British Food Journal

The effects of blind substitution of aspartame-sweetened for sugar-sweetened soft drinks on appetite
and mood
Marie Reid Richard Hammersley
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Marie Reid Richard Hammersley, (1998),"The effects of blind substitution of aspartame-sweetened for sugar-sweetened soft
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 The effects of blind substitution of
aspartame-sweetened for sugar-sweetened soft
drinks on appetite and mood
It has been suggested that
habitual consumers of sugar
experience “cravings” when
deprived. Subjects (n = 27)
who habitually consumed
sugar-sweetened drinks were
placed on a seven-day regime
receiving either sugar-sweet-
ened drinks, or aspartame-
Downloaded by University of Victoria At 08:33 03 February 2016 (PT)
sweetened alternatives. A
between-subjects design was
used to prevent subjects
comparing the drinks, which
were given blind with the
cover story that the study was
testing a new drink. In fact
commercial carbonated
beverages were given. At the
end, subjects were unable to
guess which they had
received. Subjects completed
a prospective food diary and
rated mood daily using the
Profile of Mood States, as well
as before and after each test
drink, using simple visual
analogue scales. Compared to
subsequent days, on the first
day of the study subjects
receiving aspartame-sweet-
ened drinks ate fewer grams
of carbohydrate and had
fewer sugar episodes (where
sugars, or sugar-fat, or sugar-
alcohol mixtures were con-
sumed). Overall energy intake
for the day was unaffected. By
day two, there were no differ-
ences between the groups in
diet or mood. Body weight at
seven days was unaltered
from baseline. Blind substitu-
tion of aspartame-sweetened
for sugar-sweetened soft
drinks did not increase other
sugar consumption and did
not adversely affect mood.
Any effects of this dietary
change appear transient.
British Food Journal
100/5 [1998] 254–259
© MCB University Press
[ISSN 0007-070X]
[ 254 ]
Marie Reid
Department of Psychiatry, University of Sheffield, Sheffield, UK
Richard Hammersley
Social Sciences Research Training Unit, University of Sheffield, Sheffield, UK
Introduction
Consumption of food high in refined carbohy-
drate may lead to weight gain in the long
term (Ramirez, 1987; Spitzer and Rodin, 1981).
Another concern is that oral health can be
adversely affected by frequent episodes of
fermentable carbohydrate consumption
(Newbrun, 1991). Sugar-sweetened soft drinks
are one common source of fermentable carbo-
hydrate (CHO) in the diet. For both these
health reasons, partial substitution in the
diet of sugars by artificial sweeteners may be
desirable. There may, however, be three poten-
tial difficulties, which relate to the phenome-
non termed carbohydrate craving. First,
people may simply make up for the change by
consuming more CHO elsewhere in the diet.
Second, reducing the CHO content of the diet
may increase hunger, as may intense artifi-
cial sweeteners (Blundell and Hill, 1986;
Rogers and Blundell, 1989). Third, it has been
proposed that people may use CHO to manage
everyday mood (Spring et al., 1986) and the
effects of artificially-sweetened drinks on
mood may be different.
Some studies surveying the general popula-
tion have found that sugar intake is nega-
tively correlated with fat intake (Gibney et
al., 1995; Hulshoff et al., 1993) while others
have found a positive relationship between
the two nutrients (Macdiamid et al., 1995). In
an intervention study (Tordoff and Alleva,
1990), comparing the long-term effects of
beverages sweetened with high-fructose corn
syrup or aspartame on eating and body
weight (three-week), it was found that the
carbohydrate beverage supplement increased
overall energy intake from the rest of the diet
and body weight, while the aspartame sweet-
ened drink had the opposite effect. The nutri-
ent content of the diet only varied in its sugar
content and this was primarily due to the
content of the test drinks. There was no com-
pensatory change in fat consumption.
Other relevant studies have been conducted
over much shorter time periods, typically less
than 12 hours and we have reviewed these
elsewhere (Reid and Hetherington, 1997).
There is some evidence that consumption of
foods and drinks containing refined carbohy-
drate such as sugar increases the motivation
to eat both generally (Rolls et al., 1988; Teff et
al., 1989) and specifically for foods high in
sugar (Geiselman and Novin, 1982). These
effects are similar to the effects of artificial
sweeteners (Blundell and Hill, 1986; Rogers
and Blundell, 1989), which suggests that per-
haps intense sweetness (whatever its source)
stimulates appetite. Indeed, when sweetness
and other sensory factors are controlled with
a blind, between-subjects design, then com-
paring sucrose and saccharin containing
drinks, sucrose delays the next meal and
appears neither to increase carbohydrate
consumption at that meal, nor to reduce the
meal’s energy value (Reid and Hammersley,
1994; 1995). This suggests that sweetness,
rather than the metabolism of CHO or artifi-
cial sweeteners, is the primary cause of
increased appetite in the short term.
