Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies.

By reducing energy density, low-energy sweeteners (LES) might be expected to reduce energy intake (EI) and body weight (BW). To assess the totality of the evidence testing the null hypothesis that LES exposure (versus sugars or unsweetened alternatives) has no effect on EI or BW, we conducted a systematic review of relevant studies in animals and humans consuming LES with ad libitum access to food energy. In 62 of 90 animal studies exposure to LES did not affect or decreased BW. Of 28 reporting increased BW, 19 compared LES with glucose exposure using a specific 'learning' paradigm. Twelve prospective cohort studies in humans reported inconsistent associations between LES use and body mass index (-0.002 kg m(-)(2) per year, 95% confidence interval (CI) -0.009 to 0.005). Meta-analysis of short-term randomized controlled trials (129 comparisons) showed reduced total EI for LES versus sugar-sweetened food or beverage consumption before an ad libitum meal (-94 kcal, 95% CI -122 to -66), with no difference versus water (-2 kcal, 95% CI -30 to 26). This was consistent with EI results from sustained intervention randomized controlled trials (10 comparisons). Meta-analysis of sustained intervention randomized controlled trials (4 weeks to 40 months) showed that consumption of LES versus sugar led to relatively reduced BW (nine comparisons; -1.35 kg, 95% CI -2.28 to -0.42), and a similar relative reduction in BW versus water (three comparisons; -1.24 kg, 95% CI -2.22 to -0.26). Most animal studies did not mimic LES consumption by humans, and reverse causation may influence the results of prospective cohort studies. The preponderance of evidence from all human randomized controlled trials indicates that LES do not increase EI or BW, whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.

The effect of a low-energy food foam on appetite measures during a 1-day reduced-energy meal plan.

BACKGROUND/OBJECTIVES: We have previously shown that 500 ml of a foamed drink ('foam') significantly improved appetite versus a non-foamed control. The objectives of this research were to assess the effect of smaller volumes of foams on appetite, and the potential benefits of foam ingestion and its timing on appetite measures in a reduced-energy context. SUBJECTS/METHODS: Two randomized, parallel design studies (pre- and main study) were conducted using healthy adult subjects. Pre-study: 133 subjects (age 18-50 years, body mass index (BMI) 20-32 kg m(-2)) each consumed either 10, 25, 50, 100, 150 or 250 ml foamed meal replacer (~0.2 kcal ml(-1)), 150 min after a fixed breakfast. Main study: four groups of subjects (n=134; age 18-60 years, BMI 22.5-35.0 kg m(-2)) consumed 200 ml/22 kcal foam (based on pre-study results) immediately after main meals (M), after snacks (S), in-between snacks and main meals (I) or not at all (control, C) within 1 day of a reduced-energy meal plan consisting of three main meals and three snacks. Measurements included self-reported appetite (six scales, reported as area under the curve (AUC)) and (main study only) end-of-day appetite questionnaire. RESULTS: Pre-study: the strongest effect on appetite was produced by 250 ml (consistent across scales), whereas 150 ml showed more pronounced effects than 100 and 50 ml in most scales. Volumes 10 and 25 ml had no effects on any scale. Main study: 200 ml foam reduced appetite AUC substantially in all treatments, particularly M (for example, hunger AUC reduced by 35% (P <0.001), 28% (P <0.05) and 20% (P=0.11) for M, S and I, respectively versus C). A strong reduction in 'appetite for a snack' was seen for all timings (all P <0.05). The end-of-day appetite ratings confirmed these findings. CONCLUSIONS: Modest amounts of a low-energy foam can reduce appetite measures during a 1-day reduced-energy meal plan.

Acute effects of mustard, horseradish, black pepper and ginger on energy expenditure, appetite, ad libitum energy intake and energy balance in human subjects.

