) or aspartame-sweetened (3 kcal) soft drinks (Birch et
al, 1989). Adults who consumed sucrose- or aspartame-
Figure 4 Rated intent to eat following the consumption of breakfasts
sweetened with sucrose or aspartame. Subjects were 12 normal-weight
females. Breakfasts A and B had energy density of 1.4 kcal=g; breakfasts C
and D had energy density of 0.6 kcal=g. From Drewnowski et al (1994a).
sweetened lemonade (166 kcal vs 5 kcal showed similar
hunger ratings as measured 0, 30, and 60 min later (Rolls et
al, 1990). Adults who consumed a high- or low-calorie
pudding or a gelatin dessert (mean energy difference: 206
kcal) also had similar ratings of hunger and desire to eat
120 min later (Rolls et al, 1989). The volume of food
consumed, rather than small differences in sweetness or
energy value, determined hunger and satiety in the short
term.
Similar results were obtained with solid and semi solid
foods (Rogers & Blundell, 1989). Two studies (Levy &
Heaton, 1993; Green et al, 1994) used breakfasts of yogurtlike creamy white cheese (fromage blanc) that were either
plain, sweetened with aspartame or sucrose, or sweetened
with aspartame and supplemented with maltodextrin. A
difference in energy density of 0.6 kcal=g vs 1.4 kcal=g
(weight 500 g) had no initial impact on ratings of hunger or
the intent to eat in 12 normal-weight women (Drewnowski,
1993). However, as shown in Figure 4, the low-energy
condition led to increased motivational ratings 2.5 h later.
While the low energy-density version was as satisfying
initially as the high energy density version, it was associated with increased hunger ratings later on. However, the
elevated hunger ratings did not lead to compensatory eating
at lunch.
Energy compensation
Some investigators (Rogers & Blundell, 1989; Rogers,
1993) have argued that diet products lead to false energy
savings, since compensatory eating occurs during the next
meal or later during the day. The ingestion of saccharinsweetened (131 kcal) as opposed to glucose-sweetened
yogurt (295 kcal) reportedly led to complete energy compensation in a meal 60 min later (Black et al, 1993). Birch
et al (1989) showed that 2 ± 5 y old children compensated
perfectly for calories removed from soft drinks by the use
of intense sweeteners. Complete energy compensation was
also observed in a longer-term residential study, conducted
with six normal-weight, non-dieting males (Foltin et al,
1990). The carbohydrate content of lunch was reduced by
400 kcal, mostly by substituting aspartame for sugar.
Subjects made up for the energy de®cit by dinner time on
every day of the experiment (Foltin et al, 1990).
Intense sweeteners and weight control
A Drewnowski
Table 3
761
Intense sweeteners and energy density of foods
Portion size (g) Energy (kcal) Energy density (kcal=g) Sugar (g=100 g) Water (g=100g)
Regular soda
Diet soda
Lemonade, dry mix
Diet lemonade, dry mix
Jell-O
Jell-O (sugar-free)
Banana cream pudding
Banana cream (sugar-free)
Yogurt, fat-free
Yogurt, fat-free `light'
370
370
240
240
140
121
147
130
170
170
155
1
102
5
81
8
165
88
160
90
0.42
0.01
0.42
0.02
0.60
0.07
1.1
0.7
0.94
0.53
10.4
0
11.2
0
13.4
0
19.3
0
17.7
5.9
89
100
89
99.5
85
85
73
84
N/A
N/A
N=A ˆ not applicable.
Other studies observed either partial energy compensation or none (Anderson et al, 1989). Men and women given
low- or high-calorie versions of a pudding or gelatin dessert
consumed similar amounts of food at a buffet lunch presented 2 h later (Rolls et al, 1989). In another study (Rolls
et al, 1990), aspartame-sweetened lemonade led to energy
compensation when lunch was presented 30 or 60 min later,
but not when lunch and lemonade were consumed at the
same time. In a study of normal-weight men and women
(Drewnowski et al, 1994a), a 400 kcal de®cit at breakfast
time led to slightly higher energy intakes at lunch (111
kcal). No energy compensation was observed at later meals,
such that low energy-density breakfasts resulted in lower
energy intakes by the end of the day. The extent of energy
compensation may depend on the subjects' sex and age,
their habitual diet, and dietary restraint. Rolls et al (1994)
found near-perfect energy compensation among non-dieting young men, but variable results with a group of
restrained women. In contrast, a recent study of 14
restrained women (Lavin et al, 1997) reported not only
complete compensation but rebound eating.
In that study (Lavin et al, 1997), fourteen restrained
female subjects consumed four 330 ml soft drinks during
the day, while being provided with lunch, evening meal,
and unlimited access to high-fat and high-carbohydrate
snacks. The drinks were lemonade sweetened with 80 g of
sucrose (1.0 kcal=ml), lemonade sweetened with aspartame
(0 kcal=ml) and carbonated mineral water. As in past
studies, no differences in hunger or fullness ratings were
observed, suggesting that the subjects were insensitive to
320 kcal versus none. However, energy compensation did
occur and total daily energy intakes across the three
experimental conditions were the same. The aspartame
condition was followed by elevated energy intakes on the
next day (Lavin et al, 1997). However, the data were
somewhat atypical. Despite dietary restraint, the young
women consumed a mean of 3000 kcal=d, including up to
168 grams of fat in the aspartame condition. On the ®rst day
of testing, mean percentage of energy from fat was 46%,
while on the second day alcohol intakes reached a mean of
22 g, equivalent to four drinks.
