Non-Sugar Sweeteners: Helpful Tool or Health Risk?

If you're trying to lose weight, you've probably wondered whether switching to sugar-free foods or diet drinks is a good idea.

With growing awareness around the health impacts of excess sugar intake, many people are looking for alternatives to help support their weight loss goals. This has led to increasing interest in non-sugar sweeteners (NSS), which contain little or no calories, making them an appealing alternative to sugar.

Non-sugar sweeteners have been used in the food industry since the 1950s. However, for just as long as they’ve existed, there has also been ongoing debate around their safety and long-term health effects. So, what does the latest evidence actually say?

What are Non-Sugar Sweeteners?

Non-sugar sweeteners (NSS) are low-calorie or calorie-free sweeteners used as alternatives to sugar. They are typically 200 to 20,000 times sweeter than sugar, so even minuscule amounts can provide the same sweet taste without the calories. They are commonly added to packaged foods and drinks and are also used in home kitchens by adding to coffee, tea, or baking.

There are two main types:

Artificial sweeteners

Artificial sweeteners are synthetically produced compounds designed to provide sweetness without the calories of sugar. Common examples include aspartame, sucralose, saccharin and acesulfame potassium.

Natural sweeteners

Natural sweeteners are derived from plant sources, although some may still undergo processing or modification. Common examples include stevia, monk fruit, erythritol and xylitol.

Are Non-Sugar Sweeteners Safe?

The World Health Organization (WHO) reviewed 283 studies on non-sugar sweeteners (NSS), including aspartame, sucralose, stevia, saccharin, and acesulfame potassium. The evidence was rated from very low to high confidence depending on the quality and consistency of the research.

Here’s what they found:

• Replacing sugar with NSS may reduce daily calorie intake and lead to small short-term reductions in body weight and BMI.
• Higher long-term NSS intake was associated with increased body weight and a greater risk of type 2 diabetes, cardiovascular disease, and overall mortality.
• Some evidence suggested a possible link between saccharin and bladder cancer, though confidence in the findings was very low.
• Higher NSS intake during pregnancy was associated with an increased risk of preterm birth.

What Do These Results Mean?

At first glance, these findings may seem conflicting.

In the short term, replacing sugar with non-sugar sweeteners may help reduce calorie intake and support modest weight loss, particularly when sugary drinks or foods are replaced with lower-calorie alternatives.

However, the longer-term evidence raises some concerns around potential health risks and weight gain over time.

It’s important to remember that much of the evidence in this area is considered low or very low confidence. This is common in nutrition research, especially when reviewing large numbers of studies with different designs, populations, and dietary patterns. This means the results should be interpreted carefully rather than seen as definitive proof of harm or no harm.

Can Non-Sugar Sweeteners Help You Lose Weight?

Yes, but probably only in the short term.

Replacing sugary foods and drinks with artificially sweetened alternatives can reduce calorie intake and may lead to modest short-term weight loss. However, current evidence suggests artificial sweeteners do not appear to support long-term weight loss, and higher intakes have been associated with poorer health outcomes in some observational studies.

All of the non-sugar sweeteners (NSS) included in the WHO review have met food safety standards and are approved for use in food and drinks. However, many of the findings showed a ‘dose-response’ relationship, meaning higher intakes of NSS were linked with a greater risk of negative health outcomes, including type 2 diabetes, cardiovascular disease, and overall mortality.

The research also found that while NSS may help reduce calorie intake in the short term, they did not appear to support long-term weight loss. In some cases, higher NSS intake was associated with increased body weight over time.

That said, NSS may still be helpful as a short-term strategy for some people. Swapping sugary foods or drinks for artificially sweetened alternatives can reduce overall calorie intake and make it easier to transition away from foods high in added sugar. The broader recommendation remains to limit foods and drinks high in added sugars that offer little nutritional value.

Research in this area is ongoing, but current WHO guidance advises against using NSS as a long-term weight management strategy. As with many dietary habits, a moderation approach is likely best.

References

1. Rios-Leyvraz, M., & Montez, J. (2022). Health effects of the use of non-sugar sweeteners: A systematic review and meta-analysis. World Health Organization.