There is no compelling evidence to indicate important health benefits of non-sugar sweeteners, and potential harms cannot be ruled out, according to a review of more than 50 published studies in The BMJ.
Although several non-sugar sweeteners are approved for use, less is known about their potential benefits and harms within acceptable daily intakes because the evidence is often limited and conflicting.
To better understand these potential benefits and harms, a team of European researchers analysed 56 studies comparing no intake or lower intake of non-sugar sweeteners with higher intake in healthy adults and children. Measures included weight, blood sugar (glycaemic) control, oral health, cancer, cardiovascular disease, kidney disease, mood and behaviour. Studies were assessed for bias and certainty of evidence.
Overall, the results show that for most outcomes there seemed to be no statistically or clinically relevant differences between those exposed to non-sugar sweeteners and those not exposed, or between different doses of non-sugar sweeteners. For example, in adults, findings from a few small studies suggested small improvements in body mass index and fasting blood glucose levels with non-sugar sweeteners, but the certainty of this evidence was low.
Lower intakes of non-sugar sweeteners were associated with slightly less weight gain (-0.09 kg) than higher intakes, but again the certainty of this evidence was low.