Nonnutritive Sweeteners, Body Weight and Cardiometabolic Health - Inconclusive Results

A recent systematic review and meta-analysis of the health impact of nonnutritive sweeteners (e.g. aspartame, sucralose, stevioside) was recently published in the Canadian Medical Association Journal. The authors concluded that nonnutritive sweeteners may not help weight loss. While the observational studies suggested that regular intake may be associated with an increase in BMI, randomized trial evidence found no effect of these sweeteners on BMI. The observational studies found that nonnutritive sweetener use was associated with increased cardiometabolic risk (i.e. type 2 diabetes, stroke, high blood pressure and metabolic syndrome); however, these outcomes were not assessed in the randomized trials. Based on the differences regarding weight changes between the studies of the two design types, it is possible that people who routinely use nonnutritive sweeteners may be at higher risk of weight gain or have lifestyles that increase their risks of adverse metabolic outcomes and the sweeteners may not be the cause of these problems. An NHS Behind the Headlines article has pointed out important limitations of the existing research and concluded that more research is needed to confirm the positive and negative health impacts of nonnutritive sweeteners. For more information on sweeteners, see PEN Knowledge Pathway - Sweeteners.