Most recent studies suggest that energy from carbohydrate, when ingested in a beverage as opposed to a solid
food, may fail to provoke a compensation response, at least
in the short-term (Mattes 1996). In a study of soft drinks
consumption, 24 subjects failed to compensate for additional energy from sucrose-sweetened mineral water (0.4
kcal=g) during lunch and dinner on experimental days or on
the following day (Beridot-Therond et al, 1998).
Control of body weight
Only a few clinical and epidemiological studies have
addressed long-term use of intense sweeteners. An early
clinical study by Porikos et al (1982) showed that replacing
sucrose with aspartame over a period of 11 d led to partial
(40%) compensation for the missing sucrose calories. In
another study (Tordoff & Alleva, 1990), the consumption of
1135 mL of aspartame-sweetened as opposed to fructosesweetened soda daily for 21 d was associated with lower
energy intakes in both male and in female subjects. Male
subjects also lost weight during the 3-week period. The
calorie savings derived not from a reduction in food intake
but from a decline in energy derived from soft drinks.
Regular users of intense sweeteners may learn to compensate accurately for the missing calories (Bellisle &
Perez, 1994; Louis-Sylvestre et al, 1989). If so, then intense
sweeteners will have little impact on the long-term control
of food intake or body weight. A recent study of extended
use of reduced-sugar foods by non-obese free-living
females (Gatenby et al, 1997) showed that the subjects
did reduce sucrose intakes relative to control groups.
However, there were no differences in total sugars or in
carbohydrate consumption and no differences in body
weight over the study period were observed. Casual use
of diet products may have little impact on total energy
intakes or body weight status (Gatenby et al, 1997).
Studies of intense sweeteners in obesity treatment are
even more limited. In a pilot study of obese outpatients
(Kanders et al, 1988; Blackburn et al, 1993), 46 female
users of aspartame lost slightly more weight (7.4 kg as
compared to 5.8 kg) when they supplemented a low-energy
diet with aspartame-sweetened foods and beverages; however, a small group of male subjects (n ˆ 11) showed the
opposite trend. At the 1-y follow up, maintenance of lower
body weight was predicted by increased physical activity
levels, reduced preference for sweets, and higher consumption of aspartame-sweetened foods.
A later clinical study (Blackburn et al, 1997) recruited
obese women for a multidisciplinary 17-month weight
control program. A total of 163 women were randomly
assigned to one of two groups, being asked either to abstain
from or to freely consume aspartame-sweetened foods and
beverages during the weight loss phase (16 weeks), a 1-y
maintenance program, and a 2-y follow-up period. The
active phase was based on a 1500 kcal diet, composed of
24% fat, 56% carbohydrate, and 20% protein, and an
exercise prescription for 200 min physical activity per
week. Monthly group sessions and annual follow ups
were part of the program.
Intense sweeteners and weight control
A Drewnowski
762
At the end of the active weight loss period, the aspartame group consumed a mean of 0.29 g aspartame per day,
approximately equivalent in terms of sweetening power
(for liquids) to 150 g of sucrose. While the reported range
of aspartame intakes was from 0.075 to 0.53 g=d, it is
impossible to estimate the energy density of the diet.
Exercise prescription seemed to be effective; subjects
who initially reported a mean of 4 min of physical activity
per week increased activity levels to > 2 ± 3 h per week
(Blackburn et al, 1993).
While the initial weight loss (10% of initial body
weight) was comparable for the two groups, the aspartame
group showed better weight maintenance during the followup period. Speci®cally, participants in the aspartame group
regained only 2.6% of initial body weight after 71 weeks
and 4.6% after 175 weeks. In contrast, participants in the
no-aspartame group experienced an average weight regain
of 5.4% and 9.4%, respectively. The aspartame group lost
signi®cantly more weight overall and regained signi®cantly
less weight during maintenance and follow-up than did the
no-aspartame group (Blackburn et al, 1993). These data
suggest that while aspartame per se does not promote rapid
weight loss, the inclusion of aspartame sweetened products
in a multidisciplinary weight control program may promote
the long term maintenance of reduced body weight (Blackburn et al, 1997). Whether the aspartame group consumed a
more energy-dilute diet is, of course, the key question.
Conclusions: sweeteners in a healthy diet
As incomes rise and populations become more urban, traditional plant-based diets high in complex carbohydrates and
®ber give way to more varied diets that incorporate more
meat and animal products. Such diets are more energy dense,
since they derive a higher percentage of energy from animal
protein, starches, sugars, and fats (Drewnowski & Popkin,
1997). Faced with the health consequences of over-nutrition,
the food industry has sought to increase the satiating value of
foods (Drewnowski, 1993). One strategy has been to reduce
energy density by increasing food bulk and volume. However, substituting water, ®ber and protein for the more
energy-dense (and more palatable) sugar and fat can result
in bland and monotonous diets. Few dieters adhere to
energy-dilute diets for very long (Drewnowski, 1998).
Though naturally energy-dilute foods such as raw vegetables and fruit are widely distributed in the food supply,
many consumers prefer to lower the energy density of their
diet by using intense sweeteners and fat replacement
products. Intense sweeteners offer a very effective
method of reducing energy density of foods while maintaining their palatability (Drewnowski, 1995). According to
current theories on energy density and satiety, palatable
diet soft drinks provide volume and therefore affect satiety,
even though their energy density is zero. However, most
studies on intense sweeteners and energy density have been
short-term ones, and our understanding of energy density
issues is therefore limited. Whether the energy density
approach to weight reduction will be effective in the long
term still remains to be determined.
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