Effects of stevia consumption on appetite in adults: A systematic review and dose-response meta-analysis of randomized controlled trials

Abstract

Stevia is an intense, calorie-free sweetener that is frequently used to reduce energy intake; however, studies examining its effects on appetite and energy intake have produced mixed results, indicating that a definitive consensus has not yet been reached. This systematic review and meta-analysis aimed to determine the impact of stevia on appetite and energy intake in adults. The PROSPERO registration number for this research is CRD42023414411. The databases PubMed (MEDLINE), Scopus, Web of Science, and Google Scholar were systematically searched. In addition, the reference lists of extracted articles and pertinent reviews were examined. Two evaluators performed screening, quality assessment, and data extraction independently. Furthermore, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was employed to systematically assess the certainty level of the evidence presented in our study. Eleven clinical trials with a total of 428 participants were included. We found no significant changes in any appetite scores following stevia consumption (very low to moderate certainty of the evidence). Moreover, subgroup analyses demonstrated the scores of desires to eat increased significantly in the oral intake of stevia and not enteral intake subgroup (WMD: 0.45; 95 CI: 0.009, 0.89; P = 0.046). In addition, the number of studies reporting energy intake was limited, preventing a meta-analysis of this variable. In conclusion, stevia consumption has no significant effect on appetite scores in adults but it seems that more long-term clinical trials are needed to obtain more accurate results.