Energy balance
Substituting low- and no-calorie sweetened beverages (LNCSB) for sugar-sweetened beverages (SSB) is associated with lower body weight and reduced risk of coronary heart disease, type 2 diabetes, and mortality, with effects comparable to substituting water for SSB.
If you currently drink sugar-sweetened beverages, switching to low- or no-calorie sweetened beverages (like diet soda or unsweetened iced tea) can help you lose a small amount of weight over time and may lower your risk of heart disease and type 2 diabetes. This benefit is similar to switching to water, making LNCSBs a viable, safe option for reducing sugar intake.
Substitution of LNCSB for sugar-sweetened beverages (SSB) was associated with lower weight... and lower incidence of obesity (OB)... coronary heart disease... cardiovascular disease mortality, and total mortality... The available evidence provides some indication that LNCSB in their intended substitution for SSB may be associated with cardiometabolic benefit, comparable with the standard of care, water.
Why this rating
The paper explicitly states the evidence certainty is 'low to very low' due to imprecision, indirectness, and inconsistency, though substitution analyses show moderate certainty for weight.
Source
Relation of Change or Substitution of Low- and No-Calorie Sweetened Beverages With Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Prospective Cohort Studies
Jennifer J. Lee et al. · Diabetes Care · 2022
DOI 10.2337/dc21-2130
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