It has also been suggested that simple car-
bohydrates affect mood over a period of
hours. They may reduce arousal (Pivonka
and Grunewald, 1990; Spring et al., 1993;
Thayer, 1987), perhaps first increasing
arousal (Thayer, 1987). However, these find-
ings may be due to psychological, rather than
physiological, factors (Hammersley and Reid,
1997; Reid and Hammersley, 1995). It is also
possible that mood effects vary depending
upon the exact form of carbohydrate used and
perhaps some people are particularly
affected. Any mood changes after sugar-
sweetened drinks might help maintain the
habit of consuming them. However, long-term
effects on mood may differ from short-term
effects.
The effects of switching from sugar sweet-
ened to artificially sweetened soft drinks have
not been previously examined. The aim of the
present study was to determine the effects on
medium term food intake and mood of provid-
ing either sugar-sweetened or aspartame-
sweetened beverages, consumed several
times a day over a seven-day period, in the
diet of normal adults who habitually con-
sumed sugar-sweetened drinks. Changing to
artificially sweetened drinks may lead to any
of the following long-term effects: changes in
overall energy intake; changes in carbohy-
drate intake; changes in rated energy; and
other mood changes. On the basis of the exist-
ing literature, any changes could be in either
 Marie Reid and
Richard Hammersley
The effects of blind
substitution of
aspartame-sweetened for
sugar-sweetened soft drinks
on appetite and mood
British Food Journal
100/5 [1998] 254–259
Downloaded by University of Victoria At 08:33 03 February 2016 (PT)
direction, or vary in direction across the
seven days of the study.
Method
Subjects
Of the subjects, 20 were university students
recruited by advertising in Dundee and
another 12 subjects were recruited from busi-
nesses in Glasgow. Four students failed to
complete the study, leaving 14 males and 14
females who returned data. One subject was
excluded because she became ill during the
study and did not complete her diary on
seven consecutive days. Table I summarises
subject characteristics. Experimental groups
did not differ significantly on any of these
purpose of the study was stated as being “To
investigate the effects of certain nutrients in
soft drinks on people’s psychological well-
being”. No mention of the aspartame-sweet-
ened drink was made to the participants.
Height and weight were recorded and sub-
jects were screened for eating disorders using
the EDI (Garner, 1990), and were selected on
the basis that their scores fell within the
normal range on all eight scales. The 28 par-
ticipants were divided into two groups who
received sucrose drinks or aspartame sweet-
ened drinks to consume under natural condi-
tions over a seven-day period. On the basis of
their normal soft drink intake subjects were
issued with two, three or four 250ml bottles of
soft drink per day. Table II lists the nutrient
composition of both the regular and diet Irn

variables.
Bru drinks.
The soft drinks were actually plastic bottles
of Irn Bru or Diet Irn Bru with the labels
Procedure removed and the caps painted a uniform
Potential subjects received an intake inter- colour. Irn Bru was chosen as it is one of the
view, when they were given a written descrip- market-leading carbonated beverages in
tion of the study. Only subjects who reported Scotland. Some people can discriminate
that they habitually consumed at least two between Irn Bru and Diet Irn Bru by taste and
sugar-sweetened drinks per day were smell when both are available for comparison.
accepted. The selected subjects indicated that Hence subjects received only one beverage
they did not generally consider consuming with the cover story described above, which
diet substitutes. They were informed that suggested that the drink was a “new” drink
they would be required to drink a minimum with unknown properties.Thus as far as possi-
of two test drinks per day and keep a food ble orosensory factors and expectancies about
diary. They were informed that the drinks the test drinks were controlled.
