Süßstoffe und ihre Wirkung auf das Körpergewicht

ZUSAMMENFASSUNG

Süßstoffe sind chemisch, geschmacklich und biologisch heterogene, hochpotente Süßungsmittel, die in kalorienreduzierten Getränken, hochprozessierten Speisen und diätetischen Ersatzmahlzeiten verwendet werden. Maximal empfohlene Verzehrsmengen (“acceptable daily intake”, ADI) werden bei ausgewogener Ernährung und bei ausgeprägter Nutzung trotz konservativer Auslegung meist nicht erreicht. Süßstoffmischungen begünstigen die Unterschreitung der ADIs und die Geschmacksoptimierung. Epidemiologisch ist Süßstoffverzehr mit Adipositas, Typ-2-Diabetes, kardiovaskuläre Erkrankungen und Krebs assoziiert. Starke Confounder (andere Lebensstilfaktoren) und „reverse causality“ schwächen aber die Aussagekraft.

In verblindeten randomisiert-kontrollierten Studien (RCTs) bewirken Süßstoffe gegenüber Zucker eine signifikante Reduktion von Körpergewicht und Leberfett, während glykämische Parameter zum Nachteil trenden. Der Gewichtsverlust liegt unter der Erwartung gemäß der theoretisch eingesparten Kalorien. Psychologische oder metabolische Störeffekte der Süßstoffe sind daher aktuell Gegenstand intensiver Forschung, bei der das Inkretinsystem, die Konditionierung auf Süßreize und das Darmmikrobiom Ansatzpunkte darstellen.

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