Chilli peppers have been shown to enhance diet-induced thermogenesis (DIT) and reduce energy intake (EI) in some studies, but there are few data on other pungent spices. The primary aim of the present study was to test the acute effects of black pepper (pepper), ginger, horseradish and mustard in a meal on 4 h postprandial DIT. The secondary aim was to examine the effects on subjective appetite measures, ad libitum EI and energy balance. In a five-way placebo-controlled, single-blind, cross-over trial, twenty-two young (age 24·9 (SD 4·6) years), normal-weight (BMI 21·8 (SD 2·1) kg/m²) males were randomly assigned to receive a brunch meal with either pepper (1·3 g), ginger (20 g), horseradish (8·3 g), mustard (21 g) or no spices (placebo). The amounts of spices were chosen from pre-testing to make the meal spicy but palatable. No significant treatment effects were observed on DIT, but mustard produced DIT, which tended to be larger than that of placebo (14 %, 59 (SE 3) v. 52 (SE 2) kJ/h, respectively, P=0·08). No other spice induced thermogenic effects approaching statistical significance. Subjective measures of appetite (P>0·85), ad libitum EI (P=0·63) and energy balance (P=0·67) also did not differ between the treatments. Finally, horseradish decreased heart rate (P=0·048) and increased diastolic blood pressure (P= 0·049) compared with placebo. In conclusion, no reliable treatment effects on appetite, EI or energy balance were observed, although mustard tended to be thermogenic at this dose. Further studies should explore the possible strength and mechanisms of the potential thermogenic effect of mustard actives, and potential enhancement by, for example, combinations with other food components.

Potential benefits of satiety to the consumer: scientific considerations.

Foods and dietary patterns that enhance satiety may provide benefit to consumers. The aim of the present review was to describe, consider and evaluate research on potential benefits of enhanced satiety. The proposal that enhanced satiety could only benefit consumers by a direct effect on food intake should be rejected. Instead, it is proposed that there is a variety of routes through which enhanced satiety could (indirectly) benefit dietary control or weight-management goals. The review highlights specific potential benefits of satiety, including: providing appetite control strategies for consumers generally and for those who are highly responsive to food cues; offering pleasure and satisfaction associated with low-energy/healthier versions of foods without feeling 'deprived'; reducing dysphoric mood associated with hunger especially during energy restriction; and improved compliance with healthy eating or weight-management efforts. There is convincing evidence of short-term satiety benefits, but only probable evidence for longer-term benefits to hunger management, possible evidence of benefits to mood and cognition, inadequate evidence that satiety enhancement can promote weight loss, and no evidence on which consumers would benefit most from satiety enhancement. The appetite-reducing effects of specific foods or diets will be much more subtle than those of pharmaceutical compounds in managing hunger; nevertheless, the experience of pharmacology in producing weight loss via effects on appetite suggests that there is potential benefit of satiety enhancement from foods incorporated into the diet to the consumer.

No appetite efficacy of a commercial structured lipid emulsion in minimally processed drinks.

BACKGROUND/OBJECTIVES: Fabuless (Olibra) is a commercially structured lipid emulsion, claimed to be a food ingredient that is effective for food intake and appetite reduction. The present study assessed its efficacy in a yoghurt-based mini-drink undergoing low or minimal food manufacturing (thermal and shear) processes. SUBJECTS/METHODS: Study 1: Twenty-four healthy volunteers (16 female, 8 male; age: 18-47 years; body mass index (BMI): 17-28 kg m(-2)) took part in a randomised, placebo-controlled, double-blind parallel crossover trial. Consumption of a minimally processed 'preload' mini-drink (containing two different doses of Fabuless or a control fat) at 2 h after breakfast was followed by appetite and mood ratings, and food intake measured in ad libitum meals at 3 and 7 h post consumption of the preload. Study 2: As Study 1 (16 female, 8 male; age: 20-54 years; BMI: 21-30 kg m(-2)). A chilled, virtually unprocessed, preload breakfast mini-drink (containing minimally processed Fabuless or a control fat) was provided 5 min after a standardised breakfast, followed by appetite and mood ratings, and food intake measured in ad libitum meals at 4 and 8 h post consumption of the preload. RESULTS: The structured lipid emulsion tested had no significant effect on the primary measures of food intake or appetite. CONCLUSIONS: Even when exposed to minimal food-manufacturing conditions, Fabuless showed no efficacy on measures of appetite and food intake.

The effect of protease inhibitors derived from potato formulated in a minidrink on appetite, food intake and plasma cholecystokinin levels in humans.

