The Sweet Tooth Trial: A Parallel Randomized Controlled Trial Investigating the Effects of A 6-Month Low, Regular, or High Dietary Sweet Taste Exposure on Sweet Taste Liking, and Various Outcomes Related to Food Intake and Weight Status
Eva M. Čad, Monica Mars, Lesha Pretorius, Merel van der Kruijssen, Claudia S. Tang, Hanne BT de Jong, Michiel G.J. Balvers, Katherine M. Appleton, Kees de Graaf
Abstract
Background Public health organizations currently recommend lowering the consumption of sweet-tasting foods, on the assumption that a lower exposure to sweet-tasting foods lowers preferences for sweet taste, decreasing sugar and energy intake, and aiding obesity prevention. However, empirical data supporting this narrative are lacking. Objectives The objective of this study was to assess the effects of a 6-mo low, regular, and high dietary sweet taste exposure on liking for sweet taste. Methods In a parallel-groups randomized controlled intervention study, 180 healthy adults (female/male: 123/57; aged: 35 ± 15 y; body mass index (in kg/m 2 ): 23 ± 3) were provided with dietary advice and ∼50% daily energy needs for 6 mo, where 7% (low sweet taste exposure, n = 61), 35% (regular sweet taste exposure, n = 60), or 80% (high sweet taste exposure, n = 59) provided foods and beverages were sweet tasting from sugars, low-calorie sweeteners, fruits and dairy. Before, at 6 mo, and at a 4-mo follow-up, sweet taste liking, sweet taste intensity perception, food choice, energy intake, body weight, markers for diabetes and cardiovascular disease, and adverse events were assessed. Results Sweet food consumption varied between groups over the intervention period (self-reported dietary measures (percentage energy, percentage weight): smallest χ 2 (16) = 59.4, P < 0.001; urinary markers for sucrose, sucralose, and saccharin: smallest χ 2 (10) = 21.0, P = 0.02). However, from baseline to month 6, no differences between groups were found in sweet taste liking ( χ 2 (40) = 37.9, P = 0.56), sweet taste intensity perception (χ 2 (40) = 20.7, P = 0.99), sweet food choice (χ 2 (10) = 10.1, P = 0.43), energy intake (χ 2 (10) = 12.7, P = 0.24), body weight (χ 2 (10) = 14.3, P = 0.16), markers for diabetes and cardiovascular disease (largest χ 2 (10) = 15.9, P = 0.10) or adverse events. After the intervention, participants also spontaneously returned to baseline levels of sweet food intake. Conclusions In the current trial, altering exposure to sweet-tasting foods did not change sweet taste liking, nor other outcomes. These results do not support public health advice to reduce exposure to sweet-tasting foods, independent of other relevant factors such as energy density and food form. This trial was registered at clinicaltrials.gov as NCT04497974.