What we know—and don’t—about non-nutritive sweeteners

Other lines of investigation, including animal studies, have shown that long-term use of NNSs is associated with numerous metabolic derangements including weight gain.²¹ The negative effects of NNSs appear to be the greatest in males and those who are obese and have high-calorie diets.²¹

A 2017 meta-analysis concluded that evidence from RCTs does not support a benefit of NNSs on weight management, and that routine consumption of NNSs may be associated with increased body mass index (BMI) and cardiometabolic risk.²² Another systematic review and meta-analysis found that there was a higher pooled risk for obesity among those who drank beverages containing NNSs vs those who drank sugar-containing beverages.²³

Based on the most current literature, we conclude that NNSs are not beneficial for weight loss. While there is concern about weight gain through psychological effects (stimulation of sweetness receptors without satiety), further well-designed research is needed to explore whether this concern has merit.

WHAT IS THE EFFECT OF NNSs ON APPETITE?

There appears to be no effect. While original studies seemed to indicate there was an effect, later studies leaned to the contrary.

Consumption of diet beverages or non- nutritive sweeteners increases with age and is especially common among women with higher levels of education and income.

The notion that NNSs might enhance appetite and food intake was advanced in the 1980s by John Blundell and his research team.²⁴ The hypothesis was that since NNSs uncouple sweet taste and calories, they do not exert the normal post-ingestive inhibitory influence that real sugar does. This, in turn, disrupts appetite control mechanisms.^25-27

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