BACKGROUND: Protease inhibitor 2 derived from potato (PI2) is claimed to reduce appetite and food intake, stimulate the satiety hormone cholecystokinin (CCK) and lower postprandial glucose peaks when taken before a meal. However, current literature is inconclusive with regard to its efficacy and mechanism. Furthermore, the potential effect of PI2 on appetite motivational ratings without an immediately following meal has not previously been reported. OBJECTIVE: To comprehensively test the effects of 30 mg PI2 in a minidrink on appetite ratings, subsequent food intake, and plasma CCK and glucose responses. DESIGN: Minidrinks with or without 30 mg PI2 were compared in three separate substudies (A, B and C), each using a two-way, placebo-controlled, balanced-order, cross-over design and 23 or 24 subjects (mean over groups: body mass index 25.0 kg m(-2), range 22.5-30.7 kg m(-2); age 41.3, range 18-62 years). The minidrink was given (A) 120 or (B) 30 min before an ad libitum lunch or (C) 30 min before a fixed lunch. Study parameters were self-reported satiety (substudies A and C), ad libitum meal intake (substudies A and B), and (in an n=12 subset) plasma CCK and blood glucose in all substudies. All results were analyzed using analysis of covariance. Protease-inhibitory activity of the PI2-containing minidrinks was assessed under simulated gut conditions. RESULTS: PI2 did not differ from control for any study parameters, in any substudy, despite confirmation of the inhibitory activity of PI2. CONCLUSIONS: In this study protease inhibition using PI2 in a minidrink at a dose of 30 mg, as commercially used, had no (functional) efficacy on a range of behavioral and physiological appetite and intake control measures.

Ileal brake: a sensible food target for appetite control. A review.

With the rising prevalence of obesity and related health problems increases, there is increased interest in the gastrointestinal system as a possible target for pharmacological or food-based approaches to weight management. Recent studies have shown that under normal physiological situations undigested nutrients can reach the ileum, and induce activation of the so-called "ileal brake", a combination of effects influencing digestive process and ingestive behaviour. The relevance of the ileal brake as a potential target for weight management is based on several findings: First, activation of the ileal brake has been shown to reduce food intake and increase satiety levels. Second, surgical procedures that increase exposure of the ileum to nutrients produce weight loss and improved glycaemic control. Third, the appetite-reducing effect of chronic ileal brake activation appears to be maintained over time. Together, this evidence suggests that activation of the ileal brake is an excellent long-term target to achieve sustainable reductions in food intake. This review addresses the role of the ileal brake in gut function, and considers the possible involvement of several peptide hormone mediators. Attention is given to the ability of macronutrients to activate the ileal brake, and particularly variation attributable to the physicochemical properties of fats. The emphasis is on implications of ileal brake stimulation on food intake and satiety, accompanied by evidence of effects on glycaemic control and weight loss.

Sweet taste exposure and the subsequent acceptance and preference for sweet taste in the diet: systematic review of the published literature.

Background: There are consistent, evidence-based global public health recommendations to reduce intakes of free sugars. However, the corresponding evidence for recommending reduced exposure to sweetness is less clear. Objective: Our aim was to identify and review the published evidence investigating the impact of dietary exposure to sweet-tasting foods or beverages on the subsequent generalized acceptance, preference, or choice of sweet foods and beverages in the diet. Design: Systematic searches were conducted to identify all studies testing relations of variation in exposure to sweetness through foods and beverages with subsequent variation in the generalized acceptance, preference, or choice of sweetened foods or beverages, in humans aged >6 mo. Results: Twenty-one studies met our inclusion criteria, comprising 7 population cohort studies involving 2320 children and 14 controlled trials involving 1113 individuals. These studies were heterogeneous in study design, population, exposure, and outcomes measured, and few were explicitly designed to address our research question. The findings from these were inconsistent. We found equivocal evidence from population cohort studies. The evidence from controlled studies suggests that a higher sweet taste exposure tends to lead to reduced preferences for sweetness in the shorter term, but very limited effects were found in the longer term. Conclusions: A small and heterogeneous body of research currently has considered the impact of varying exposure to sweet taste on subsequent generalized sweet taste preferences, and this evidence is equivocal regarding the presence and possible direction of a relation. Future work should focus on adequately powered studies with well-characterized exposures of sufficient duration. This review was registered with PROSPERO as CRD42016051840, 24 November 2016.

Systematic review of the evidence for sustained efficacy of dietary interventions for reducing appetite or energy intake.

