There is an ongoing debate about the possible influences of nonnutritive sweeteners (NNS) on body weight. We conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs) with NNS to assess their impact on body weight. We systematically searched for RCTs at least 4 weeks in duration, evaluating the effect of NNS on body weight, both in subjects with healthy weight and in subjects with overweight/obesity at any age, and compared the effects of NNS vs caloric and noncaloric comparators. The primary outcome was the difference in body weight between NNS and comparators. Twenty studies were eligible (n = 2914). Participants consuming NNS showed significant weight/BMI differences favouring NNS compared with nonusers. Grouping by nature of comparator revealed that NNS vs placebo/no intervention and NNS vs water produced no effect. When comparing NNS vs sucrose, significant weight/BMI differences appeared favouring NNS. Consumption of NNS led to significantly negative weight/BMI differences in unrestricted energy diets, but not in weight‐reduction diets. Participants with overweight/obesity and adults showed significant favourable weight/BMI differences with NNS. Data suggest that replacing sugar with NNS leads to weight reduction, particularly in participants with overweight/obesity under an unrestricted diet, information that could be utilized for evidence‐based public policy decisions.

中文翻译：

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非营养性甜味剂在多种临床情况下对体重和BMI的影响：系统评价和荟萃分析。

关于非营养性甜味剂（NNS）对体重的可能影响的争论一直在进行。我们对NNS的随机对照试验（RCT）进行了系统的回顾和荟萃分析，以评估其对体重的影响。我们系统地搜索了至少持续4周的RCT，评估了NNS对体重健康的受试者和任何年龄段的超重/肥胖受试者的体重的影响，并比较了NNS与热量和非热量比较者的影响。主要结果是NNS和比较者之间的体重差异。二十项研究符合条件（n = 2914）。与非使用者相比，食用NNS的参与者表现出明显的体重/ BMI差异，偏爱NNS。根据比较者的性质分组显示，NNS与安慰剂/无干预，NNS与水无作用。比较NNS与蔗糖时，明显的体重/ BMI差异似乎有利于NNS。在无限制的能量饮食中，摄入NNS会导致体重/ BMI显着为负，而在减肥饮食中却没有。超重/肥胖和成年人的参与者与NNS表现出明显的有利体重/ BMI差异。数据表明，用NNS代替糖可以减轻体重，特别是在饮食无限制的情况下超重/肥胖的参与者，这些信息可用于基于证据的公共政策决策。超重/肥胖和成年人的参与者与NNS表现出明显的有利体重/ BMI差异。数据表明，用NNS代替糖可以减轻体重，特别是在饮食无限制的情况下超重/肥胖的参与者，这些信息可用于基于证据的公共政策决策。超重/肥胖和成年人的参与者与NNS表现出明显的有利体重/ BMI差异。数据表明，用NNS代替糖可以减轻体重，特别是在饮食无限制的情况下超重/肥胖的参与者，这些信息可用于基于证据的公共政策决策。