provided would be very similar in taste to the Those who were eligible for the experiment
Scottish soft drink Irn Bru but that it had were asked to return on a scheduled day,
been made up especially for the study. The which was either a Monday or a Tuesday, to
keep the weekend constant within the seven-
day test period. They were given their supply
Table I of soft drinks for the week and were informed
Characteristics of subjects in the two study groups to drink the agreed amount each day and
Sugar Aspartame record the time each bottle was consumed in
Women (n = 7) their food diary. They were advised to keep
one without weight unopened bottles in a refrigerator or a cool
Men (n = 7) Women (n = 6) Men (n = 7) data place. Following our previous method (Reid
and Hammersley, 1994; 1995) they were then
Age 19.4 22.0 19.7 19.7
issued a food diary, divided into one-hour
SD 1.3 2.6 2.0 1.9
time slots, to complete for the seven days of
Height (cm) 180.6 161.9 177.5 168.3
the experiment. They were requested to
SD 3.2 5.9 8.2 3.9
record all food and liquid intake, the exact
Weight (kg) 73.4 61.9 78.7 66.5
SD 13.0 14.2 17.0 10.0
BMI 22.5 23.4 25.0 23.5 Table II
SD 2.7 3.7 4.8 3.5 Nutrient composition of regular and diet Irn Bru
Energy intake drinks per 100ml
predicted from
basal metabolic Sugar Aspartame
rate (kcal) 1,799.8 1,401.9 1,880.7 1,471.2 Energy value (kcal) 43 4.1
SD 148.2 210.3 256.6 148.2 Protein Trace Trace
Mean energy CHO (g) 10.5 0.89
intake from Fat Trace Trace
diaries (kcal) 2,204.7 2,301.0 2,025.5 1,778.9 Iron (mg) 0.35 0.35
SD 605.4 856.0 818.7 586.4 Vitamin C 0 0

[ 255 ]
 Marie Reid and
Richard Hammersley
The effects of blind
substitution of
aspartame-sweetened for
sugar-sweetened soft drinks
on appetite and mood
British Food Journal
100/5 [1998] 254–259
Downloaded by University of Victoria At 08:33 03 February 2016 (PT)
[ 256 ]
amount consumed, and the time of day the
food was consumed. In order that subjects
could make a more accurate estimate of the
quantities eaten pictures of various common
foods with portion sizes marked A, B, C were
attached to the diary booklet. The experi-
menter spent about 20 minutes training each
subject on the accurate completion of the
diary. Subjects were informed that they
should contact the experimenter if they had
any questions or problems throughout the
seven-day period.
They were also asked to complete the Pro-
file of Mood States (POMS) (McNair et al.,
1971) daily at midday. The use of POMS to
assess long-term mood seemed appropriate
since it asks respondents to rate how they feel
“today” compared with normal. The bi-polar
form of the POMS was used, which provides
six dimensions of mood: agreeableness/
hostility, clearheadedness/confusion, compo-
sure/anxiety, confident/unsure, elation/
depression and energy/tiredness. Previous
research has found that the energetic/tired
dimension tends to vary after carbohydrate
ingestion.
In addition to this, they were given seven-
point scales to self-complete before and after
they had consumed each test drink. The ends
of the scales were marked energetic/tired,
calm/tense and hungry/full, measuring the
two mood dimensions proposed by Thayer
(1978) and satiation.
Subjects returned to the laboratory at the
end of the seven-day period when their weight
was measured again and their diaries and
rating forms were collected. Subjects’ diaries
at that point were reviewed by the experi-
menter, clarifying any ambiguities or missing
data. In order to ascertain whether unblind-
ing had occurred, subjects were asked at the
end of the experiment what they thought they
had to drink. None reported that they
believed that they had been consuming ordi-
nary Irn Bru or Diet Irn Bru. Several subjects
believed that “something had been put in the
drink” which affected their mood and behav-
iour. Two subjects reported mild indigestion
due to the carbonation of the drinks, one
subject reported an increase in his libido, but
no subject reported nausea or other symp-
toms. Once the study was complete, subjects
were debriefed in writing about the nature
and purpose of the experiment.
Results
All variables were analysed using MANOVA
with gender (male or female) and drink
(sugar or aspartame-sweetened) as indepen-
dent variables and day as a repeated measure.
Food intake
Compliance with the test drink regime was
good. Of 27 subjects, 24 complied to within
one bottle of what was requested. The remain-
ing three skipped and/or added two or more
bottles to the regime, usually by drinking less
one day and more the next. Women consumed
a mean of 2.4 bottles of test drink per day (SD
0.6) and men 2.9 (SD 0.5). Consumption levels
did not differ by drink type.
