April 17, 2018
TAKE-HOME MESSAGE
- The authors reviewed recent studies evaluating the effects of nonnutritive sweeteners (NNSs) on body weight and on chronic diseases related to obesity. There is a positive association seen between NNS and body weight and related health conditions in cross-sectional and prospective cohort studies. Cellular and rodent models indicate a possible harmful effect of NNSs on metabolic health. However, use of NNSs is associated with marginal benefits on body weight in randomized controlled trials with little data regarding related health conditions.
- In observational studies, use of NNSs is associated with increased body weight and a higher risk of metabolic disease. In contrast, randomized controlled trials show an association between NNSs and some weight loss. Further studies are needed to clarify the effects of NNSs on weight and metabolic health.
Abstract
OBJECTIVE
The objective of this review was to critically review findings from recent studies evaluating the effects of nonnutritive sweeteners (NNSs) on metabolism, weight, and obesity-related chronic diseases. Biologic mechanisms that may explain NNS effects will also be addressed.
METHODS
A comprehensive review of the relevant scientific literature was conducted.
RESULTS
Most cross-sectional and prospective cohort studies report positive associations between NNS consumption, body weight, and health conditions, including type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease. Although findings in cellular and rodent models suggest that NNSs have harmful effects on metabolic health, most randomized controlled trials in humans demonstrate marginal benefits of NNS use on body weight, with little data available on other metabolic outcomes.
CONCLUSIONS
NNS consumption is associated with higher body weight and metabolic disease in observational studies. In contrast, randomized controlled trials demonstrate that NNSs may support weight loss, particularly when used alongside behavioral weight loss support. Additional long-term, well-controlled intervention studies in humans are needed to determine the effects of NNSs on weight, adiposity, and chronic disease under free-living conditions.