We assessed evidence for changes in efficacy of food-based interventions aimed at reducing appetite or energy intake (EI), and whether this could be used to provide guidance on trial design. A systematic search identified randomized controlled trials testing sustained efficacy of diets, foods, supplements or food ingredients on appetite and/or EI. Trials had to include sufficient exposure duration (≥3 days) with appetite and/or EI measured after both acute and repeated exposures. Twenty-six trials met the inclusion criteria and reported data allowing for assessment of the acute and chronic effects of interventions. Most (21/26) measured appetite outcomes and over half (14/26) had objective measures of EI. A significant acute effect of the intervention was retained in 10 of 12 trials for appetite outcomes, and six of nine studies for EI. Initial effects were most likely retained where these were more robust and studies adequately powered. Where the initial, acute effect was not statistically significant, a significant effect was later observed in only two of nine studies for appetite and none of five studies for EI. Maintenance of intervention effects on appetite or EI needs to be confirmed but seems likely where acute effects are robust and replicable in adequately powered studies.

Dietary carbohydrates: a review of international recommendations and the methods used to derive them.

BACKGROUND/OBJECTIVES: Renewed dietary recommendations for carbohydrates have recently been published by various international health authorities. The present work (1) reviews the methods and processes (systematic approach/review, inclusion of public consultation) used to identify, select and grade the evidence underpinning the recommendations, particularly for total carbohydrate (CHO), fibre and sugar consumption, and (2) examines the extent to which variation in the methods and processes applied relates to any differences in the final recommendations. SUBJECTS/METHODS: A search of WHO, US, Canada, Australia and European sources identified 19 documents from 13 authorities with the desired detailed information. Processes and methods applied to derive recommendations were compiled and compared. RESULTS: (1) A relatively high total CHO and fibre intake and limited intake of (added or free) sugars are generally recommended. (2) Even where recommendations are similar, the specific justifications for quantitative/qualitative recommendations differ across authorities. (3) Differences in recommendations mainly arise from differences in the underlying definitions of CHO exposure and classifications, the degree to which specific CHO-providing foods and food components were considered, and the choice and number of health outcomes selected. (4) Differences in the selection of source material, time frames or data aggregation and grading methods appeared to have minor influence. CONCLUSIONS: Despite general consistency, apparent differences among the recommendations of different authorities would likely be minimized by: (1) More explicit quantitative justifications for numerical recommendations and communication of uncertainty, and (2) greater international harmonization, particularly in the underlying definitions of exposures and range of relevant nutrition-related outcomes.

Metabolically active functional food ingredients for weight control.

The scale of the obesity epidemic creates a pressing consumer need as well as an enormous business opportunity for successful development and marketing of food products with added benefits for weight control. A number of proposed functional food ingredients have been shown to act post-absorptively to influence substrate utilization or thermogenesis. Characteristics and supporting data on conjugated linoleic acid, diglycerides, medium-chain triglycerides, green tea, ephedrine, caffeine, capsaicin and calcium, are reviewed here, giving examples of how these could act to alter energy expenditure or appetite control. Consideration is also given to other factors, in addition to efficacy, which must be satisfied to get such ingredients into foods. We conclude that, for each of the safe, putatively metabolically active agents, there remain gaps in clinical evidence or knowledge of mechanisms, which need to be addressed in order to specify the dietary conditions and food product compositions where these ingredients could be of most benefit for weight control.

Gustatory function and dietary habits in users and nonusers of smokeless tobacco.

Nicotine and smoking may modify gustatory function or preferences and are associated with altered energy balance; however, there is no information on whether smokeless tobacco (ST) has similar effects. Evaluations of gustatory function (threshold sensitivity, perceived intensity of suprathreshold stimuli, preferences) were conducted on 28 chronic ST users and 30 nonusers after both abstaining and using ST. Subjects also maintained 7-d dietary records that included descriptions of the predominant taste qualities of foods. There were few user vs nonuser differences in gustatory measures. Among nonusers, use of ST reduced perceived intensity of salty, sour, and bitter stimuli. Users reported greater alcohol intakes and lower consumption of carbohydrates, sweet foods, fruits, and grains. Chronic use of ST does not appear to have substantial effects on gustatory function but may be associated with decreased carbohydrate intakes, perhaps related to increased alcohol use and possibly because of reduced consumption of sweet-tasting foods.

Sensory preferences for fats: relationships with diet and body composition.