Both frequency and quantity measures
were calculated from food diaries assuming
standard portion sizes (Davies and Dicker-
son, 1991). For this purpose an “eating
episode” was defined as an hourly period
within which food to the value of at least
30kcal was consumed. This was to exclude
hours when only tea or coffee were
consumed, although other beverages within
the hour exceeding 30kcal could count as
“eating episodes”. “Meals” were arbitrarily
defined as hour periods during which at least
150kcal was consumed.
Intakes of sugar episodes were also
analysed. A “sugar episode” was defined as
any hour where at least 90 per cent of the
energy content of the food came from either
simple sugars, or sugar-fat mixtures, or car-
bohydrate-alcohol mixtures, to include the
consumption of mixed alcoholic drinks such
as rum and coke. Such foods included sweets
and chocolate, fruit, sugar-sweetened drinks,
tea and coffee with sugar and/or milk and
alcoholic drinks with carbohydrate content.
Both the psychological and physiological
mechanisms which have been proposed to
explain carbohydrate craving and mood
changes, including sweetness perception
(Blass, 1991; Hill et al., 1991) and changes in
serotonin levels (Wurtman et al., 1981), sug-
gest that increases in carbohydrate consump-
tion are likely to occur in this form, rather
than in the form of carbohydrates mixed in
with other nutrients, as in balanced meals.
For daily energy intake, there were no main
effects of drink or gender, but there was a
marginal effect of day (F(6, 18) = 2.5, p< 0.06).
Post hoc t-tests showed no effects of the test
drink on any day of the study. It can be seen in
Figure 1 that mean daily energy intake was
very stable across the study period. Given the
absence of a gender difference on daily
energy intake, total energy intake for the
seven-day period was compared by one-way
ANOVA with sugar-sweetened versus aspar-
tame drinks as the independent variable.
There was no effect of the manipulation (F(1,
23) = 1.77, NS).
For daily number of eating episodes, there
was a main effect of day (F(6, 138) = 5.32,
p < 0.05) and a drink by day interaction
(F(6, 138) = 2.44, p < 0.05). Post hoc t-tests
 Marie Reid and
Richard Hammersley
The effects of blind
substitution of
aspartame-sweetened for
sugar-sweetened soft drinks
on appetite and mood
British Food Journal
100/5 [1998] 254–259
Downloaded by University of Victoria At 08:33 03 February 2016 (PT)
Figure 1 Because the different measures in Table III
Mean daily energy intake across the seven are inter-related a stepwise logistic regres-
days. Bars are standard errors sion analysis was conducted to ascertain
which measures from day 1 best predicted
Daily energy intake (kcal)
drinks group. Number of meals, snacks,
2500
sugar episodes, grams of carbohydrate in
sugar episodes and total energy intake on day
2000 1 were entered. Only grams of carbohydrate
could significantly predict drinks group. It
correctly assigned 78 per cent of the sample to
1500
their correct group (Wald(1df) = 6.7, p < 0.05).
Figure 2 shows grams of carbohydrate in
1000 sugar episodes across the entire seven days.
The absence of any gender effects on intake
500
are of concern. As one would expect, males
had significantly higher predicted energy
expenditure from basal metabolic rates
0 (F(1, 22) = 27.0, p < 0.05). However, there was
0 1 2 3 4 5 6 7 8 large variance in calculated energy intake
Day
which was probably due to:
Key
Sugar
• genuine variations;
Aspartame • recording errors; and
• the difficulties of accurate calculations
from diary data.
found that on day 1 only those who received
sugar had significantly more snack episodes There was no significant change in subjects’
(30-149kcal: t = 2.2, p < 0.05) and marginally pre- and post-test body weight, confirming the
more meal episodes (150+kcal: t = 1.88, absence of an effect of the manipulation on
p = 0.072). Data from day 1 are shown in Table overall energy intake.
III.
Looking at sugar episodes, in MANOVA
Rated mood
From daily POMS ratings, only rated energy
there were significant effects of day
was affected: There was a significant drink
(F(6, 138) = 2.73, p < 0.05) and a day by drink
by day interaction (F(6,18) = 4.99, p < 0.05)
interaction (F(6, 138) = 2.51, p < 0.05). For the
and a significant drink by day by gender
grams of carbohydrate consumed during
interaction (F(6,18) = 3.46, p < 0.05). In post
sugar episodes, there were the same main
hoc t-tests, there were no significant effects of
effects of day (F(1, 138) = 2.62, p < 0.05) and the
drink on any specific day of the study.
