A recent study found there may be little to no effects—good or bad—associated with non-sugar sweeteners (NSSs).
For the study, published in BMJ, researchers queried sources including Medline (Ovid), Embase, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and others. Eligible studies were those including healthy adults or children, with or without overweight or obesity, that compared no or lower intake of an identified NSS with increased intake of an identified NSS for at least one week. NSS doses had to be within the acceptable daily intake. Primary outcomes included body weight/body mass index (BMI), glycemic control, oral health, eating behavior, preference for sweet taste, cancer, cardiovascular disease, kidney disease, mood, behavior, neurocognition, and adverse effects.
Non-sugar sweeteners and health: The weight of evidence hints at benefits, but the full picture has yet to emerge, says this #BMJEditorial https://t.co/wuMfAdnqeV @HarvardChanSPH pic.twitter.com/TwCZa7hvKM
— The BMJ (@bmj_latest) January 5, 2019
I still do believe that taking no sugar at all is better than taking non-sugar sweeteners. However this paper does point out that harms of non-sugar sweeteners have yet to be established by longer term studies https://t.co/DyctmsOv0X
— Unnikrishnan AG (@Unnikri) January 3, 2019
Final analyses included 56 studies: 35 observational studies and 21 randomized controlled trials. Researchers observed, with very low and low certainty among a low number of small studies, that NSSs may have a beneficial effect on BMI (mean difference −0.6, 95% confidence interval −1.19 to −0.01; two studies, n = 174) and fasting blood glucose (−0.16 mmol/L, −0.26 to −0.06; two, n = 52) in adults. Also with very low certainty of evidence, lower NSS doses correlated with lower weight gain (−0.09 kg, −0.13 to −0.05; one, n = 17,934) compared to higher NSS doses. There were no significant differences in any other outcomes between the use and non-use, or different doses, of NSSs. With very low to moderate certainty, the researchers stated NSSs had no significant impact on overweight or obese adults or children actively trying to lose weight. When comparing NSS intake versus sugar intake in children, there was a slight increase in BMI z score (−0.15, −0.17 to −0.12; two, n = 528, moderate certainty of evidence); however, there were no meaningful differences in body weight (−0.60 kg, −1.33 to 0.14; two, n = 467, low certainty of evidence), or between different doses of NSSs (very low to moderate certainty).
Non-sugar sweeteners: lack of evidence that they help to control weight https://t.co/VhtSktuzjA
— Bingbing Li MD PhD (@BingbingXLi) January 8, 2019
Sugar substitutes have a similar effect on health as sugars https://t.co/s0rylA4ctm
— Sergio Uribe (@sergiouribe) January 5, 2019
“For most outcomes, there seemed to be no statistically or clinically relevant difference between NSS intake versus no intake, or between different doses of NSSs,” the researchers wrote. “No evidence was seen for health benefits from NSSs and potential harms could not be excluded.”