Little is known about the factors influencing individual selection and consumption of fats or the role of sensory preferences in this process. Thirty human subjects kept diet records for 10 d and then underwent preference testing with fat-containing stimuli: 10 different foods, each prepared with 2-5 levels of fat. The mean preferred level of fat across all foods was used as an indicator of overall fat preference. Analyses indicate 1) wide individual variation in the most preferred fat level for each stimulus, with no consistent correlation among the various stimuli; 2) no consistent relationships among sensory and dietary measures; and 3) a positive correlation between overall fat preference and percent body fat (r = 0.46, P less than 0.01). Although a battery of test stimuli may be used to identify individual and group sensory preferences for fats, relationships between sensory and dietary measures remain unclear.

Extended use of foods modified in fat and sugar content: nutritional implications in a free-living female population.

The nutritional implications of the consumption of reduced-fat and reduced-sugar foods were assessed in nonobese, free-living female consumers in a 10-wk intervention trial. Subjects in control (C; n = 13), reduced-fat (RF; n = 17), and reduced-sugar (RS; n = 19) groups, all initially nonusers of reduced-fat and reduced-sugar products, kept 4-d food-intake records to establish energy and macronutrient intakes at baseline and at 2,4,7, and 10 wk. Groups RF and RS were instructed to use reduced-fat and reduced-sugar foods, respectively, ad libitum in place of habitually consumed foods with traditional composition, whereas group C was to maintain their usual diet. All foods were purchased by subjects in normal retail outlets and consumed at home. Analyses revealed no main or interactive effect of group on reported energy intake. RF subjects reduced their reported fat intake during the study (P = 0.017) compared with RS and C subjects, and RS subjects reduced their reported sucrose intake compared with RF and C subjects (P = 0.049). Group differences in total sugar intake were not significantly different. All groups reported a small but significant increase in reported protein intake during the study, whereas there were no significant effects on percentage energy from total carbohydrate. Body weights did not change significantly in any group over the study period. These results indicate that, as a single dietary strategy, casual use of macronutrient-substituted foods by consumers under normal eating conditions can significantly influence the macronutrient composition of the diet, but has little net effect on total energy intake or body weight status.

The effect of exercise and hyperlipemic diet on aortic histopathology in the rat.

Histological changes in the aorta were used as criteria to assess the effect of treadmill exercise on the development of atherosclerosis in rats consuming a moderately hyperlipemic diet. While grossly visible atherosclerotic plaques were absent, microscopic examination of sections of the abdominal aorta were distinctly different between exercised and sedentary rats. Aortas of sedentary rats fed a diet containing lard and cholesterol had a high degree of plaque development, fat accumulation, mineralization, erosion and necrosis. Aortas of exercised rats fed the same diet had considerably less atherogenic involvement. Both hyperlipemic groups had greater plaque formation than sedentary rats fed a normolipemic diet. In addition, there were marked differences in plasma lipids; exercise ameliorated the diet-induced changes in plasmatic atherogenic lipids. Our results indicate that exercise retards the development of atherosclerosis in rats fed a hyperlipemic diet.

The effects of exercise and a moderate hypercholesterolemic diet on plasma and hepatic lipoproteins in the rat.

Exercise generally has been found to produce beneficial effects on plasma lipid and lipoprotein profiles, but the mechanisms involved and possible dietary interactions have not been well defined. Weanling male Fischer 344 rats were assigned to three groups: normocholesterolemic diet sedentary (NS), hypercholesterolemic diet sedentary (HS), and hypercholesterolemic diet exercised (HE). Exercise consisted of treadmill running at 1.2 to 1.4 km/h at a 9% grade, six days weekly, for a 10-week experimental period. Lipoproteins from plasma and from a recirculating in situ liver perfusion system were then isolated and analyzed. The values of several parameters for HE tended to fall intermediate between HS and NS. Final total plasma cholesterol and liver cholesterol concentrations were significantly different among all three groups (HS greater than HE greater than NS). Plasma HDL-cholesterol and phospholipids and perfusate HDL-cholesterol production rate per gram liver were all significantly lower in HS v NS, with HE lying in between. Plasma HDL protein was lower in HS than in both other groups. Plasma total triglyceride levels were significantly lowered by exercise, but neither plasma nor perfusate VLDL triglyceride levels differed significantly among the three groups. Food intakes of HE and HS rats were similar, but HE rats had significantly lower final body weights. The results suggest that (1) exercise may ameliorate many of the changes in lipoprotein and cholesterol metabolism induced by a diet containing lard and cholesterol, and (2) some of these changes may be mediated by changes in hepatic lipoprotein production.

No effect of oral or sample temperature on sensory assessment of fat content.