same interaction between day and sugar
(F(1, 138) = 2.53, p < 0.05). Post hoc t-tests
found that on day 1 only, the sugar drinks Figure 2
group had more sugar episodes (t=3.64, Mean grams of carbohydrate consumed during
p<0.05) and consumed more grams of carbo- sugar episodes across the seven days. Bars are
hydrate during those episodes (t = 2.47, standard errors
p < 0.05). These data are also shown in Table
Grams CHO
III. 140
Sig. Diff. Day 1
120
Table III
Mean numbers of meal, snack and sugar 100
episodes on day 1 as a function of drink
80
received
Sugar Aspartame 60
Snacks of 30-149kcal 1.92 1.66 40
SD 0.79 0.89
Meals < 149kcal 5.38 4.36 20
SD 1.66 1.15 0
Number of sugar episodes 9.84 5.14 0 1 2 3 4 5 6 7 8
SD 4.0 2.7 Day
Grams of CHO in sugar Key
episodes 117.38 62.97 Sugar
SD 68.32 44.54 Aspartame
[ 257 ]
 Marie Reid and
Richard Hammersley
The effects of blind
substitution of
aspartame-sweetened for
sugar-sweetened soft drinks
on appetite and mood
British Food Journal
100/5 [1998] 254–259
Downloaded by University of Victoria At 08:33 03 February 2016 (PT)
[ 258 ]
Looking at men and women separately, men
felt more energetic after sugar on day 3 of the
study (t = 2.53, p < 0.05), but this may be type 1
error.
Discussion
Compared to the rest of the week, on day one
those who drank sugary soft drinks had more
sugar episodes, containing more carbohy-
drate, than did those who received aspar-
tame-sweetened drinks. It is not clear why
subjects who continued to receive sugar
drinks behaved differently from those who
had unknowingly switched to aspartame. One
possible explanation is that the physiological
effects of the ingested sugars somehow inter-
acted in the short term with subject expecta-
tions that they were receiving some new
drink. More important was that the effect was
absent by day two and that switching to
aspartame did not lead to increased sugar
consumption elsewhere in the diet.
Overall energy intake was unaffected by
the provision of aspartame-sweetened versus
sugar-sweetened drinks. More precisely, any
overall change in energy intake over seven
days was smaller than could be detected with
this modest sample size. As energy intake
was unaffected, it is not surprising that body-
weight was also unaffected. We have also
failed to find effects of sucrose, compared to
saccharin, on energy intake in two previous
studies over hours, rather than days (Reid
and Hammersley, 1994; 1995). It may be that
effects would differ over a longer period of
time, for example three weeks as found by
Tordoff and Alleva (1990). Or, perhaps a larger
quantity of soft drink would have more effect.
Tordoff and Alleva (1990) gave four drinks per
day to all subjects. Fewer were given here, as
the aim was to substitute for subjects’ normal
soft drink consumption, rather than add to it.
With hindsight baseline data on subjects’
diets prior to the intervention would have
been beneficial. However, this disadvantage is
offset to some extent by the use of a between-
subjects design where individual differences
are controlled by random, blind assignment
to conditions. With the study limitations in
mind, it appears that substituting aspartame
for sugar in a small number of soft drinks
does not substantially affect overall energy
intake or weight loss across a week. Effects
may differ with obese or diet restraining
subjects (Wurtman and Wurtman, 1984).
It is also important that switching to aspar-
tame did not affect mood. In fact, it is far from
clear that carbohydrates given blind have
substantial mood effects. With the exception
of Pivonka and Grunewald (1990), short-term
studies of the effects of carbohydrates on
mood have produced weak or equivocal
results (Burton and Owens, 1993; Reid and
Hammersley, 1994; 1995). Mood effects may be
more apparent when subjects know what they
are eating or drinking and can respond
according to expectations.
It would appear that as long as it is con-
ducted blind, switching from sugar soft
drinks to aspartame-sweetened soft drinks
does not have major effects on mood or eating
behaviour. This means that any barriers to
such change are largely due to people’s expec-
tations about the unacceptability of artificial
sweeteners, or the social significance of
“diet” or “light” soft drink brands. It also
appears that people can readily compensate
for the reduced sugar in their diet by eating
more, without simply increasing the number
of other sugar episodes. No evidence for crav-
ing was found in this study.
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Richard Hammersley
The effects of blind
substitution of
aspartame-sweetened for
sugar-sweetened soft drinks
on appetite and mood
British Food Journal
100/5 [1998] 254–259
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