This work examined the possible influences of oral and sample temperature on the perception of fat content of a model food system. Melting or related phenomena may contribute to the greater sensation of fat content and the highly acceptable textural characteristics associated with certain fats. Thirty-one adults assessed the fat content of 0%, 12%, 24%, 36%, and 48% oil-in-water emulsions prepared with a commercial cocoa butter substitute having a melting range of 17-41 degrees C. Samples were evaluated at combinations of sample and mouth temperatures of 20 and 36 degrees C, with oral temperatures manipulated by repeated cold- and warm-water rinses prior to assessments. There were no significant differences amongst these treatments on perceived fat content of the samples, nor were subject characteristics of age or body composition related to judgments of fat content in these stimuli. Although previous studies had shown that degree of fat saturation is associated with enhanced perception of fat content (11), that does not appear to be related to the degree or occurrence of melting in the mouth over the ranges studies here.

Relationships of consumer characteristics and food deprivation to food purchasing behavior.

A large part of domestic food intake may be determined by retail food purchase behavior, and it is commonly believed that this may be significantly influenced by the shopper's state of food deprivation. In the present study, 198 subjects recruited just prior to shopping at a large supermarket completed questionnaires eliciting information on demographic and situational variables, along with measures of time since last eating (TSLE), hunger, and dietary restraint. Upon leaving the store, subjects provided investigators with itemized receipts, having first identified all "unintended" purchases. There were no consistent main effects of TSLE, self-reported hunger, dietary restraint scores, or relative body weight on the number or cost of total, intended, and unintended food and nonfood purchases. However, there were significant interactions of weight status and measures of food deprivation upon measures of food purchasing. Although normal-weight subjects tended to increase their food purchases with food deprivation, the number and cost of food items fell markedly with extended food deprivation among overweight subjects. These effects were largely specific to food (i.e., generally not observed for nonfood purchases), but showed no consistent associations with unintended purchases or with particular foods or food groups. Higher dietary restraint and relative body weight were associated with lower reported hunger ratings, but not differences in mean TSLE, or other subject characteristics. These results run directly counter to common beliefs and recommendations for weight control and dieting, but support earlier work indicating that the food purchasing behaviors of normal-weight and overweight individuals are differently affected by food deprivation.

Effects of learned flavour cues on short-term regulation of food intake in a realistic setting.

The present study examined the effects of repeated midmorning consumption of novel-flavoured low- and high-energy yoghurt drinks on subsequent energy intake at lunch in 69 adults under actual use conditions. Subjects consumed 200 ml of low- and high-energy yoghurt drinks (67 and 273 kcal/200 ml, respectively), with 20 exposures to each drink on alternate days. Analyses focused on the development of compensation for the differences in energy content of the beverages, due to learned satiety. Results revealed incomplete energy compensation for the beverages, both at first exposure and also after 20 exposures. Relative to the no-yoghurt condition, energy intake compensation (+/-S.E.M.) averaged 39+/-36% for the low-energy yoghurt and 17+/-9% for the high-energy version, with no evidence of any change in compensation with repeated exposures. When the flavours of the yoghurt drinks were covertly switched after 20 exposures, subjects increased their energy intake after the high-energy yoghurt drink containing the flavour that was previously coupled with the low-energy yoghurt drink. Vice versa, however, when subjects switched to the low-energy yoghurt drink containing the high-energy flavour, subjects ignored the flavour cue and ate the same lunch size regardless of the energy in the yoghurt drink. We conclude that adults do not readily acquire accurate conditioned adjustments for the energy content in food after repeated experience with the food in free-living natural-eating conditions.

Nutritional implications of fat substitutes.

The possibility of replacing fats in foods through the use of alternative ingredients has generated substantial interest among food industry and nutrition professionals as well as among the lay public and news media. However, even in academic circles, there is a tendency to consider "fat substitutes" as a homogeneous group, when they are not, and also to make unproven assumptions regarding their likely efficacy in reducing fat intake and aiding in maintenance of appropriate energy balance. Governmental and industrial bodies have tended to place much greater emphasis on the potential risks of these materials than on their possible benefits. A reasoned consideration of the nutritional implications of fat substitutes examines what these materials are, how they might be used, and how they might affect eating behavior and nutritional status in the general population. The existing literature suggests that although the risks of existing and proposed fat substitutes are probably limited, their nutritional benefits are largely unproven.